Major depression and depressive symptoms in Australian Gulf War veterans 20 years after the Gulf War

Ikin, J. F., McKenzie, D. P., Gwini, S. M., Kelsall, H. L., Creamer, M., McFarlane, A. C., … Sim, M. (2016). Major depression and depressive symptoms in Australian Gulf War veterans 20 years after the Gulf War. Journal of Affective Disordes, 189, 77-84.


Background: Risk of major depression (depression) was elevated in Australia’s Gulf War veterans in a 2000–2002 (baseline) study. A follow up study has measured the Gulf War-related risk factors for depression, also the current prevalence and severity of depression, use of anti-depressant medication, and persistence, remittance or incidence of depression since baseline in Gulf War veterans and a military comparison group.

Methods: Participants completed the Composite International Diagnostic Interview v.2.1, the 9-item Patient Health Questionnaire and the Military Service Experience Questionnaire, and consented to Repatriation Pharmaceutical Benefits Scheme (RPBS) and PBS linkage.

Results: Prevalence of depression (9.7% Gulf War veterans and 7.7% comparison group; adj RR=1.2, 95% CI 0.8–1.7), and pattern of persistence, remittance and incidence of depression since baseline, were similar in the two groups, however veterans reported slightly more severe symptoms (adj median difference 1, 95% CI 0.26–1.74) and were more likely to have been dispensed anti-depressant medication (adj RR=1.56, 95% CI 1.05–2.32). Depression amongst veterans was associated with self-reported Gulf War-related stressors in a dose-response relationship (adj RR 1.06, 95% CI 1.02–1.09).

Limitations: Lower participation rates at follow up resulted in reduced statistical power compared with baseline, Gulf War related stressor data collected at baseline was at risk of recall bias, and RPBS and PBS databases do not capture all dispensed Nervous System medications.

Conclusions: More than 20 years after the Gulf War, veterans are experiencing slightly more severe depressive symptoms than a military comparison group, and depression continues to be associated with Gulf War-related stressors.

DOI/Australian-New Zealand Clinical Trials Registry