The impact of post-traumatic stress on quality of life and fatigue in women with Gulf War Illness.
The impact of post-traumatic stress on quality of life and fatigue in women with Gulf War Illness.
复制标题
DOI：
10.1186/s40359-022-00752-5
复制
发表时间：
2022-02-25
期刊：
影响因子：
3.6
通讯作者：
Craddock TJA
中科院分区：
文献类型：
--
作者：
Shastry N;Sultana E;Jeffrey M;Collado F;Kibler J;DeLucia C;Fletcher MA;Klimas N;Craddock TJA
海湾战争疾病是一种慢性、多症状的疾病，其特征是疲劳、肌肉疼痛、认知问题、失眠、皮疹和胃肠道问题，据估计，在1990年至1991年波斯湾战争期间， ~ 750,000名退伍军人中有30%受到影响。在这场战争中，被派往战场的女退伍军人报告的医疗症状，如认知和呼吸问题，比同时代没有部署的女退伍军人的比例高出一倍。GWI症状表现的异质性使诊断和有效治疗的确定变得复杂。并存疾病的存在加剧了这一点。明确疾病的亚组可能有助于减轻这些并发症。一个明显的分组是按照性别划分的。我们的目标是确定是否可以根据创伤后应激障碍(PTSD)症状的表现将GWI女性进一步细分为不同的亚组。通过迈阿密退伍军人事务医疗健康中心招募了被诊断为退伍军人事务部的退伍军人(n = 35)和健康的久坐对照组(n = 35)。症状通过兰德简式健康调查、多维度疲劳量表和戴维森创伤量表进行评估。以创伤后应激障碍症状为协变量，对健康和疲劳的测量进行分层回归建模。随后，对两个不同的GWI组进行了单变量分析，基于他们的戴维森创伤总评分值的截止点70，并对所有测量进行异方差t检验。根据创伤后应激障碍症状在所有健康和创伤症状上发现的明显差异，在女性GWI退伍军人中产生了两个亚组。分层回归模型显示了创伤后应激障碍和严重创伤后应激障碍的共同作用，因为这两种疾病对生活质量和疲劳感都有可测量的影响(ΔR2=0.08-0.672)，在心理和情感测量上存在显著差异。总体而言，一个切入点分析表明，与那些没有创伤后应激障碍症状的GWI女性和健康对照组相比，有GWI和PTSD症状的女性的生活质量更差，在所有指标中都更疲惫。我们目前的发现支持这样一种理解，即GWI和PTSD的共同症状随后会导致较差的生活质量和疲劳，并建立了不同临床表现的可能性。
Gulf War Illness (GWI) is a chronic, multi-symptomatic disorder characterized by fatigue, muscle pain, cognitive problems, insomnia, rashes, and gastrointestinal issues affecting an estimated 30% of the ~ 750,000 returning military Veterans of the 1990–1991 Persian Gulf War. Female Veterans deployed to combat in this war report medical symptoms, like cognition and respiratory troubles, at twice the rate compared to non-deployed female Veterans of the same era. The heterogeneity of GWI symptom presentation complicates diagnosis as well as the identification of effective treatments. This is exacerbated by the presence of co-morbidities. Defining subgroups of the illness may help alleviate these complications. One clear grouping is along the lines of gender. Our aim is to determine if women with GWI can be further subdivided into distinct subgroups based on post-traumatic stress disorder (PTSD) symptom presentation. Veterans diagnosed with GWI (n = 35) and healthy sedentary controls (n = 35) were recruited through the Miami Veterans Affairs Medical Health Center. Symptoms were assessed via the RAND short form health survey, the multidimensional fatigue inventory, and the Davidson trauma scale. Hierarchal regression modeling was performed on measures of health and fatigue with PTSD symptoms as a covariate. This was followed by univariate analyses conducted with two separate GWI groups based on a cut-point of 70 for their total Davidson trauma scale value and performing heteroscedastic t-tests across all measures. Based on the distinct differences found in PTSD symptomology regarding all health and trauma symptoms, two subgroups were derived within female GWI Veterans. Hierarchical regression models displayed the comorbid effects of GWI and PTSD, as both conditions had measurable impacts on quality of life and fatigue (ΔR2 = 0.08–0.672), with notable differences in mental and emotional measures. Overall, a cut point analysis indicated poorer quality of life and greater fatigue within all measures for women with GWI and PTSD symptoms in comparison to those women with GWI without PTSD symptoms and healthy controls. Our current findings support the understanding that comorbid symptoms of GWI and PTSD subsequently result in poorer quality of life and fatigue, along with establishing the possibility of varying clinical presentations.
登录
查看更多内容
DOI：
10.1016/s0197-2456(02)00192-7
发表时间：
2002-06-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
Collins, JF;Donta, ST;Feussner, JR
通讯作者：
Feussner, JR
DOI：
10.1097/jom.0000000000000627
发表时间：
2016-01-01
影响因子：
3.2
作者：
Dursa, Erin K.;Barth, Shannon K.;Bossarte, Robert M.
通讯作者：
Bossarte, Robert M.
DOI：
10.15436/2378-6841.17.1551
发表时间：
2017
期刊：
Journal of environment and health sciences
影响因子：
--
作者：
Coughlin SS;Krengel M;Sullivan K;Pierce PF;Heboyan V;Wilson LCC
通讯作者：
Wilson LCC
DOI：
10.1111/j.2517-6161.1995.tb02031.x
发表时间：
1995-01-01
影响因子：
5.8
作者：
BENJAMINI, Y;HOCHBERG, Y
通讯作者：
HOCHBERG, Y
影响因子：
5.5
作者：
Barrett, DH;Gray, GC;Reeves, WC
通讯作者：
Reeves, WC