Mohanty April F, Muthukutty Anusha, Carter Marjorie E, Palmer Miland N, Judd Joshua, Helmer Drew, McAndrew Lisa M, Garvin Jennifer H, Samore Matthew H, Gundlapalli Adi V
*Informatics, Decision Enhancement, and Surveillance (IDEAS) Center, VA Salt Lake City Health Care System, Department of Internal Medicine, University of Utah School of Medicine †Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, UT ‡Department of Veteran Affairs, War Related Illness and Injury Study Center, New Jersey Health Care System, East Orange, NJ §Department of Education and Counseling Psychology, University of Albany, Albany, NY.
Med Care. 2015 Apr;53(4 Suppl 1):S143-8. doi: 10.1097/MLR.0000000000000314.
Chronic multisymptom illness (CMI) may be more prevalent among female Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) deployed Veterans due to deployment-related experiences.
To investigate CMI-related diagnoses among female OEF/OIF/OND Veterans.
We estimated the prevalence of the International Classification of Disease-9th edition-Clinical Modification coded CMI-related diagnoses of chronic fatigue syndrome, fibromyalgia (FM), and irritable bowel syndrome (IBS) among female OEF/OIF/OND Veterans with Veterans Health Administration (VHA) visits, FY2002-2012 (n=78,435). We described the characteristics of female Veterans with and without CMI-related diagnoses and VHA settings of first CMI-related diagnoses.
The prevalence of CMI-related diagnoses among female OEF/OIF/OND Veterans was 6397 (8.2%), over twice as high as the prevalence 95,424 (3.9%) among the totality of female Veterans currently accessing VHA (P<0.01). There were statistically significant differences in age, education, marital status, military component, service branch, and proportions of those with depression and/or post-traumatic stress disorder diagnoses across females with and without CMI-related diagnoses. Diagnoses were mainly from primary care, women's health, and physical medicine and rehabilitation clinics.
CMI-related diagnoses were more prevalent among female OEF/OIF/OND Veterans compared with all female Veterans who currently access VHA. Future studies of the role of mental health diagnoses as confounders or mediators of the association of OEF/OIF/OND deployment and CMI are warranted. These and other factors associated with CMI may provide a basis for enhanced screening to facilitate recognition of these conditions. Further work should evaluate models of care and healthcare utilization related to CMI in female Veterans.
由于与部署相关的经历，慢性多症状疾病（CMI）在持久自由行动/伊拉克自由行动/新黎明行动（OEF/OIF/OND）中部署的女性退伍军人中可能更为普遍。
调查OEF/OIF/OND女性退伍军人中与CMI相关的诊断。
我们估计了2002财年至2012年期间在退伍军人健康管理局（VHA）就诊的OEF/OIF/OND女性退伍军人（n = 78,435）中，根据国际疾病分类第九版临床修订本编码的与CMI相关的慢性疲劳综合征、纤维肌痛（FM）和肠易激综合征（IBS）诊断的患病率。我们描述了有和没有与CMI相关诊断的女性退伍军人的特征以及首次CMI相关诊断的VHA环境。
OEF/OIF/OND女性退伍军人中与CMI相关诊断的患病率为6397（8.2%），是目前接受VHA服务的所有女性退伍军人中患病率95,424（3.9%）的两倍多（P < 0.01）。在有和没有与CMI相关诊断的女性中，年龄、教育程度、婚姻状况、军事组成部分、军种以及患有抑郁症和/或创伤后应激障碍诊断的比例存在统计学上的显著差异。诊断主要来自初级保健、妇女健康以及物理医学与康复诊所。
与目前接受VHA服务的所有女性退伍军人相比，OEF/OIF/OND女性退伍军人中与CMI相关的诊断更为普遍。有必要对心理健康诊断作为OEF/OIF/OND部署与CMI关联的混杂因素或中介因素的作用进行进一步研究。这些以及与CMI相关的其他因素可能为加强筛查以促进对这些疾病的识别提供依据。进一步的工作应评估与女性退伍军人中CMI相关的护理模式和医疗保健利用情况。
