Chronic Widespread Pain in Veterans of the First Gulf War: Impact of Deployment Status and Associated Health Effects

  • Valerie L. Forman-Hoffman
    Address reprint requests to Dr. Valerie Forman Hoffman, The University of Iowa, Roy J. and Lucille A. Carver College of Medicine, 200 Hawkins Drive, SE 605-GH, Iowa City, IA, 52242.
    Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP), Iowa City Veteran’s Affairs Medical Center, Iowa City, Iowa.

    Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa.

    Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa.
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  • Paul M. Peloso
    Amgen, Inc., Thousand Oaks, California.
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  • Donald W. Black
    Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, Iowa.
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  • Robert F. Woolson
    Department of Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina, Charleston, South Carolina.
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  • Elena M. Letuchy
    Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa.
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  • Bradley N. Doebbeling
    Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, Indiana.

    Indiana University Center for Health Services and Outcomes Research, Regenstrief Institute, Inc., IU School of Medicine, Indianapolis, Indiana.

    Center for Implementing Evidence-based Practice (CIEBP), Health Services Research Service, Roudebush VA Medical Center, Indianapolis, Indiana.
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Published:August 20, 2007DOI:


      Our study sought to 1) determine if deployment status is associated with chronic widespread pain (CWP), and 2) evaluate whether veterans with CWP have greater psychiatric comorbidity, higher health care utilization, and poorer health status than veterans without CWP. Five years after the conclusion of the first Gulf War (August 1990 to June 1991), we conducted a cross-sectional study of veterans who listed Iowa as the home of record using a stratified sampling design to determine their health status. We compared the prevalence of CWP between deployed and nondeployed veterans. Logistic and multiple linear regression models were constructed to test whether CWP was associated with comorbidities and health-related outcomes of interest. Five hundred ninety of 3695 veterans interviewed (16%) had CWP. Gulf deployment was associated with higher prevalence of CWP than deployment elsewhere (OR = 2.03, 95%CI = 1.60–2.58), after adjustment. Both deployed and nondeployed veterans with CWP reported more health care utilization and comorbidities and lower health-related quality of life scores than veterans without CWP. Deployed veterans were more likely to have CWP than nondeployed veterans, and CWP was associated with poor health outcomes. Military and medical personnel should be aware that efforts to prevent, identify, and treat CWP in veterans returning from the current war may be needed.


      This article indicates that deployed veterans may have an increased risk for development of CWP, which is associated with greater healthcare utilization and comorbidity and lower quality of life. The risk of poor health outcomes suggests that veterans returning from the present conflict should be screened for CWP on their return.

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