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Temporal relationships between Gulf War deployment and subsequent psychological disorders in Royal Australian Navy Gulf War veterans

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Abstract

Background

Although much has been published on the effects of the 1990/1991 Gulf War on the psychological health of veterans, few studies have addressed the pattern and timing of post-war development of psychological disorders. Our study aims to identify the most common psychological disorders that first appeared post-Gulf War, the period of peak prevalence and the sequence of multiple psychological disorders.

Methods

The temporal progression of psychological disorders in male Australian naval Gulf War veterans with no prior psychological disorders was calculated across each year of the post-Gulf War period. DSM-IV diagnoses were obtained using the Composite International Diagnostic Interview.

Results

Psychological disorder rates peaked in the first 2 years (1991–1992) following the Gulf War. Alcohol use disorders were the most likely to appear first. Classification and regression tree analysis found that risk of disorder was exacerbated if veterans had been exposed to a high number of potential psychological stressors during their military service. Lower military rank was associated with increased risk of alcohol disorders, particularly during the first 2 years post-Gulf War. In veterans with two or more disorders, anxiety disorders and alcohol disorders tended to appear before affective disorders.

Conclusions

Our study found that psychological disorders occur in sequence following Gulf War deployment. Our findings may help clinicians to anticipate, and better manage, multiple symptomatology. The findings may also assist veteran and defence organisations in planning effective mental health screening, management and prevention policy.

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Acknowledgments

This study was funded by the Australian Government, Department of Veterans’ Affairs. The first author was funded by a doctoral scholarship from the National Medical Health and Research Council. The Australian Centre for Posttraumatic Mental Health, of which Professor Creamer is Director, is partially funded by the Department of Veterans’ Affairs. Professor McFarlane is Chair of the Mental Health Consultative Group to the Director General of the Health Service Branch of the Australian Defence Force. The above organisations had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report, or in the decision to submit the paper for publication. The study was overseen by a Scientific Advisory Committee and by a veterans’ Consultative Forum. We are grateful to members of both groups for their contribution and support. We gratefully acknowledge the contribution of the contact and recruitment team at the Department of Veterans’ Affairs, and the staff at Health Services Australia who conducted the medical and psychological assessments. Lastly, but most importantly, we wholeheartedly thank all the participants in the study.

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Authors and Affiliations

  1. Monash University, Department of Epidemiology and Preventive Medicine, Alfred Hospital, Commercial Road, Melbourne, VIC, 3004, Australia

    Dean P. McKenzie, Helen L. Kelsall, Andrew B. Forbes, Jillian F. Ikin & Malcolm R. Sim

  2. Australian Centre for Posttraumatic Mental Health, University of Melbourne, East Melbourne, Australia

    Mark Creamer

  3. Department of Psychiatry, University of Adelaide, Adelaide, SA, Australia

    Alexander C. McFarlane

Authors
  1. Dean P. McKenzie
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  2. Mark Creamer
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  3. Helen L. Kelsall
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  4. Andrew B. Forbes
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  5. Jillian F. Ikin
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  6. Malcolm R. Sim
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  7. Alexander C. McFarlane
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Correspondence to Dean P. McKenzie.

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McKenzie, D.P., Creamer, M., Kelsall, H.L. et al. Temporal relationships between Gulf War deployment and subsequent psychological disorders in Royal Australian Navy Gulf War veterans. Soc Psychiat Epidemiol 45, 843–852 (2010). https://doi.org/10.1007/s00127-009-0134-1

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  • DOI: https://doi.org/10.1007/s00127-009-0134-1

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