Mental health comorbidity patterns and impact on quality of life among veterans serving during the first Gulf War

Valerie L. Forman-Hoffman, Caroline P. Carney, Tomoko R. Sampson, Paul M. Peloso, Robert F. Woolson, Donald W. Black, Bradley N. Doebbeling

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Purpose: To examine the patterns of coexisting (comorbid) mental disorders and whether comorbidity influences quality of life ratings in a sample of U.S. veterans. Patients and Methods: The Iowa Gulf War Study Case Validation study evaluated 602 military personnel, two-thirds of whom had symptoms of depression, cognitive dysfunction, or chronic widespread pain, who were activated or on active duty sometime during the first Gulf War (GW). Mental health disorders were defined using the SCID-IV, and the Health Utilities Index Mark 3 (HUI3) was used to measure health-related quality of life (HRQoL). Comorbidity was defined as having two or more mental disorders that spanned across at least two separate categories (e.g., depressive disorders and anxiety disorders). Results: Over 35% of veterans with a current mental disorder had at least one other comorbid mental disorder. Those with mental disorder comorbidity had lower HUI scores than veterans with only one or less mental disorders (mean 0.41 ± 0.30 vs. 0.72 ± 0.25, p < 0.0001). Conclusion: The co-occurrence of mental disorders that span at least two mental disorder categories is associated with impaired HRQoL in this veteran population. Early identification of mental health comorbidity may lead to interventions to enhance HRQoL among military personnel.

Original languageEnglish (US)
Pages (from-to)2303-2314
Number of pages12
JournalQuality of Life Research
Issue number10
StatePublished - Dec 2005
Externally publishedYes


  • Comorbidity
  • Gulf War
  • Health Utilities Index
  • Health outcomes
  • Quality of life

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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