Iraq and Afghanistan Veterans report symptoms consistent with chronic multisymptom illness one year after deployment

Abstract

Many Veterans returning from service in Operation Iraqi Freedom/Operation Enduring Freedom (OIF/ OEF) experience chronic pain. What is not known is whether for some OIF/OEF Veterans this pain is part of a larger condition of diffuse multisystem symptoms consistent with chronic multisymptom illness (CMI). We use data from a prospective longitudinal study of OIF/OEF Veterans to determine the frequency of CMI. We found that 1 yr after deployment, 49.5% of OIF/OEF Veterans met criteria for mild to moderate CMI and 10.8% met criteria for severe CMI. Over 90% of Veterans with chronic pain met criteria for CMI. CMI was not completely accounted for either by posttraumatic stress disorder or by predeployment levels of physical symptoms. Veterans with symptoms consistent with CMI reported significantly worse physical health function than Veterans who did not report symptoms consistent with CMI. This study suggests that the presence of CMI should be considered in the evaluation of OIF/OEF Veterans. Further, it suggests that the pain management for these Veterans may need to be tailored to take CMI into consideration. RightsWorks produced by employees of the U.S. Government as part of their official duties are not copyrighted within the U.S. The content of this document is not copyrighted. Abstract-Many Veterans returning from service in Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) experience chronic pain. What is not known is whether for some OIF/OEF Veterans this pain is part of a larger condition of diffuse multisystem symptoms consistent with chronic multisymptom illness (CMI). We use data from a prospective longitudinal study of OIF/OEF Veterans to determine the frequency of CMI. We found that 1 yr after deployment, 49.5% of OIF/OEF Veterans met criteria for mild to moderate CMI and 10.8% met criteria for severe CMI. Over 90% of Veterans with chronic pain met criteria for CMI. CMI was not completely accounted for either by posttraumatic stress disorder or by predeployment levels of physical symptoms. Veterans with symptoms consistent with CMI reported significantly worse physical health function than Veterans who did not report symptoms consistent with CMI. This study suggests that the presence of CMI should be considered in the evaluation of OIF/OEF Veterans. Further, it suggests that the pain management for these Veterans may need to be tailored to take CMI into consideration.

A Pilot Study of Airborne Hazards and Other Toxic Exposures in Iraq War Veterans

“…In a prospective longitudinal study, approximately half of Operations Iraqi Freedom/Enduring Freedom (OIF/OEF) Veterans met the criteria for mild to moderate CMI. Additionally, 11% fulfilled the case definition for severe CMI, while 90% of those with chronic musculoskeletal pain met the criteria for CMI [27]. Nonetheless, the symptoms most common to OIF/OEF Veterans were not necessarily those most often observed among the Gulf War I cohort, suggesting overlapping but not equivalent conditions.…”

Longitudinal relationship between onset of physical symptoms and functional impairment

“…Combat deployment leads to chronic physical symptoms for approximately 30% of Veterans (McAndrew et al, 2016). By examining the cross-lagged relationships between physical symptoms and functional impairment among deploying military personnel, we can better understand these relationships as physical symptoms and functional impairment are developing.…”

“…Participants were recruited as part of the HEROES Project, a prospective longitudinal study of Army National Guard and Army Reserve enlisted soldiers deploying to Operation Iraqi/Enduring Freedom. Details on the HEROES project including response bias and drop out can be found in our prior published work using this sample (L. McAndrew et al, 2016;Lisa M. McAndrew et al, 2013;Lisa M McAndrew, Markowitz, et al, 2017;Lisa M McAndrew, Phillips, et al, 2017;Yan et al, 2013). Military personnel between the ages of 18 and 60 were eligible.…”

The Association Between Toxic Exposures and Chronic Multisymptom Illness in Veterans of the Wars of Iraq and Afghanistan

“…This is an important question because there have been reports from veterans in recent conflicts of symptoms that share similarities with CMI experienced by Gulf War era veterans [22,23]. Specifically, “Post-deployment Multi-Symptom Disorder” is characterized by post-concussive symptoms, chronic pain, and posttraumatic stress disorder (PTSD) symptoms [22] and CMI is defined as fatigue, mood and cognitive abnormalities, and musculoskeletal pain [23,24]. This research has indicated that Veterans of Iraq and Afghanistan had higher rates of CMI than soldiers who did not deploy [23].…”

“…This research has indicated that Veterans of Iraq and Afghanistan had higher rates of CMI than soldiers who did not deploy [23]. Further, nearly 50% of Veterans who served in Iraq and Afghanistan meet criteria for CMI 1 year following deployment [24]. Yet, other studies have demonstrated that Veterans of the wars in Iraq and Afghanistan experience symptom elevations generally [25] and do not experienced higher levels of symptoms than those who deployed to the Gulf-War [23,25,26].…”