Ismail, K. et al. Is There a Gulf War Syndrome ? Lancet (1999) 353: 179-182.
With the results of the questionnaire survey described in the above paper (Unwin et. al.), the authors used factor analysis to investigate whether he symptoms reported by British Gulf War veterans were sufficiently different from recognized disorders to be considered a new disorder. The first three identified factors and the symptoms which loaded onto them were: 1) mood-cognition (headaches, irritability, sleep difficulties, feeling jumpy, unrefreshing sleep, fatigue, feeling distant or cut off from others, forgetfulness, loss of concentration, avoiding doing things or situations, and distressing dreams; 2) respiratory system (inability to breathe deeply, fast breathing, shortness of breath at rest, and wheezing); and, 3) peripheral nervous system (tingling in fingers or arms, tingling in legs or arms, and numbness or tingling in fingers or toes). Applying the factors identified in the Gulf War veterans, the authors found little difference from the patterns of symptoms reported by veterans who did not deploy to the Gulf and veterans of the Bosnia deployment. Although Gulf War veterans reported a higher frequency of symptoms, the similarity in the patterns of symptoms among all three study groups did not support the existence of a syndrome unique to Gulf War veterans. The discussion portion of the paper compares the methods and results of the study with the two previously published studies of Gulf War veterans which used factor analysis (Haley, R. et al. and Fukuda, K. et al.).