Ten years on: what do we know about the Gulf War syndrome?

Wessely, Simon

doi:10.7861/clinmedicine.1-1-28

Cited by 55 publications

(25 citation statements)

References 87 publications

(82 reference statements)

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“…18 We are currently facing a general lack of confidence in public institutions as a whole, and that includes both medicine and the Armed Forces. 3,19,20 As O'Neill stated, whether mistrust is well founded or not, it has a debilitating impact on society. 20 From this perspective the Armed Forces are no different to the NHS and other public institutions.…”

Section: Discussionmentioning

confidence: 99%

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Screening for physical and psychological illness in the British Armed Forces: II: Barriers to screening – learning from the opinions of Service personnel

et al. 2004

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Objective: To identify any potential barriers to the effectiveness of a military health screening programme based on the beliefs of British Service personnel. Methods:As part of a pilot evaluation of the suitability of a new health screening questionnaire for the British Armed Forces, 73 men and women from the three Services, of various ranks and age, underwent a semi-structured interview after completing a screening questionnaire. Participants were asked about the veracity of their answers and their views regarding a screening questionnaire. Afterwards questionnaires were sent to 4496 randomly selected personnel from the three Services, which validated the main emerging themes. A constant comparative method of analysis was used to identify and categorise all ideas presented. Results:The main barriers to health screening were lack of trust, perceived low quality of healthcare, and perceived lack of concern within the institution about work environments and home life. The central issue was 'confidence' in military health care provision. Screening was considered worthwhile, but many confided that they would not honestly answer some items in the questionnaire. Lack of trust in medical confidentiality, stigmatisation and fears that the process would jeopardise career prospects were stressed. Many Service personnel admitted to seeking medical help outside the Armed Forces. Conclusions:Concerns raised by Service personnel may endanger the value of a screening programme and the provision of health services. Greater emphasis needs to be placed upon gaining the confidence of those targeted for health screening.

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Section: Discussionmentioning

confidence: 99%

“…The recent war in Iraq further ignites the situation. [1][2][3] Previous research in the military has mainly focused on the choice of instruments available, their validity, and when best employed, e.g. during recruit selection or pre/post operational deployment.…”

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confidence: 99%

Screening for physical and psychological illness in the British Armed Forces: II: Barriers to screening – learning from the opinions of Service personnel

et al. 2004

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“…As Wessely stated, 'Illnesses identical to the complaints reported by Gulf veterans are found in civilians who have never served in the Armed Forces, let alone taken part in the Gulf War' . 4 Indeed, rather than extending the range of investigations on veterans who have so many vague symptoms similar to those seen (SSIDC) in the general public, a more appropriate 'bio-psycho-social model may provide a better solution' . 31 Furthermore, is it appropriate that veterans be subjected to more investigations than a civilian population?…”

Section: Discussionmentioning

confidence: 99%

“…4 We therefore decided to review our investigation protocols. There have been unfounded suggestions that even more investigations should be undertaken on veterans irrespective of clinical indications.…”

mentioning

confidence: 99%

Results of investigations on Gulf War veterans

2005

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-Investigations were undertaken on veterans of the Gulf conflict of 1990/91 at the Gulf Veterans' Medical Assessment Programme (GVMAP), to determine whether routine investigations should be carried out on these veterans. Blood investigations were analysed of a 10% random sample of veterans and also of two veteran groups -one group was well (asymptomatic) and the other unwell (post-traumatic stress disorder). Neurological investigations were carried out as well as 1,000 ultrasound studies and 3,000 ECGs. Almost all blood tests proved normal. The only significant differences found between the two groups were for the alanine/ aspartate transaminase and gamma glutamyl transaminase values, where there were more abnormal findings in the unwell group. Abnormal, but expected, neurological investigations were found in those referred for these tests. Ultrasound abnormalities were related to known established clinical diagnoses, apart from three cases. ECG abnormalities were only present in those with known clinical diagnoses. It was concluded that reducing the number of investigations would not only be cost effective but should help to lessen veterans' anxieties. KEY WORDS: Gulf War veterans 1990/91, implications, results, routine investigations, way forwardA short time after their return from the Gulf War of 1990/1, some veterans began to complain of symptoms of ill health, which became popularly known as 'Gulf War Syndrome' . There have been unsubstantiated claims in the media and by some veterans' activist groups that Gulf War service is linked to increased rates of mortality, birth defects, pregnancy problems and other more specific illnesses. Elsewhere claims of specific illnesses or unique syndromes have been made 1,2 and carefully reviewed, 3,4 finding little, if any, evidence of these links. In the UK, in response to these symptoms, the Ministry of Defence established in October 1993 the Gulf Veterans' Medical Assessment Programme (GVMAP), which was much heralded by the media. Similarly, in the USA, the Department for Veterans' Affairs Gulf Registry Health Examination Program (VA Registry) also started assessing veterans who had left the armed services in 1992. In 1994, the Department of Defense set up the Gulf veterans Comprehensive Clinical Evaluation Program (CCEP).The GVMAP was never intended as a screening programme but, since it is the only programme available to Gulf veterans, it acted as a surrogate screening programme. Investigations were undertaken to help the medical assessments when it was thought that there may have been a condition specifically related to the Gulf War. Initial research, [5][6][7][8] and that carried out later, 9,10 benefiting from the results of almost a decade of research and assessment, found no evidence to support the concept of 'Gulf War Syndrome' or any unique Gulf War related illness. Similar conclusions have been reached at CCEP. 11 The diagnosis of 'symptoms, signs and ill defined conditions' (SSIDC) has now virtually disappeared in recent literature compared with ea...

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“…Other illnesses relate to more specific environmental factors. They include Gulf War Syndrome [2], syndromes related to dental amalgam [3]and silicone breast implants [4], electrical hypersensitivity [5], sick building syndrome [6], including toner-related illness, and so-called painter-related encephalopathy [7]. The list seems to get longer by the year.…”

Section: New Environmental Illnessesmentioning

confidence: 99%