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PubMed2000

Factor analysis of self-reported symptoms: does it identify a Gulf War syndrome?

Active duty US Naval mobile construction battalion personnel (Seabees) were surveyed in 1994 for the presence of a variety of symptoms. Questions were drawn from the Hopkins Symptom Checklist and from a collection of symptoms either defining clinical depression or commonly reported by Persian Gulf War veterans. Of those surveyed, 524 were Gulf War veterans and 935 were nondeployed Gulf War-era veterans. Factor analysis applied to Gulf War veterans yielded five factors, three deriving from the Hopkins Symptom Checklist, one suggesting clinical depression, and one containing symptoms commonly reported by Gulf War veterans. Factor analysis applied to nondeployed veterans yielded five similar factors. Three of the factors yielded statistically significantly greater standardized factor scores for Gulf War veterans than for nondeployed veterans. Four of the factors resembled factors resulting from a previous analysis on a sample of similar Gulf War veterans. Gulf War veterans and nondeployed era veterans reported similar clusters of symptoms and illnesses. However, Gulf War veterans reported these same clusters with greater frequencies than did nondeployed veterans. The authors conclude that, in contrast to a previous report, factor analysis did not identify a unique Gulf War syndrome.

Adult↗
PubMed2002

Zagreb University School of Medicine: students grades during war.

AIM: To investigate whether examination grades of the students at the Zagreb University School of Medicine changed during the 1991-1995 war in Croatia. METHODS: The retrospective descriptive study included examination grades from 5 major courses in the first 5 years of the medical studies: Anatomy (first year), Physiology (second year), Pathology (third year), Internal Medicine (fourth year), and Surgery (fifth year). We compared the war-period (1991-1995) with two control periods: before (1989-1990) and after the war (1996-2000). The passing grades at the Zagreb University range from 2 to 5, with 2 as the lowest and 5 as the highest grade. There were a total of 17,682 examinations from the 5 courses in the studied periods. RESULTS: Grades were higher in the pre-war and post-war periods than in the war period (p<0.001 for both comparisons). Grades in the individual courses followed the general trend, except for the surgery course, where grades during the war were better than in the control periods, and the physiology course, where continual worsening, irrespective of the war, was observed. CONCLUSION: Medical students obtained significantly lower grades in 5 major courses during the war than before or after it. Thus, it is reasonable to assume that different factors, some related and some unrelated to war, could have adversely influenced students performance.

Croatia↗
PubMed1995

[Occurrence and etiology of tooth caries in wearers of fixed dentures during the war].

Concerning the destruction, war and caries are complemental. They don't have the same final causes, but on the microplan, both of them have destruction as a consequence. War causes complete destruction of organism, and the crude killing of human being. The people who do not get killed are faced to all negative etiological factors which disturb general health of organism. We have been following the parameter for the need of intervention in the field of dental protetic, frequent erosive changes of dental tissues sediments of caries and etiological factors which facilitate commencement and development lesions of caries on the tooth-carier of fixed protectical work. During this work we have been analyzing the patients who have been treated at The Clinic for Dental Health during the war in Bosnia and Herzegovina. Etiological factors, that caused commencement and development lesions of caries on the tooth-carier of fixed protetical work, are identical to those that are described in accessible literature, but also there have been some specific features which have been seen during the war conditions, as follows: *inadequate nutriment-patients were usually eating adhesive food, noodis, *impossibility of maintaining and providing the extents of oral hygiene, difficult or impossible access to a hygiene knot, *the lack of equipment for maintaining the oral hygiene, toothpaste, toothbrush, water, *Fight for the bare life, war is time for survival and it cites patient to seiftuiage in care for their own health, patient fights for existence and treats the acute states. In this relation brushing the teeth comes to the last place, *war conditions unable patients in approaching to therapeuts, and they can not use stomatological equipment due to the lack of electric power and water. *time as a factor--war circumstances delayed the intervention in the mouth of patient at the right time. Percent of sediments of caries inclinical study on the tooth-carier fixed protetical work is at the high level of 65%. This percentage could be justified by a fact that all patients came with already developed lesions of caries. War is enemy of human health in every segment, so increasing number of lesions of caries is one of the logical consequences. War in BiH has presented that stomatological science and practice during war are just curative. Esthetic stomatology and right-time interventions, preventions don't exist. There is only necessary stomatology.

Bosnia and Herzegovina↗
PubMed2004

Psychological health of Australian veterans of the 1991 Gulf War: an assessment using the SF-12, GHQ-12 and PCL-S.

