Gwini S M, Kelsall H L, Sim M R, Ikin J F, McFarlane A C, Forbes A B
School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Centre for Traumatic Stress Studies, University of Adelaide, Adelaide, South Australia, Australia.
Occup Environ Med. 2016 Mar;73(3):195-8. doi: 10.1136/oemed-2015-103169. Epub 2016 Jan 6.
Previously we established that symptoms reported by 1990-1991 Gulf War veterans were correlated and exhibited a pattern with 3 factors (psychophysiological distress, somatic distress and arthroneuromuscular distress), and this pattern was similar to that observed in a military comparison group. In this follow-up study, we examined whether the patterns of symptomatology have changed over time.
Using data on 56 symptoms that was collected in 2000-2003 (wave 1) and 2011-2012 (wave 2) from an Australian cohort of Gulf War veterans (veterans) and a military comparison group, exploratory factor analysis was conducted and Tucker's Congruence Coefficient (TCC) was used to determine factor structure similarity across study groups and waves.
The results showed that the 3 factors observed at wave 1 were still present at wave 2, and factor structures across study groups and study waves were fairly similar, with TCC ranging 0.86-0.92. Veterans consistently reported more symptoms across all 3 factors. Veterans' symptomatology specific to psychophysiological distress increased between waves 1 and 2 (ratio of means 1.15; 95% CI 1.07 to 1.25) but psychophysiological distress symptomatology was constant in the comparison group (ratio of means 0.97; 95% CI 0.89 to 1.06). Somatic and arthroneuromuscular distress symptomatology significantly increased over time for both study groups, although at a similar rate.
While the symptom groupings (measured by the 3 factors) remained unchanged at 10 years of follow-up, and remained comparable between Gulf War and comparison group, symptomatology continued to be elevated in Gulf War veterans than in the comparison group, and was most evident for psychophysiological distress.
此前我们确定，1990 - 1991年海湾战争退伍军人报告的症状相互关联，并呈现出与3个因素（心理生理困扰、躯体困扰和关节神经肌肉困扰）相关的模式，且这种模式与在军事对照组中观察到的模式相似。在这项随访研究中，我们检验了症状模式是否随时间发生了变化。
利用2000 - 2003年（第1波）和2011 - 2012年（第2波）从澳大利亚海湾战争退伍军人队列（退伍军人）和军事对照组收集的56种症状的数据，进行探索性因素分析，并使用塔克一致性系数（TCC）来确定各研究组和各波次之间因素结构的相似性。
结果显示，在第1波观察到的3个因素在第2波时仍然存在，各研究组和各研究波次的因素结构相当相似，TCC范围为0.86 - 0.92。退伍军人在所有3个因素上始终报告有更多症状。退伍军人特定于心理生理困扰的症状在第1波和第2波之间有所增加（均值比为1.15；95%置信区间为1.07至1.25），但对照组中心理生理困扰症状保持不变（均值比为0.97；95%置信区间为0.89至1.06）。两个研究组的躯体和关节神经肌肉困扰症状随时间均显著增加，尽管增加速率相似。
虽然在10年的随访中症状分组（由3个因素衡量）保持不变，且海湾战争退伍军人组与对照组之间仍具有可比性，但海湾战争退伍军人的症状水平仍高于对照组，并且在心理生理困扰方面最为明显。
