The Long Aftermath of the 1991 Gulf War
- Simon Wessely, MA, BM BCh, MSc, MD, FRCP, FRCPsych
- From King's Centre for Military Health Research, King's College London, London SE5 9RJ, United Kingdom.
Soldiers fortunate enough to return from war in sound body have often encountered further problems (1, 2). Nevertheless, the scale and nature of the problems reported by veterans of what we must now call the first Gulf War came as a surprise. Casualties were fortunately extremely light and the duration of fighting short. Yet with the passage of time, a trickle, then a flood, of veterans on both sides of the Atlantic began reporting health problems.
It soon became clear that we were not dealing with a new disease, with anything that affected mortality (3, 4), or with any easily defined, known disease entity (5, 6). Nor, as it turned out, was a classic psychiatric disorder the answer. The textbook war-related psychiatric disorder, post-traumatic stress disorder, was present, of course, but not in sufficient quantity to account for what was a substantial health effect (7). Instead, we were seeing an increase in symptomatic ill health, as a series of large epidemiologic studies from the United States (8), the United Kingdom (9, 10), Canada, Denmark, and Australia (11) all reported similar findings.
There was no shortage of possible culprits. For example, what was then an indisputable threat from chemical and biological weapons made all prudent commanders insist on the widespread use of medical countermeasures to protect the armed forces. The United Kingdom chose to vaccinate our military against not only the usual infective hazards but also against plague, anthrax, and pertussis, the last chosen deliberately to increase the speed of protection against anthrax. Given that all medical interventions, even preventive measures, have side effects, it is reasonable to ask, as many veterans did, whether these countermeasures could have …
This 100-word excerpt has been provided in the absence of an abstract.
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