ABSTRACT
Prior studies of mental health consequences of the Gulf War [GW] have been confined to Allied forces, limiting the ability to control for important geographically and culturally-related factors. We conducted an epidemiological mental health study among Iraqi soldiers and civilians who are still residing in Iraq. This group has been exposed to sustained socio-environmental stress. A cross-sectional sample of 742 Iraqi GW veterans and 413 civilians responded to a validated mental health survey. The response rate was 96.3%. Mental health disorders, including post traumatic stress disorder [PTSD], were classified using both self-reports and validated scales. War-related exposure was calculated using the sum score of items assessing trauma exposure. Iraqi soldiers reported significantly more depression [Odds Ratio [OR] 4.9; 95% confidence interval [CI] 2.2-11.1] and anxiety [OR 3.9; 95% CI, 1.2-13.3] compared to civilians, adjusting for age, education, and smoking. Soldiers closest to Kuwait during the GW reported significantly more depression compared to soldiers deployed further away from the war epicenter [OR 104.6; 95% CI, 28.0-390.8] and anxiety [OR 4.1; 95% CI, 1.5-11.1]. The highest self-reported trauma exposure occurred in the southwest of Iraq. Iraqi soldiers that took part in the GW are at increased risk suffering from many of the same mental health disorders plaguing Allied soldiers. Soldiers closest to Kuwait were more at risk, suggesting a direct link to war-specific environmental exposures, although self-reported trauma exposure was higher in the southwest of Iraq. The study offers additional insights into the mental health consequences of living under sustained socio-environmental stress, originating from the Iraqi war. The study points out socio-environmental factors worthy of further explorations