Quality of Life in Gulf War Veterans: the Influence of Recency and Persistence of Psychiatric Morbidity
Important contributors to quality of life (QOL), such as psychosocial factors, have received limited exploration in veteran populations, in contrast to a significant amount of research focused on health-related quality of life (HRQL). This study investigated QOL and HRQL amongst Gulf War veterans compared with an era-military comparison group 20 years after the 1990/91 Gulf War, and whether psychiatric status over time and psychiatric comorbidities predicted QOL and HRQL. We then investigated which of a range of psychological health, physical health and social factors contribute greatest to QOL. Psychological interviews and postal questionnaires were administered to a cohort of Gulf War veterans and a military-era comparison group in 2000–02 and 2011–12. Gulf War veterans had poorer QOL and HRQL compared with a military comparison group, but the pattern of factors that influenced QOL was the same for both groups. Poorer QOL and HRQL were significantly associated with more recent and persistent psychiatric morbidity over time. Further analyses showed that affective disorders, followed by anxiety disorders had the largest impact on QOL and HRQL, and that QOL and HRQL were negatively affected by each additional psychiatric diagnosis. The importance of these findings was highlighted in a structural equation model that revealed psychological health contributed most to QOL, social support contributed a moderate amount, but physical health contributed only a very small amount. QOL in veterans is an important issue even many years after deployment and psychological health plays a predominant role in QOL.
KeywordsQuality of life Wellbeing Gulf War Veterans Military psychology Psychological health
Compliance with Ethical Standards
Conflict of Interest
The authors declare no conflicts of interest.
The article has been produced using funding provided by the Australian Department of Veterans’ Affairs. However, the views expressed in the article do not necessarily represent the views of the Minister for Veterans’ Affairs or the Department of Veterans’ Affairs. The Commonwealth does not give any warranty nor accept any liability in relation to the contents of this work.
- Chan, Y.-F., Huang, H., Bradley, K., & Unützer, J. (2014). Referral for substance abuse treatment and depression improvement among patients with co-occurring disorders seeking behavioral health services in primary care. Journal of Substance Abuse Treatment, 46, 106–112. https://doi.org/10.1016/j.jsat.2013.08.016.CrossRefGoogle Scholar
- Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale: Erlbaum.Google Scholar
- Forman-Hoffman, V. L., Carney, C. P., Sampson, T. R., Peloso, P. M., Woolson, R. F., Black, D. W., et al. (2005). Mental health comorbidity patterns and impact on quality of life among veterans serving during the first Gulf War. Quality of Life Research: an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 14(10), 2303–2314.CrossRefGoogle Scholar
- Slade, T., Johnston, A., Oakley Browne, M. A., Andrews, G., & Whiteford, H. (2009). 2007 national survey of mental health and wellbeing: methods and key findings. Australasian Psychiatry, 43(7), 594–605.Google Scholar
- Weathers, F. W., Litz, B. T., Herman, D. S., Huska, J. A., & Keane, T. M. (1993). The PTSD checklist (PCL): reliability, validity, and diagnostic utility. Paper presented at the 9th Annual Conference of the International Society for Traumatic Stress Studies. San Antonio.Google Scholar
- World Health Organisation. (1997). Composite international diagnostic interview CIDI auto 2.1 administrator's guide and reference. Geneva: World Health Organisation.Google Scholar