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海湾战争一代退伍军人10年后的慢性多症状疾病综合征

Chronic multisymptom illness complex in Gulf War I veterans 10 years later.

作者信息

Blanchard Melvin S, Eisen Seth A, Alpern Renee, Karlinsky Joel, Toomey Rosemary, Reda Domenic J, Murphy Frances M, Jackson Leila W, Kang Han K

机构信息

Medical and Research Services, St. Louis Veterans Affairs Medical Center, St. Louis, MO 63106, USA.

出版信息

Am J Epidemiol. 2006 Jan 1;163(1):66-75. doi: 10.1093/aje/kwj008. Epub 2005 Nov 17.

Abstract

Prior research has demonstrated that shortly after the 1991 Gulf War (Gulf War I), chronic multisymptom illness (CMI) was more common among deployed veterans than among nondeployed veterans. The aims of the current study were to determine the prevalence of CMI among deployed and nondeployed veterans 10 years after Gulf War I, compare the distribution of comorbid conditions, and identify prewar factors associated with CMI. Cross-sectional data collected from 1,061 deployed veterans and 1,128 nondeployed veterans examined between 1999 and 2001 were analyzed. CMI prevalence was 28.9% among deployed veterans and 15.8% among nondeployed veterans (odds ratio = 2.16, 95% confidence interval: 1.61, 2.90). Deployed and nondeployed veterans with CMI had similarly poorer quality-of-life measures and higher prevalences of symptom-based medical conditions, metabolic syndrome, and psychiatric disorders. Diagnoses of prewar anxiety disorders (not related to post-traumatic stress disorder) and depression were associated with CMI among both deployed and nondeployed veterans. Nicotine dependence and veteran-reported physician-diagnosed infectious mononucleosis were associated with CMI among deployed veterans, and migraine headaches and gastritis were associated with CMI among nondeployed veterans. CMI continues to be substantially more prevalent among deployed veterans than among nondeployed veterans 10 years after Gulf War I, but it manifests similarly in both groups. It is likely to be a common, persistent problem among veterans returning from the current Gulf War.

摘要

先前的研究表明,在1991年海湾战争(第一次海湾战争)后不久,与未参战的退伍军人相比,参战退伍军人中慢性多症状疾病(CMI)更为常见。本研究的目的是确定第一次海湾战争10年后参战和未参战退伍军人中CMI的患病率,比较共病情况的分布,并确定与CMI相关的战前因素。对1999年至2001年间收集的1061名参战退伍军人和1128名未参战退伍军人的横断面数据进行了分析。参战退伍军人中CMI的患病率为28.9%,未参战退伍军人中为15.8%(优势比=2.16,95%置信区间:1.61,2.90)。患有CMI的参战和未参战退伍军人在生活质量指标方面同样较差,基于症状的医疗状况、代谢综合征和精神障碍的患病率更高。战前焦虑症(与创伤后应激障碍无关)和抑郁症的诊断与参战和未参战退伍军人中的CMI均相关。尼古丁依赖以及退伍军人报告的医生诊断的传染性单核细胞增多症与参战退伍军人中的CMI相关,偏头痛和胃炎与未参战退伍军人中的CMI相关。在第一次海湾战争10年后,CMI在参战退伍军人中的患病率仍然显著高于未参战退伍军人,但在两组中的表现相似。这很可能是当前海湾战争退伍军人中一个常见且持续存在的问题。

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