BACKGROUND: Elevated rates of psychological morbidity and symptomatology have been widely reported in 1991 Gulf War veterans. The present study used brief self-report instruments to compare the psychological health of Australian Gulf War veterans with that of a randomly sampled military comparison group. METHOD: The 12-item Short Form Health Survey (SF-12), 12-item General Health Questionnaire (GHQ-12), Posttraumatic Stress Disorder Checklist--Specific (PCL-S) and Military Service Experience (MSE) questionnaire were administered to 1424 male Australian Gulf War veterans and 1548 male Australian Defence Force members who were operational at the time of the Gulf War conflict, but were not deployed there. RESULTS: The Gulf War veterans exhibited poorer psychological health, as measured by the above three instruments, than the comparison group members. For Gulf War veterans, the number of stressful experiences, as measured by the MSE questionnaire, was correlated with scores on the three instruments. SF-12 mental health component summary scores and PCL-S caseness, but not GHQ-12 caseness, differed significantly between Gulf War veterans and comparison group members who had been on at least one active deployment. CONCLUSIONS: More than a decade after the 1991 Gulf War, Australian Gulf War veterans are exhibiting higher levels of current (past month) psychological ill-health, as measured using the GHQ-12 and PCL-S, as well as lower mental health status, as measured by the SF-12, than the comparison group. Although not a replacement for formal psychiatric diagnosis, instruments such as those above may aid in the assessment of veterans' psychological health.

Adult↗
PubMed2005

Vasopressinergic hypothalamic neurons are recruited during the audiogenic seizure of WARs.

The Wistar Audiogenic Rat (WAR) is a genetic model of reflex epilepsy with seizures induced by high-intensity sound stimulation (120 dB SPL). In spite of the known neural substrates involved in WAR seizure phenotype, neuroendocrine hypothalamic neurons were never investigated. In this work, AVP immunohistochemistry in the hypothalamus and radioimmunoassay (RIA) in plasma and in hypothalamic and hypophysial tissues were performed on both controls and WARs in order to evaluate the dynamics of AVP release due to seizure induction. Susceptible animals (WARs) displayed at least tonic-clonic convulsions followed by clonic spasms, while resistant Wistar rats (R) had no convulsive behavior. Animals were sacrificed at 3 instances: basal condition (without stimulus) and at 3 and 10 min after sound stimulation. For the immunohistochemistry AVP study, brains were harvested and processed by the avidin-biotin-peroxidase detection method. Optic densitometry was used for quantifying AVP labeling in supraoptic (SON) and paraventricular (PVN) hypothalamic nuclei. SON presented higher densitometry levels (%D--relative to background) for both WARs and R when compared to PVN. Nevertheless, both nuclei presented a marked decrease, referenced to basal levels, in %D for WARs at 3 min (approximately 35%) against a discrete change for R (approximately 90%). RIA results were significantly higher in the hypophysis of WARs when compared to R rats, at 3 min. Also, at 3 min, plasma AVP in WARs (89.32 +/- 24.81 pg/mL) were higher than in R (12.01 +/- 2.39 pg/mL). We conclude, based on the AVP releasing profiles, that vasopressinergic hypothalamic neurons are recruited during the audiogenic seizure of WARs.

Acoustic Stimulation↗
PubMed2004

Neuroethological study of status epilepticus induced by systemic pilocarpine in Wistar audiogenic rats (WAR strain).

The administration of pilocarpine (PILO) is widely recognized as resulting in an experimental model of temporal lobe epilepsy; it is characterized by induction of status epilepticus (SE) and spontaneous recurrent seizures after a latent period. We provide in this work a neuroethological description of the SE induced by PILO. Behavioral evaluations were made in Wistar Audiogenic Rats (WARs) and Wistar resistant (R) animals. The experimental group (R) and WARs were pretreated with methyl scopolamine (1mg/kg ip) and injected with PILO (R animals, 340-380 mg/kg ip; WARs, 240-280 mg/kg ip). Among R animals, 36% developed SE, and among WARs, 53%. The control group (R animals and WARs) was injected only with methyl scopolamine plus saline. The ETHOMATIC method was used for evaluation of seizures. Sequences included in the analysis were chosen using (1) fixed observation windows and (2) behavioral triggers. The R group showed that the threshold for seizure is variable, so seizure onset and behavioral evolution were better described using behavioral triggers than fixed observation windows. The observation windows selected in similar duration intervals do not characterize the seizures. Sequential analysis in the WAR group showed high mortality after SE and greater susceptibility to PILO, compared with R animals. We conclude that with neuroethological tools it is possible to better map the sequence and evolution of SE induced by PILO compared to only using behavioral and arbitrary seizure severity scales. This sequence is faster and stronger in severity when WARs are compared with R animals. Although the WARs underwent an evolution of SE in some way equivalent to that of R animals, some rats presented tonic-clonic convulsions after PILO injection, very similar to acute audiogenic seizures, a brainstem-dependent model. The current data also point to the PILO-plus-WAR combination as a suitable protocol to study the genetic-epilepsy connection in experimental temporal lobe epilepsy.

