Department of Preventive and Social Medicine, Te Tari Hauora Tūmatanui, University of Otago, Dunedin, New Zealand.
School of Psychology, Te Kura Hinengaro Tangata, Massey University, Palmerston North, New Zealand.
N Z Med J. 2023 Aug 4;136(1580):62-67. doi: 10.26635/6965.6121.
To describe patterns of multiple symptom illness (MSI) in New Zealand military veterans, defined as clusters of "medically unexplained" symptoms not fitting within a specific medical diagnosis, and to investigate the relationship with exposure to traumatic events.
We designed an online cross-sectional survey. The participants of interest were the 3,874 currently serving veterans who had been deployed to a conflict zone, but all veterans were eligible to participate. A modified Centers for Disease Control (CDC) 54-item symptom checklist identified MSI, the post-traumatic checklist-military version (PCL-M) identified symptoms of post-traumatic stress disorder (PTSD) and the brief trauma scale assessed "war zone" service. Factor analysis was used to identify unobserved "latent factors" in the data, factor severity scores and the number of symptoms being calculated for each respondent.
The CDC questionnaire was completed by 1,819 veterans, with 1,672 completing the PCL-M. The factor analysis revealed three factors, explaining 86% of the variation in the data. Factor 1 symptoms were of an arthro-neuromuscular nature, Factor 2 cognitive and Factor 3 psycho-physiological. Discriminant function analysis showed that the factors could discriminate between those with and without PTSD but could not discriminate between those who did and did not serve in a war zone.
In veterans, multiple symptoms including pain, sleep disorders, cognitive problems and avoidance, especially when severe, may be worthy of further investigation by health professionals because of the possible association with PTSD.
描述新西兰退伍军人的多种症状疾病（MSI）模式，定义为“无法解释的”症状集群，不符合特定的医学诊断，并研究其与创伤性事件暴露的关系。
我们设计了一项在线横断面调查。有兴趣的参与者是 3874 名现役退伍军人，他们曾被部署到冲突地区，但所有退伍军人都有资格参加。经过修改的疾病控制与预防中心（CDC）54 项症状清单确定了 MSI，创伤后清单-军事版（PCL-M）确定了创伤后应激障碍（PTSD）的症状，简短创伤量表评估了“战区”服务。因子分析用于识别数据中未观察到的“潜在因素”，为每个受访者计算因子严重程度评分和症状数量。
有 1819 名退伍军人完成了 CDC 问卷，有 1672 名退伍军人完成了 PCL-M。因子分析显示了三个因素，解释了数据中 86%的变化。第 1 个因子的症状是关节神经肌肉性质，第 2 个因子是认知，第 3 个因子是心理生理。判别函数分析表明，这些因素可以区分 PTSD 患者和非 PTSD 患者，但不能区分战区服务人员和非战区服务人员。
在退伍军人中，多种症状包括疼痛、睡眠障碍、认知问题和回避，尤其是当症状严重时，可能值得健康专业人员进一步调查，因为它们可能与 PTSD 有关。
