SIGNS, SYMPTOMS, AND ILL-DEFINED CONDITIONS IN PERSIAN-GULF-WAR VETERANS - FINDINGS FROM THE COMPREHENSIVE CLINICAL-EVALUATION PROGRAM

Objective: The purpose of this study was to analyze the type and frequ ency of signs, symptoms, and ill-defined conditions (SSID; Internation al Classification of Diseases-9th Revision, Clinical Modification (ICD -9-CM) codes 780-799) identified by physicians evaluating Persian Gulf War veterans; to determine the influence of the extent of evaluation on the type and frequency of SSID diagnoses; and to search for evidenc e for a new illness, or illness related to wartime exposures, in veter ans with ill-defined conditions. Method: Comprehensive examinations we re provided for 21,579 consecutive Persian Gulf War veterans with symp toms or health concerns after the war. Data recorded on all individual s includes demographics, self-reported exposures, symptoms, and physic ian-assigned ICD-9-CM primary and secondary diagnoses. A detailed psyc hosocial history, including a multidisciplinary discussion, was incorp orated for a subset of participants. Results: SSID conditions were pri mary diagnoses for 17.2% of veterans, and either primary or secondary diagnoses for 41.8%. Although some SSIDs were objective conditions (eg , sleep apnea), most were simply symptoms. More comprehensive evaluati on, especially the multidisciplinary discussion of findings, decreased the frequency of symptoms as diagnoses and increased the number of DS M-IV psychiatric diagnoses. Ill-defined conditions were not associated with particular self-reported exposures or demographic variables. Con clusions: Ill-defined conditions identified by physicians in Gulf War veterans are most often symptoms. More definitive, often psychological , diagnoses can be made by increasing the intensity of the evaluation and by multidisciplinary input. Evidence for a new or unique illness r elated to wartime exposures did not emerge from this analysis.