Acoustic Stimulation↗
PubMed1992

The Gulf War and its impact on burnout and well-being of working civilians.

Burnout signifies the chronic depletion of coping resources following prolonged exposure to emotionally charged demands. It is manifested by symptoms of emotional, physical and cognitive exhaustion, and is usually studied in relation to occupational stressors. We hypothesized that the major life crisis engendered by missile attacks would give rise to burnout or exacerbate preexisting burnout symptoms. We also hypothesized that individuals suffering from prewar burnout would appraise the war as being more threatening and would be more vulnerable to upper respiratory infections (URI). Wartime and pre-war (baseline) levels of burnout and related symptomatology (cognitive weariness, listlessness, tension and somatic complaints) were compared among 162 Israeli civilians who carried on with their employment duties throughout the Gulf War. We found that the war impacted primarily on younger individuals (age < 45). All the pre-war levels of the above measures increased significantly (except for a marginal increase in tension). The impact of the war was mediated by threat appraisal, as indicated by worry and apprehension. Worry was positively associated with pre-war burnout, and negatively with age and education. Pre-war burnout was associated positively with wartime URIs. It was concluded that the war accelerated the depletion of coping resources and that burnout may be affected by factors other than occupational stress.

Adaptation, Psychological↗
PubMed2001

Explanation for low prevalence of PTSD among older Finnish war veterans: social solidarity and continued significance given to wartime sufferings.

A relatively low rate of Post-Traumatic Stress Disorder (PTSD) (<10%), has been reported among Finnish veterans of World War II. Possible explanations for this are explored by means of depth interviews with 30 veterans (mean age of 77 years), staying at a Disabled Veterans Hospital and at a Rehabilitation Centre, drawing on an Attachment Theory perspective. The Impact of Event Scale, the General Health Questionnaire, as well as health survey, medical problems, and war experience questions, were administered as part of the interview. A low rate of PTSD symptomatology was also reported in this sample alongside a relatively high level of subjective well-being. Without exception, they spoke freely about the war, often with emotion. Themes that received emphasis in their accounts included the Finnish fighting spirit and the strong reciprocal bonds of loyalty that were felt during the war. The war now featured prominently as part of their integrity as old men, representing a honourable task that they had been called on to fulfil. The significance they attributed to the war had not waned with time. Although this study of older war veterans, in common with other such studies, does not consider the less resilient who have not survived to old age, it does suggest that the strong community spirit built up in the war and continued in Finnish veterans' association after the war together with the continuing esteem of Finnish society, has contributed to the high levels of well-being expressed by the survivors.

Adaptation, Psychological↗
PubMed2004

Miscarriage, stillbirth and congenital malformation in the offspring of UK veterans of the first Gulf war.

OBJECTIVES: To assess whether the offspring of UK veterans of the first Gulf war are at increased risk of fetal death or congenital malformation. METHOD: This was a retrospective reproductive cohort study of UK Gulf war veterans and a demographically similar comparison group who were in service at the time but were not deployed to the Gulf. Reproductive history was collected by means of a validated postal questionnaire between 1998 and 2001. RESULTS: In all, 27 959 pregnancies reported by men and 861 pregnancies reported by women were conceived after the first Gulf war and before November 1997. The risk of reported miscarriage was higher among pregnancies fathered by Gulf war veterans than by non-Gulf war veterans (OR = 1.4, 95% CI: 1.3, 1.5). Stillbirth risk was similar in both groups. Male Gulf war veterans reported a higher proportion of offspring with any type of malformation than the comparison cohort (OR = 1.5, 95% CI: 1.3, 1.7). Examination by type of malformation revealed some evidence for increased risk of malformations of the genital system, urinary system (renal and urinary tract), and 'other' defects of the digestive system, musculo-skeletal system, and non-chromosomal (non-syndrome) anomalies. These associations were weakened when analyses were restricted to clinically confirmed conditions. There was little or no evidence of increased risk for other structural malformations, specific syndromes, and chromosomal anomalies. Among female veterans, no effect of Gulf war service was found on the risk of miscarriage. The numbers of stillbirths and malformations reported by women were too small to allow meaningful analyses. CONCLUSION: We found no evidence for a link between paternal deployment to the Gulf war and increased risk of stillbirth, chromosomal malformations, or congenital syndromes. Associations were found between fathers' service in the Gulf war and increased risk of miscarriage and less well-defined malformations, but these findings need to be interpreted with caution as such outcomes are susceptible to recall bias. The finding of a possible relationship with renal anomalies requires further investigation. There was no evidence of an association between risk of miscarriage and mothers' service in the gulf.

