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Depression in Gulf War veterans: a systematic review and meta-analysis

Published online by Cambridge University Press:  20 February 2015

J. D. Blore ,
M. R. Sim ,
A. B. Forbes ,
M. C. Creamer  and
H. L. Kelsall
J. D. Blore
Affiliation:
Faculty of Medicine, Nursing and Health Sciences, Monash Centre for Occupational and Environmental Health (MonCOEH), School of Public Health and Preventive Medicine, Monash University, L5, The Alfred Centre, Melbourne, VIC, Australia Faculty of Medicine, Dentistry and Health Sciences, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
M. R. Sim
Affiliation:
Faculty of Medicine, Nursing and Health Sciences, Monash Centre for Occupational and Environmental Health (MonCOEH), School of Public Health and Preventive Medicine, Monash University, L5, The Alfred Centre, Melbourne, VIC, Australia
A. B. Forbes
Affiliation:
Faculty of Medicine, Nursing and Health Sciences, School of Public Health and Preventive Medicine, Monash University, L6, The Alfred Centre, VIC, Australia
M. C. Creamer
Affiliation:
Department of Psychiatry, Australian Centre for Posttraumatic Mental Health, The University of Melbourne, Parkville, VIC, Australia
H. L. Kelsall*
Affiliation:
Faculty of Medicine, Nursing and Health Sciences, Monash Centre for Occupational and Environmental Health (MonCOEH), School of Public Health and Preventive Medicine, Monash University, L5, The Alfred Centre, Melbourne, VIC, Australia
*
* Address for correspondence: Dr H. L. Kelsall, Monash Centre for Occupational and Environmental Health (MonCOEH), Monash University, The Alfred Centre, Commercial Road, Melbourne, VIC 3004, Australia. (Email: helen.kelsall@monash.edu)
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Abstract

Background

Although post-traumatic stress disorder (PTSD) has been a focus of attention in 1990/1991 Gulf War veterans, the excess risk of depression has not been clearly identified. We investigated this through a systematic review and meta-analysis of studies comparing depression in Gulf War veterans to depression in a comparison group of non-deployed military personnel.

Method

Multiple electronic databases and grey literature were searched from 1990 to 2012. Studies were assessed for eligibility and risk of bias according to established criteria.

Results

Of 14 098 titles and abstracts assessed, 14 studies met the inclusion criteria. Gulf War veterans had over twice the odds of experiencing depression [odds ratio (OR) 2.28, 95% confidence interval (CI) 1.88–2.76] and dysthymia or chronic dysphoria (OR 2.39, 95% CI 2.0–2.86) compared to non-deployed military personnel. This finding was robust in sensitivity analyses, and to differences in overall risk of bias and psychological measures used.

Conclusions

Despite divergent methodologies between studies, depression and dysthymia were twice as common in Gulf War veterans and are important medical conditions for clinicians and policymakers to be aware of in managing Gulf War veterans’ health.

Keywords

DepressionGulf Warmeta-analysissystematic reviewveterans
Type
Review Article
Information
Psychological Medicine , Volume 45 , Issue 8 , June 2015 , pp. 1565 - 1580
Copyright
Copyright © Commonwealth of Australia 2015 

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