2012 National Meeting

1096 — Chronic Multisymptom Illness: An Unrecognized Public Health Concern among OEF/OIF Veterans

McAndrew LM, and Chandler HK, War Related Illness and Injury Study Center (WRIISC), NJ; D'Andrea EA, VA Philadelphia; Lange G, War Related Illness and Injury Study Center (WRIISC), NJ; Engel C, Walter Reed National Military Medical Center; Uniformed Services University of the Health Sciences; Quigley KS, Edith Nourse Rogers VA Memorial Hospital; Northeastern University;

Objectives:
Following the Persian Gulf (PG) War, U.S. troops returned home with serious health concerns and physical symptoms that were termed either Gulf War Illness or Chronic Multisymptom Illness (CMI). In contrast, Mild Traumatic Brain injury (mTBI) and Post Traumatic Stress Disorder (PTSD) have been the focus of the recent deployment s to Iraq and Afghanistan (OIF and OEF, respectively). To date, no study has examined the prevalence of CMI among OEF/OIF service members.

Methods:
The HEROES Study is an HSR&D-funded prospective longitudinal study which assessed 790 National Guard and Reserve Army enlisted personnel pre-deployment, immediately after deployment, 3 months and 1 year post-deployment. CMI was assessed using the Fukuda, et al. (1998) definition. PTSD was assessed using the PTSD Checklist-civilian version (PCL-C).

Results:
335 OEF/OIF service members completed the one year post-deployment assessment. At one year after return from deployment, 57.2% screened positive for CMI (10.7% screened positive for severe CMI) and 16.0% met criteria for PTSD. 94.9% of service members with PTSD also met criteria for CMI. Only 23.6% of service members with CMI also meet criteria for PTSD. Factors associated with CMI included greater combat exposure (r = .23), a greater number of stressful deployment experiences (r = .28), more PTSD symptoms (r = .41), more pre-deployment stressful life events (r = .22), and more severe non-specific physical symptoms pre-deployment (r = .20). Additional results will be reported.

Implications:
We found an alarming rate of CMI which was not fully accounted for by PTSD. Despite the potential significant public health impact, there has been relatively little attention to physical symptoms and functional impairments among Veterans returning from OEF/OIF.

Impacts:
This study suggests that CMI is a significant, unrecognized public health concern. Early diagnosis and management is necessary to avert the kind of serious chronic health effects seen in PG Veterans with CMI.