Abortion, Spontaneous↗
PubMed1998

Stiff upper lip: coping strategies of World War II veterans with phantom limb pain.

OBJECTIVE: Study of coping with phantom pain in nonclinical war veteran amputees. DESIGN: Semistructured interview with amputees in their home setting. SETTING: Residential home for war veteran amputees or respondents' own homes. PATIENTS: Amputee veterans of World War II with phantom pain. OUTCOME MEASURES: Pain (McGill Pain Questionnaire) and pain history, coping (daily coping; Stone and Neale, J Pers Soc Psychol 1984;46:892-906), size of social network, and quality of war memories. RESULTS: No differences in pain or coping were associated with place of residence (and prevalence of cues) or social networks; war memories appeared not to be associated with availability of cues, whether media coverage or other amputees. There was some association between the emotional tone of war memories and pain intensity. Veteran amputees were in general accepting of high levels of pain and made little use of medical resources, relating that to past experience of their pain being dismissed. CONCLUSION: Coping with phantom pain in war veteran amputees is predominantly silent acceptance of the pain, with little use of social support however available, and rare recourse to medical help, based on past unhelpful experience. Pain and mood appeared to be unrelated to specific war cues, but higher pain scores were reported by those with unhappier war memories.

Adaptation, Psychological↗
PubMed2002

Children's trauma and adjustment reactions to violent and nonviolent war experiences.

OBJECTIVE: According to most studies, more than half of children exposed to war meet criteria for posttraumatic stress disorder (PTSD). Although we know that children are adversely affected by atrocities of war, we do not know which specific war events are associated with children's stress reactions. For example, it is unclear whether differences exist in response to violent versus nonviolent war-trauma experiences. This study examined the relationship of violent and nonviolent war experiences to children's trauma reactions and adjustment in a group of children from Bosnia. METHOD: During the 1994 siege in Sarajevo, 791 children aged 6 to 16 years participated in a study of trauma experience and response, in which assessment questionnaires (Impact of Event Scale, PTSD Reaction Index, Children's Depression Inventory, Child Behavior Checklist, and War Experience Questionnaire) were completed by children and their teachers. RESULTS: In this sample 41% had clinically significant PTSD symptoms. Children were adversely affected by exposure to both violent and nonviolent war-traumas. An additive effect of trauma exposure on trauma reactions was also found. However, many war experiences were not associated with children's adjustment and trauma reactions. CONCLUSIONS: Additive effects of violence and deprivations during war may overwhelm the coping skills of children and leave them vulnerable to externalizing and internalizing adjustment difficulties and symptoms of PTSD.

Adaptation, Psychological↗
PubMedDate not supplied

Posttraumatic stress symptomatology is associated with unexplained illness attributed to Persian Gulf War military service.

OBJECTIVE: Controversy exists concerning unexplained illness in Persian Gulf War veterans, especially regarding the contribution of psychological trauma. We sought to determine if war zone trauma or posttraumatic stress symptomatology (PTSS) are associated with illnesses reported by Gulf War veterans that were documented by medical examination but not attributable to a medical diagnosis. METHODS: A total of 1119 (55% response rate) of 2022 randomly sampled veterans of the United States Persian Gulf War were screened and 237 cases and 113 controls were identified by medical examination for a case-control study comparing Persian Gulf War military veterans with or without medically documented, but unexplained, symptoms. Multivariate logistic regression and cross-validation analyses examined self-report measures of demographics, subjective physical symptoms and functioning, psychiatric symptoms, stressors, war zone trauma, and PTSS, to identify correlates of case-control status. RESULTS: Posttraumatic stress symptomatology and somatic complaints were independently associated with case status, as were (although less consistently) war zone trauma and depression. Age, education, and self-reported health, stress-related somatization, pain, energy/fatigue, illness-related functional impairment, recent stressors, and anxiety were univariate (but not multivariate) correlates of case status. CONCLUSIONS: PTSS related to war zone trauma warrants additional prospective research study and attention in clinical screening and assessment as a potential contributor to the often debilitating physical health problems experienced by Persian Gulf War veterans.

