Signs, symptoms, and ill-defined conditions in Persian Gulf War veterans: Findings from the comprehensive clinical evaluation program

Michael J. Roy, Patricia A. Koslowe, Kurt Kroenke, Charles Magruder

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Objective: The purpose of this study was to analyze the type and frequency of signs, symptoms, and ill-defined conditions (SSID; International Classification of Diseases-9th Revision, Clinical Modification (ICD-9-CM) codes 780-799) identified by physicians evaluating Persian Gulf War veterans; to determine the influence of the extent of evaluation on the type and frequency of SSID diagnoses; and to search for evidence for a new illness, or illness related to wartime exposures, in veterans with ill-defined conditions. Method: Comprehensive examinations were provided for 21,579 consecutive Persian Gulf War veterans with symptoms or health concerns after the war. Data recorded on all individuals includes demographics, self- reported exposures, symptoms, and physician-assigned ICD-9-CM primary and secondary diagnoses. A detailed psychosocial history, including a multidisciplinary discussion, was incorporated for a subset of participants. Results: SSID conditions were primary diagnoses for 17.2% of veterans, and either primary or secondary diagnoses for 41.8%. Although some SSIDs were objective conditions (eg, sleep apnea), most were simply symptoms. More comprehensive evaluation, especially the multidisciplinary discussion of findings, decreased the frequency of symptoms as diagnoses and increased the number of DSM-IV psychiatric diagnoses. Ill-defined conditions were not associated with particular self-reported exposures or demographic variables. Conclusions: Ill-defined conditions identified by physicians in Gulf War veterans are most often symptoms. More definitive, often psychological, diagnoses can be made by increasing the intensity of the evaluation and by multidisciplinary input. Evidence for a new or unique illness related to wartime exposures did not emerge from this analysis.

Original languageEnglish
Pages (from-to)663-668
Number of pages6
JournalPsychosomatic Medicine
Volume60
Issue number6
StatePublished - Nov 1998

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Gulf War
Indian Ocean
Program Evaluation
Veterans
Signs and Symptoms
International Classification of Diseases
Physicians
Demography
Sleep Apnea Syndromes
Mental Disorders
Diagnostic and Statistical Manual of Mental Disorders
History
Psychology
Health

Keywords

  • Anxiety
  • Depression
  • Fatigue
  • Gulf War
  • Sleep disorder
  • Somatization

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Psychology(all)

Cite this

Signs, symptoms, and ill-defined conditions in Persian Gulf War veterans : Findings from the comprehensive clinical evaluation program. / Roy, Michael J.; Koslowe, Patricia A.; Kroenke, Kurt; Magruder, Charles.

In: Psychosomatic Medicine, Vol. 60, No. 6, 11.1998, p. 663-668.

Research output: Contribution to journalArticle

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