Fear of nuclear war increases the risk of common mental disorders among young adults: a five-year follow-up study.
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BACKGROUND: Evidence on the relation between fear of war and mental health is insufficient. We carried out a prospective cohort study to find out whether fear of nuclear war is related to increased risk of common mental disorders. METHODS: Within two months preceding the outbreak of Persian Gulf War in January 1991, 1518 adolescents [mean age 16.8 years, SD 0.9] filled in a self-administered questionnaire. Of the 1493 respondents, 47% gave their written informed consent to participate in the follow-up study. There were no material differences between those who chose to respond anonymously and those who volunteered to give their name and address for the follow-up study. In 1995, the response to the follow-up questionnaire was 92%. Common mental disorders were assessed by 36-item version of the General Health Questionnaire [GHQ]. A score 5 or higher was considered to indicate caseness. We excluded 23 cases which had used mental health services in the year 1991 or earlier and two cases with deficient responses to GHQ. This left 626 subjects for analysis [400 women]. RESULTS: After adjusting for significant mental health risk factors in logistic regression analysis, the risk for common mental disorders was found to be significantly related to the increasing frequency of fear for nuclear war, high scores of trait anxiety and high scores of immature defense style. Elevated risk was confined to the group reporting fear of nuclear war once a week or more often [odds ratio 2.05; 95% confidence interval 1.29-3.27]. CONCLUSION: Frequent fear of nuclear war in adolescents seems to be an indicator for an increased risk for common mental disorders and deserves serious attention. (+info)
Symptoms and medical conditions in Australian veterans of the 1991 Gulf War: relation to immunisations and other Gulf War exposures.
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AIMS: To investigate whether Australian Gulf War veterans have a higher than expected prevalence of recent symptoms and medical conditions that were first diagnosed in the period following the 1991 Gulf War; and if so, whether these effects were associated with exposures and experiences that occurred in the Gulf War. METHODS: Cross-sectional study of 1456 Australian Gulf War veterans and a comparison group who were in operational units at the time of the Gulf War, but were not deployed to that conflict (n = 1588). A postal questionnaire was administered and the likelihood of the diagnosis of self-reported medical conditions was assessed and rated by a medical practitioner. RESULTS: Gulf War veterans had a higher prevalence of all self-reported health symptoms than the comparison group, and more of the Gulf War veterans had severe symptoms. Increased symptom reporting was associated with several exposures, including having more than 10 immunisations, pyridostigmine bromide tablets, anti-biological warfare tablets, pesticides, insect repellents, reportedly being in a chemical weapons area, and stressful military service experiences in a strong dose-response relation. Gulf War veterans reported psychological (particularly post-traumatic stress disorder), skin, eye, and sinus conditions first diagnosed in 1991 or later more commonly than the comparison group. Over 90% of medical conditions reported by both study groups were rated by a medical practitioner as having a high likelihood of diagnosis. CONCLUSION: More than 10 years after the 1991 Gulf War, Australian veterans self-report all symptoms and some medical conditions more commonly than the comparison group. Further analysis of the severity of symptoms and likelihood of the diagnosis of medical conditions suggested that these findings are not due to over-reporting or to participation bias. (+info)
The health of Australian veterans of the 1991 Gulf War: factor analysis of self-reported symptoms.
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BACKGROUND: A recent report showed that Australian veterans of the 1991 Gulf War displayed a greater prevalence of a multitude of self-reported symptoms than a randomly sampled comparison group of military personnel who were eligible for deployment but were not deployed to the Gulf. AIMS: To investigate whether the pattern, rather than frequency, of symptom reporting in these Australian Gulf War veterans differed from that of the comparison group personnel. METHODS: Factor analysis was used to determine whether the co-occurrence of 62 symptoms in 1322 male Gulf War veterans can be explained by a number of underlying dimensions, called factors. The methodology was also applied to 1459 male comparison group subjects and the factor solutions of the two groups were compared. RESULTS: For the Gulf War veterans, a three factor solution displayed replicability and construct validity. The three factors were labelled as psycho-physiological distress, somatic distress, and arthro-neuromuscular distress, and were broadly similar to those described in previous studies of Gulf War veterans. A concordant three factor solution was also found for the comparison group subjects, with strong convergence of the factor loadings and factor scores across the two groups being displayed. CONCLUSION: Results did not display evidence of a unique pattern of self-reported symptoms among Gulf War veterans. Results also indicated that the differences between the groups lie in the degrees of expression of the three underlying factors, consistent with the well documented evidence of increased self-reported symptom prevalence in Gulf War veterans. (+info)
Variations in health communication needs among combat veterans.