Adult↗
PubMed2004

Gulf War veterans with anxiety: prevalence, comorbidity, and risk factors.

BACKGROUND: Veterans of the first Gulf War have higher rates of medical and psychiatric symptoms than nondeployed military personnel. METHODS: To assess the prevalence of and risk factors for current anxiety disorders in Gulf War veterans, we administered a structured telephone interview to a population-based sample of 4886 military personnel from Iowa at enlistment. Participants were randomly drawn from Gulf War regular military, Gulf War National Guard/ Reserve, non-Gulf War regular military, and non-Gulf War National Guard/Reserve. Medical and psychiatric conditions were assessed through standardized interviews and questionnaires in 3695 subjects (76% participation). Risk factors were assessed using multivariate logistic regression models. RESULTS: Veterans of the first Gulf War reported a markedly higher prevalence of current anxiety disorders than nondeployed military personnel (5.9% vs. 2.8%; odds ratio = 2.1; 95% confidence interval = 1.3-3.1), and their anxiety disorders are associated with co-occurring psychiatric disorders. Posttraumatic stress disorder, panic disorder, and generalized anxiety disorder were each present at rates nearly twice expected. In our multivariate model, predeployment psychiatric treatment and predeployment diagnoses (posttraumatic stress disorder, depression, or anxiety) were independently associated with current anxiety disorder. Participation in Gulf War combat was independently associated with current posttraumatic stress disorder, panic disorder, and generalized anxiety disorder. CONCLUSIONS: Current anxiety disorders are relatively frequent in a military population and are more common among Gulf War veterans than nondeployed military personnel. Predeployment psychiatric difficulties are robustly associated with the development of anxiety. Healthcare providers and policymakers need to consider panic disorder and generalized anxiety disorder, in addition to posttraumatic stress disorder, to ensure their proper assessment, treatment, and prevention in veteran populations.

Adult↗
PubMedDate not supplied

Impact of war on American adolescents.

PROBLEM: The impact of the Persian Gulf war on adolescents in Columbia, Charleston, and Sumter, SC. METHODS: Four semiannual surveys measured adolescents' exposure to and evaluations of the Persian Gulf war, and the relationship between this exposure and mental distress. FINDINGS: Of the sample, 814 (65.9%) reported being distressed by the war and 849 (69%) reported feeling better after the war ended. More than half the sample had a friend or relative sent to the war (n = 725, 58.8%), and of these, 458 were African American. Nine percent (n = 111) of the sample had a mother, father, or both a mother and a father in the war. CONCLUSIONS: There was a positive correlation between adolescents' ratings on the Negative Impact of War Scores and Mental Distress Scores despite the easy victory and public support for the war in the United States. Females and African Americans viewed the war more negatively than did Caucasian males.

Adaptation, Psychological↗
PubMed1994

Impact of the Gulf War on the anxiety, cortisol, and growth hormone levels of Israeli civilians.

OBJECTIVE: The authors investigated the impact of continuous and repeated stress on Israeli civilians exposed to missile attacks during the Gulf War. METHOD: Study 1 included 26 healthy volunteers aged 28-59 years. Their scores on the Hamilton Anxiety Rating Scale and levels of plasma cortisol and growth hormone (GH) were evaluated before, during, and after the war. Study 2 included 13 healthy volunteers aged 25-59 years. Their scores on the state portion of the State-Trait Anxiety Inventory and levels of cortisol and GH were measured three times daily (8:00 a.m., noon, and 6:00 p.m.) at two time points (during and after the war). RESULTS: Anxiety levels of civilians exposed to the threat of war and later to actual missile attacks were significantly higher before and during the war than afterward. Anxiety during the war reached a peak in the evening. The increase in anxiety was not accompanied by any change from basal morning cortisol and GH levels or by diurnal variations in these hormones. CONCLUSIONS: Anxiety levels during the war were similar to those 1 day before its onset, which can be explained by the nature of coping processes. During the war, anxiety levels were highest in the evening, reflecting the war routine (missile attacks occurred mostly at night). The unaltered hormone levels and their normal diurnal variations despite the subjects' persistent anxiety were probably due to adaptation of the hypothalamic-pituitary-adrenal and hypothalamic-somatotropin axes to continuous stress.

