Unexplained Suffering in the Aftermath of War
- From Harvard Medical School and Brigham and Women's Hospital, Boston, MA 02115-6011.
In 1990, military forces from Iraq invaded and occupied Kuwait and massed at the Saudi Arabia border. Early in 1991, an international alliance led by the United States attacked Iraqi forces and rapidly drove them back into Iraq. More than 500 000 U.S. personnel were involved in the Gulf War military action. Approximately 300 were killed and 500 were wounded—remarkably low numbers for a force of that size.
But the end of hostilities was not the end of the story. By the end of 1991, many Gulf War veterans felt unwell. They reported various persistent and debilitating symptoms. Both the U.S. Department of Defense and the U.S. Department of Veterans Affairs created registries of ailing combatants from the Gulf War. The most commonly reported symptoms were fatigue, rashes, headache, muscle and joint pain, and memory impairment (1, 2). Disability claims mounted. By 2001, nearly 20% of personnel deployed to the Gulf War were receiving some form of disability compensation (3).
Was the Gulf War, in fact, associated with an unusual burden of chronic multisymptom reports? Data from the registries could not answer that question, since the individuals in the registries were self-selected. Therefore, the U.S. Department of Veterans Affairs initiated several large population-based studies.
The studies—conducted in the United States (4, 5), the United Kingdom (6, 7), Canada (8), and Denmark (9)—shared certain features. Each study identified a large random sample of combatants from all branches of the armed services who had been deployed to the Gulf War and a similarly large random …
This 100-word excerpt has been provided in the absence of an abstract.
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