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Health and Human Services Department of Defense Veterans Affairs Health and Human Services Gulf War Information Department of Defense Gulf War Information Veterans Affairs Gulf War Information Home Home Advanced Search Glossary FAQs Site Map Contact Us
 Research Topics    |    Major Focus Areas
Research Topics
ACCIDENTS & INJURIES
BONE, JOINT & MUSCLE
BRAIN & NERVOUS
CANCER
CARDIOVASCULAR
CHEMICAL WARFARE
DIGESTIVE HEALTH
ENVIRONMENTAL & OCCUPATIONAL HEALTH
FAMILY HEALTH
GENERAL HEALTH & PHYSICAL SYMPTOMS
GENETIC STUDIES
HEALTH RESEARCH OF ALLIED FORCES
IMMUNE/BLOOD SYSTEM
INFECTIONS
LUNG & RESPIRATORY
MENTAL HEALTH
MILITARY WORKING DOGS
MORTALITY/DEATH
REPRODUCTIVE HEALTH/OUTCOMES
SLEEP DISORDER
Treatment
VACCINES & PROTECTIVE MEDICATIONS
Lung & Respiratory
Project Summary

Title: A Controlled Epidemiological and Clinical Study into the Effect of Gulf War Service on Servicemen and Women of the United Kingdom Armed Forces
Synopsis: This study compares the unexplained illnesses and symptoms of three United Kingdom military groups -- Gulf War-era deployed veterans, Gulf War-era non-deployed veterans, and Bosnia Conflict deployed veterans.
Overall Project Objective: This research assesses the prevalence of unexplained illnesses, including chronic fatigue-like symptoms, in members of the United Kingdom Armed Forces who were deployed to the Persian Gulf during the Gulf War and who have served in Bosnia.
Status/Results to Date: The mailing of 12,750 questionnaires to serving and discharged personnel was successfully completed. Response rates from the three groups (Gulf War veterans, veterans of Bosnia deployment and veterans deployed to neither Bosnia nor the Gulf War: Era veterans) were approximately 70% for Gulf War veterans, 62% for Bosnia veterans, and 63% for Era veterans. Clinical studies were performed on 98 "well" and 111 "ill" GWV and 79 and 55, respectively, ill Era and Bosnia veterans. The investigators indicated that the results suggest there is no objective neurocognitive deficit attributable to service in the Gulf War. They did demonstrate that an emotional and psychological disorder is common in GWV and may be clinically significant for a minority of the subjects. They also found that test performance in ill veterans was impaired relative to well controls but still within a normal range. Cognitive difficulties detected were found to be likely to be attributable to any active deployment and hence not likely to be related to specific Gulf related exposures - with the exception of one test measure. Because the latter test measure did not yield to an obvious pathophysiological explanation, the investigators indicated that further neuromotor coordination research in Gulf War veterans could be helpful.
Project:DoD-39
Agency:Department Of Defense
Location:King's College School of Medicine
P.I. Name:Simon Wessely, M.D.
Research Type:Epidemiology
Research Focus:Symptoms & General Health
Focus Category:Lung & Respiratory
Status:Complete
Study Start Date:June 01,1996
Estimated Completion Date:October 31,2000
Specific Aims: This study is a two stage cohort study. Stage 1 consists of a postal health screening questionnaire to be sent to three groups who were/are in the Armed Forces; those who served in the Persian Gulf, those who served in Bosnia, and those who served in neither the Persian Gulf or Bosnia. The second stage involves performing neurophsychological tests on cases identified by stage 1 and a control group.
Methodology: This epidemiological study of the prevalence of unexplained illnesses in the populations at risk used a two-stage design. Stage 1 was a questionnaire survey of 4,520 Gulf War veterans selected at random, an equivalent sample of Bosnia veterans, and appropriate control groups for each. Stage 2 involved interview, examination, and testing of all those (approximately 10%) in Stage 1 who fall above a cutoff defining subjective health. Information gathered at Stage 2 was used to estimate the prevalence of diagnosed and unexplained morbidity, including chronic fatigue symptoms, in UK service personnel, and to calculate whether there was an excess associated with Gulf War and/or Bosnia service. Positive findings would allow researchers to examine pre-morbid and psychosocial factors which may be implicated in such an increase, as well as identify avenues for further biological and psychosocial research.
Most Recent Publications:

