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L. A. Tiersky, B. H. Natelson, J. Ottenweller,
G. Lange, N. Fiedler, and J. DeLuca
Persian Gulf Research Center, DVA Medical Center, East
Orange, NJ and
Departments of Neurosciences and PM&R, New Jersey Medical School,
Newark, NJ
Objective: The purpose of this investigation was
to determine if: 1) psychiatric disturbance can explain the reduced overall
functional ability observed in GWVs with unexplained fatigue and, 2) if
psychiatric disturbance has an additive effect on functional disability
and well-being in GWVs with fatigue.
Method: Subjects underwent a comprehensive physical
and psychological evaluation and completed measures of functional status,
employment status, fatigue, and mood. The evaluation protocol produced
three subject groups: 1) 29 GWVs with fatigue and a psychiatric diagnosis(es);
2) 19 GWVs with only unexplained fatigue; and 3) 45 Healthy GWVs.
Results: GWVs with unexplained fatigue were found
to suffer from significant functional decline and decreased well-being
in all spheres relative to healthy GWVs. Moreover, veterans with psychiatric
illnesses were the most impaired, relative to the other groups, on measures
of life quality that emphasized psychological well-being. However, the
group with psychiatric illness(es) did not demonstrate reduced physical
functioning relative to the other fatigued veteran group.
Conclusions: Reduced physical functioning and well-being
in GWVs can not be attributed to psychiatric disturbance, but do seem
to result from fatiguing illness. Psychiatric disturbance appears to primarily
effect emotional well-being, and does not have an additive effect on declines
in physical functioning in GWVs with fatigue. Treatment efforts should
be targeted to both of the sick veteran groups, as both groups evidence
significant disability. Interventions should be geared towards reducing
fatigue.
KEYWORDS: Functional Status, Gulf War, Health Status
This research was supported by the Department of Veterans
Affairs through the new Jersey Center for Environmental Hazards Research |
