War-related psychological stressors and risk of psychological disorders in Australian veterans of the 1991 Gulf War

Background: Questions remain about the long-term health impacts of the 1991 Gulf War on its veterans. Aims: To measure psychological disorders in Australian Gulf War veterans and a military comparison group and to explore any association with exposure to Gulf War-related psychological stressors. Method: Prevalences of DSM - IV psychological disorders were measured using the Composite International Diagnostic Interview. Gulf War-related psychological stressors were measured using a service experience questionnaire. Results: A total of 31% of male Gulf War veterans and 21% of the comparison group met criteria for a DSM-IV disorder first present in the post-Gulf War period. The veterans were at greater risk of developing post-Gulf War anxiety disorders including post-traumatic stress disorder, affective disorders and substance use disorders. The prevalence of such disorders remained elevated a decade after deployment. The findings can be explained partly as a 'war-deployment effect'. There was a strong dose-response relationship between psychological disorders and number of reported Gulf War-related psychological stressors. Conclusions: Service in the 1991 Gulf War is associated with increased risk of psychological disorders and these are related to stressful experiences.