David A, Farrin L, Hull L, Unwin C, Wessely S, Wykes T. Cognitive functioning and disturbances of mood in UK veterans of the Persian Gulf War: a comparative study. Psychological Medicine, 32(8):1357-1370. Nov 2002. Abstract

Ismail K, Unwin CE, Hull L, David A, Wessely S. Defining Ill health in three British Military Cohorts. Gulf War Veterans' Illness Research, Pentagon City, June 17-19, 1998. Abstract

Farrin L, Hull L, Unwin C, Wykes T, David A. Effects of depressed mood on objective and subjective measures of attention. Journal of Neuropsychiatry and Clinical Neurosciences, Winter; 15(1):98-104. 2003. Abstract

Unwin CE, Blatchley N, Coker W, Ferry S, Hotopf M, Hull L, Ismail K, Palmer I, David A, Wessely S. Health of UK servicemen who served in Persian Gulf War. Lancet, 353(9148):169-78, Jan 1999. Abstract

Ismail K, Everitt B, Blatchley N, Hull L, Unwin CE, David A, Wessely S. Is there a Gulf War Syndrome? Lancet, 353(9148):179-82, Jan 1999. Abstract

Ismail K, Blatchley N, Hotopf M, Hull L, Palmer I, Unwin CE, David A, Wessely S. Occupational risk factors for ill health in Gulf Veterans of the United Kingdom. J Epidemiol Community Health, 54(11):834-8, Nov 2000. Abstract

Hotopf M, Mackness MI, Nikolaou V, Collier DA, Curtis C, David A, Durrington P, Hull L, Ismail K, Peakman M, Unwin C, Wessely S, Mackness B. Paraoxonase in persian gulf war veterans. Journal of Occupational and Environmental Medicine, 45(7):668-675. Jul 2003. Abstract

Jones E, McCartney H, Beech C, Hodgins-Vermaas R, Palmer I, Wessely S, Hyams KC. Post-Combat Syndromes from 1900: An Intra and Inter war Comparison. Conference on Illnesses among Gulf War Veterans. A Decade of Scientific Research, pg. 222, January 24-26, 2001. Abstract

Chalder T, Hotopf M, Unwin C, Hull L, Ismail K, David A, Wessely S. Prevalence of Gulf war veterans who believe they have Gulf war syndrome: questionnaire study. British Medical Journal, 323(7311):473-6. Sep 2001. Abstract

Hotopf M, David A, Hull L, Ismail K, Unwin CE, Wessely S. Role of vaccinations as risk factors for ill health in veterans of the Gulf war: cross sectional study. British Medical Journal, 320(7246):1363-7. May 2000. Abstract

Hull L, David A, Hyams KC, Unwin C, Wessely SC, Hotopf M. Self-reported health of Persian Gulf War veterans: a comparison of help-seeking and randomly ascertained cases. Military Medicine, 167(9):747-752. Sep 2002. Abstract

Higgins EM, Ismail K, Kant K, Harman K, Mellerio J, du Vivier AW, Wessely S. Skin disease in Gulf war veterans. Quarterly Journal of Medicine, 95(10):671-676. Oct 2002. Abstract

Hotopf M, David A, Hull L, Ismail K, Palmer I, Unwin C, Wessely S. The health effects of peace-keeping in the UK Armed Forces: Bosnia 1992-1996. Predictors of psychological symptoms. Psychological Medicine, 33(1):155-162. Jan 2003. Abstract

Hotopf M, David A, Hull L, Ismail K, Unwin C, Wessely S. The health effects of peacekeeping (Bosnia, 1992-1996): a cross-sectional study--comparison with nondeployed military personnel. Military Medicine, 168(5):408-413. May 2003. Abstract

Ismail K, Kent K, Brugha T, Hotopf M, Hull L, Seed P, Palmer I, Reid S, Unwin C, David A, Wessely S. The mental health of UK Gulf war veterans: phase 2 of a two phase cohort study. British Medical Journal, 325(7364):576-81. Sep 2002. Abstract

Bolton JP, Lee H, Gabriel R. Vaccinations as risk factors for ill health in veterans of the Gulf War. British Medical Journal, 322(7282):361-362, 1999. Article

Unwin C, Hotopf M, Hull L, Ismail K, David A, Wessely S. Women in the Persian Gulf: lack of gender differences in long-term health effects of service in United Kingdom Armed Forces in the 1991 Persian Gulf War. Military Medicine, 167(5):406-13. May 2002. Abstract