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In this cross-sectional study of US military combat veterans, we assessed the helpfulness of different media for providing health risk communication messages. We have provided preliminary results from a postal survey of 5000 veterans sampled because of their deployment to Vietnam, the Persian Gulf, or Bosnia-Kosovo. Respondents endorsed the primary care provider as the most helpful source of health information. Access to the Internet and use of this medium for seeking health information differed by race, age, and cohort. (+info)
Assessing the potential health impact of the 1991 Gulf War on Saudi Arabian National Guard soldiers.
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BACKGROUND: There has been considerable publicity that the 1991 Gulf War may have caused a wide array of health problems in military personnel. Although post-war health outcomes have been studied in US, British, Canadian, Danish, and other deployed troops, this issue has not been previously evaluated in coalition forces native to the Gulf region. METHODS: A collaborative team of US and Saudi health researchers was assembled, data sources evaluated, and hospitalizations among Saudi Arabian National Guard (SANG) soldiers between 1991 and 1999 analysed. Multivariate modelling was used to evaluate differences between 8342 soldiers exposed to combat at Al Khafji and a comparison group of 7270 soldiers in the Riyadh area. RESULTS: Among 15 612 SANG soldiers, we identified 148 with at least one hospitalization over the 9 years following the war. The adjusted rate of hospitalization was higher in the combat-exposed group (risk ratio (RR) = 1.80, 95% confidence interval (CI) 1.25-2.59). No unusual patterns of diagnoses were found and, because the overall number of hospitalizations was low, the absolute difference in risk was found to be very small. CONCLUSIONS: This is the first reported epidemiological investigation of post-war hospitalizations among coalition forces native to the Gulf region that participated in the 1991 Gulf War. A very small increase in hospitalizations was identified in SANG soldiers exposed to combat at Al Khafji. However, because of data limitations, the clinical relevance of this finding should be interpreted with caution. Future collaborative studies to better understand the health effects of deployment should be encouraged. (+info)
Neurological status of Australian veterans of the 1991 Gulf War and the effect of medical and chemical exposures.
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BACKGROUND: Since the 1991 Gulf War, concerns have been voiced about the effects on the health of veterans of Gulf War related medical and chemical exposures. METHODS: Our cross-sectional study compared 1424 male Australian Gulf War veterans and a randomly sampled military comparison group (n = 1548). A postal questionnaire asked about the presence of current neurological type symptoms, medically diagnosed neurological conditions, and medical and chemical exposures. A neurological examination was performed as part of a physical assessment. RESULTS: Veterans have a higher prevalence of neurological type symptoms (ratio of means 1.4, 95% confidence interval (CI) 1.2-1.5). Although the odds ratio (OR) of lower limb neurological type symptoms and signs in veterans compared with the comparison group was increased (OR = 1.6, 95% CI 1.0-2.7), it was of borderline significance, and there was no difference between groups according to a Neuropathy Score based on neurological signs alone (ratio of means 1.1, 95% CI 0.9-1.3). The increased OR of neurological type symptoms and signs suggestive of a central nervous system disorder (OR = 1.8, 95% CI 1.0-3.1) was also of borderline significance. Veterans were not more likely to have self-reported medically diagnosed neurological conditions, or to have neurological type symptoms and signs suggestive of an anterior horn cell disorder (OR = 0.9, 95% CI 0.5-1.6). The total number of neurological type symptoms reported by veterans, but not the Neuropathy Score, was associated with Gulf War related exposures including immunizations and pyridostigmine bromide in dose-response relationships, anti-biological warfare tablets, solvents, pesticides, and insect repellents. CONCLUSIONS: This study shows increased reporting of neurological type symptoms in Gulf War veterans, but no evidence for increased neurological effects based on objective physical signs. There may be a number of factors, including information bias, relating to increased neurological type symptom reporting in veterans. (+info)
Can epidemiology clear the fog of war? Lessons from the 1990-91 Gulf War.
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Despite over US $200 million having been spent researching illnesses following the 1990-91 Persian Gulf War, the nature and cause of such illnesses remains controversial. In this narrative review, we discuss some of the methodological issues that have affected epidemiological studies on this topic. These include low-response rates, ascertainment bias, recall bias, problems identifying suitable control groups, and problems defining the outcomes to study. From this we argue that difficulties have arisen partly owing to the significant delay between the point at which illnesses were first identified by veterans and the reporting of epidemiological studies and that health surveillance should be routine following future deployments. (+info)
Going to war does not have to hurt: preliminary findings from the British deployment to Iraq.
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We carried out a brief longitudinal mental health screen of 254 members of the UK's Air Assault Brigade before and after deployment to Iraq last year. Analysis of General Health Questionnaire (GHQ-28) scores before and after deployment revealed a lower score after deployment (mean difference=0.93, 95% CI 0.35-1.52). This indicated a highly significant relative improvement in mental health (P < 0.005). Moreover, only 9 of a larger sample of 421 (2%) exceeded cut-off criteria on the Trauma Screening Questionnaire. These findings suggest that war is not necessarily bad for psychological health. (+info)