Adult↗
PubMed2002

A hazardous profession: war, journalists, and psychopathology.

OBJECTIVE: War journalists often confront situations of extreme danger in their work. Despite this, information on their psychological well-being is lacking. METHOD: The authors used self-report questionnaires to assess 140 war journalists, who recorded symptoms of posttraumatic stress disorder (PTSD) (with the Impact of Event Scale-Revised), depression (with the Beck Depression Inventory-II), and psychological distress (with the 28-item General Health Questionnaire). To control for stresses generic to all journalism, the authors used the same instruments to assess 107 journalists who had never covered war. A second phase of the study involved interviews with one in five journalists from both groups, using the Structured Clinical Interview for Axis I DSM-IV Disorders. RESULTS: The rates of response to the self-report questionnaires were approximately 80% for both groups. There were no demographic differences between groups. Both male and female war journalists had significantly higher weekly alcohol consumption. The war journalists had higher scores on the Impact of Event Scale and the Beck Depression Inventory. Their lifetime prevalence of PTSD was 28.6%, and the rates were 21.4% for major depression and 14.3% for substance abuse. War journalists were not, however, more likely to receive treatment for these disorders. CONCLUSIONS: War journalists have significantly more psychiatric difficulties than journalists who do not report on war. In particular, the lifetime prevalence of PTSD is similar to rates reported for combat veterans, while the rate of major depression exceeds that of the general population. These results, which need replicating, should alert news organizations that significant psychological distress may occur in many war journalists and often goes untreated.

Adult↗
PubMed2003

The study of reproductive outcome and the health of offspring of UK veterans of the Gulf war: methods and description of the study population.

BACKGROUND: The aim of this study is to determine whether Gulf war veterans and their partners are at increased risk of adverse reproductive events and whether their children have increased risk of serious health problems. Methods and response to the study are reported here. METHODS: This was a retrospective cohort study of reproduction among UK Gulf war veterans, with a comparison cohort of Armed Service personnel who were not deployed to the Gulf. Reproductive history and details of children's health was collected by means of a validated postal questionnaire. A separate study of non-responders was conducted. RESULTS: Questionnaires were returned by a total of 25,084 Gulf war veterans (24,379 men) and 19,003 (18,439 men) subjects in the comparison group. After adjusting for undelivered mail the response rate was 53% for Gulf war veterans and 42% for non-Gulf veterans among men, 72% and 60% among women. Data from the non-responder study suggests that failure to respond to the main survey was largely unrelated to reproduction. 11,155 (46%) male Gulf war veterans and 7,769 (42%) male non-Gulf war veterans had conceived, or attempted to conceive, since the Gulf war. They reported 16442 and 11517 pregnancies respectively in that period. For women, 313 (44%) Gulf veterans and 235 (42%) non-Gulf veterans reported 484 and 377 pregnancies respectively conceived since the Gulf war. CONCLUSIONS: This survey enabled collection of information on a range of reproductive outcomes from veterans of the Gulf war and a suitably matched comparison cohort. Although the response rate for men was disappointing, selection bias related to reproduction does not appear to be strong in these data.

Abortion, Spontaneous↗
PubMed2006

The ACTH response to dexamethasone in Persian Gulf War veterans.

The basis of postdeployment health symptoms in Gulf War veterans remains poorly understood. Alterations in the feedback regulation of the hypothalamic-pituitary-adrenal (HPA) axis have been demonstrated in posttraumatic stress disorder (PTSD) and other bodily disorders related to stress. The objective of this article was to examine whether similar HPA axis alterations are related to Gulf War deployment, postdeployment health symptoms, or PTSD. Plasma adrenocorticotropic hormone (ACTH) was measured on consecutive mornings at 08:00 h before and after a low dose of oral dexamethasone (DEX) at 23:00 h in Gulf War veterans with PTSD (n = 14), Gulf War veterans without PTSD (n = 11), and healthy veterans never deployed to a war zone (n = 12). Both Gulf War veterans with PTSD and Gulf War veterans without PTSD had significantly lower post-DEX ACTH levels than the nonexposed veterans, in the absence of group differences in basal ACTH or DEX levels. Among Gulf War veterans, post-DEX ACTH levels were significantly associated with musculoskeletal symptoms. Gulf War deployment and postdeployment health symptoms appear to be associated with alterations in feedback regulation of the pituitary gland that suggests a possible common link between postdeployment health symptoms and other chronic stress-related conditions.

Adrenocorticotropic Hormone↗