Is there a Gulf War syndrome? Searching for syndromes by factor analysis of symptoms

Robert W. Haley, Thomas L. Kurt, Jim Hom

Research output: Contribution to journalArticle

283 Citations (Scopus)

Abstract

Objective. - To search for syndromes in Persian Gulf War veterans. Participants. - Two hundred forty-nine (41%) of the 606 Gulf War veterans of the Twenty-fourth Reserve Naval Mobile Construction Battalion living in 5 southeastern states participated; 145 (58%) had retired from service, and the rest were still serving in the battalion. Design. - Participants completed a standardized survey booklet measuring the anatomical distributions or characteristics of each symptom, a booklet measuring wartime exposures, and a standard psychological personality assessment inventory. Two-stage factor analysis was used to disentangle ambiguous symptoms and identity syndromes. Main Outcome Measures. - Factor analysis-derived syndromes. Results. - Of 249 participants, 175 (70%) reported having had serious health problems that most attributed to the war, and 74 (30%) reported no serious health problems. Principal factor analysis yielded 6 syndrome factors, explaining 71% of the variance. Dichotomized syndrome indicators identified the syndromes in 63 veterans (25%). Syndromes 1 ('impaired cognition,' characterized by problems with attention, memory, and reasoning, as well as insomnia, depression, daytime sleepiness, and headaches), 2 ('confusion-ataxia,' characterized by problems with thinking, disorientation, balance disturbances, vertigo, and impotence), and 3 ('arthro-myo-neuropathy,' characterized by joint and muscle pains, muscle fatigue, difficulty lifting, and extremity paresthesias) represented strongly clustered symptoms; whereas, syndromes 4 ('phobia- apraxia'), 5 ('fever-adenopathy'), and 6 ('weakness-incontinence') involved weaker clustering and mostly overlapped syndromes 2 and 3. Veterans with syndrome 2 were 12.5 times (95% confidence interval, 3.5-44.8) more likely to be unemployed than those with no health problems. A psychological profile, found in 48.4% of those with the syndromes, differed from posttraumatic stress disorder, depression, somatoform disorder, and malingering. Conclusion. - These findings support the hypothesis that clusters of symptoms of many Gulf War veterans represent discrete factor analysis-derived syndromes that appear to reflect a spectrum of neurologic injury involving the central, peripheral, and autonomic nervous systems.

Original languageEnglish (US)
Pages (from-to)215-222
Number of pages8
JournalJournal of the American Medical Association
Volume277
Issue number3
StatePublished - Jan 15 1997

Fingerprint

Persian Gulf Syndrome
Statistical Factor Analysis
Veterans
Gulf War
Confusion
Pamphlets
Health
Malingering
Depression
Psychology
Personality Assessment
Nervous System Trauma
Apraxias
Personality Inventory
Muscle Fatigue
Somatoform Disorders
Paresthesia
Phobic Disorders
Myalgia
Vertigo

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Is there a Gulf War syndrome? Searching for syndromes by factor analysis of symptoms. / Haley, Robert W.; Kurt, Thomas L.; Hom, Jim.

In: Journal of the American Medical Association, Vol. 277, No. 3, 15.01.1997, p. 215-222.

Research output: Contribution to journalArticle

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abstract = "Objective. - To search for syndromes in Persian Gulf War veterans. Participants. - Two hundred forty-nine (41{\%}) of the 606 Gulf War veterans of the Twenty-fourth Reserve Naval Mobile Construction Battalion living in 5 southeastern states participated; 145 (58{\%}) had retired from service, and the rest were still serving in the battalion. Design. - Participants completed a standardized survey booklet measuring the anatomical distributions or characteristics of each symptom, a booklet measuring wartime exposures, and a standard psychological personality assessment inventory. Two-stage factor analysis was used to disentangle ambiguous symptoms and identity syndromes. Main Outcome Measures. - Factor analysis-derived syndromes. Results. - Of 249 participants, 175 (70{\%}) reported having had serious health problems that most attributed to the war, and 74 (30{\%}) reported no serious health problems. Principal factor analysis yielded 6 syndrome factors, explaining 71{\%} of the variance. Dichotomized syndrome indicators identified the syndromes in 63 veterans (25{\%}). Syndromes 1 ('impaired cognition,' characterized by problems with attention, memory, and reasoning, as well as insomnia, depression, daytime sleepiness, and headaches), 2 ('confusion-ataxia,' characterized by problems with thinking, disorientation, balance disturbances, vertigo, and impotence), and 3 ('arthro-myo-neuropathy,' characterized by joint and muscle pains, muscle fatigue, difficulty lifting, and extremity paresthesias) represented strongly clustered symptoms; whereas, syndromes 4 ('phobia- apraxia'), 5 ('fever-adenopathy'), and 6 ('weakness-incontinence') involved weaker clustering and mostly overlapped syndromes 2 and 3. Veterans with syndrome 2 were 12.5 times (95{\%} confidence interval, 3.5-44.8) more likely to be unemployed than those with no health problems. A psychological profile, found in 48.4{\%} of those with the syndromes, differed from posttraumatic stress disorder, depression, somatoform disorder, and malingering. Conclusion. - These findings support the hypothesis that clusters of symptoms of many Gulf War veterans represent discrete factor analysis-derived syndromes that appear to reflect a spectrum of neurologic injury involving the central, peripheral, and autonomic nervous systems.",
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