Posttraumatic stress symptomatology is associated with unexplained illnessattributed to Persian Gulf War military service

Objective: Controversy exists concerning unexplained illness in Persian Gul f War veterans, especially regarding the contribution of psychological trau ma. We sought to determine if war zone trauma or posttraumatic stress sympt omatology (PTSS) are associated with illnesses reported by Gulf War veteran s that were documented by medical examination but not attributable to a med ical diagnosis. Methods: A total of 1119 (55% response rate) of 2022 random ly sampled veterans of the United States Persian Gulf War were screened and 237 cases and 113 controls were identified by medical examination for a ca se-control study comparing Persian Gulf War military veterans with or witho ut medically documented, but unexplained, symptoms. Multivariate logistic r egression and cross-validation analyses examined self-report measures of de mographics, subjective physical symptoms and functioning, psychiatric sympt oms, stressors, war zone trauma, and PTSS, to identify correlates of case-c ontrol status. Results: Posttraumatic stress symptomatology and somatic com plaints were independently associated with case status, as were (although l ess consistently) war zone trauma and depression. Age, education, and self- reported health, stress-related somatization, pain, energy/fatigue, illness -related functional impairment, recent stressors, and anxiety were univaria te (but not multivariate) correlates of case status. Conclusions: PTSS rela ted to war zone trauma warrants additional prospective research study and a ttention in clinical screening and assessment as a potential contributor to the often debilitating physical health problems experienced by Persian Gul f War veterans.