Natural course of symptoms in Cambodia veterans: a follow-up study

Background. Dutch (ex-)servicemen were deployed in the 1992-3-peace operati on UNTAC in Cambodia. Since their return, they have voiced concerns about t he health consequences of their service and they have reported symptoms suc h as fatigue and cognitive problems. The natural course of symptoms in Dutc h Cambodia veterans was evaluated in a prospective study. Methods. At 18-months follow-up, a questionnaire was sent to 354 veterans w ho met a set case definition for symptoms in Cambodia veterans or who had s ub-threshold scores. Initial measurement of fatigue severity, psychological well-being, depression, post-traumatic stress disorder, trait-anxiety, sel f-efficacy and causal attributions, was used to evaluate predictors for sel f-reported improvement and low levels of fatigue at follow-up. Results. At follow-up, 19 % of the respondents reported complete recovery, 20 % felt much better, 57 % had the same complaints and 4 % had become wors e compared with their initial assessment. Self-reported improvement and les s severe fatigue at follow-up were predicted by less severe fatigue at init ial assessment and more perceived control over symptoms. Conclusions. Self-reported improvement was reported in a considerable perce ntage of Cambodia veterans, whereas another substantial percentage of Cambo dia veterans continued to suffer with severe levels of fatigue and related symptoms. Predictors of improvement in Cambodia veterans and patients with chronic fatigue syndrome show similarities and also seem to bear importance for Gulf War veterans.