ABSTRACT
Clinical research of veterans' illnesses from the neuropsychology and medical literature are reviewed. Some studies reveal no significant findings, while others indeed detect a higher incidence of clinical and laboratory abnormalities in veterans of Operations Desert Storm and Desert Shield. Neuropsychological deficits are negligible and more often associated with affective, than cognitive, disruption. Some explanations of the results are offered, as are recommendations regarding the utility of clinical research.
Subject(s)
Cognition Disorders/diagnosis , Cognition Disorders/etiology , Persian Gulf Syndrome/psychology , Humans , Neuropsychological Tests , Veterans/psychologySubject(s)
Persian Gulf Syndrome , Biological Warfare , Chemical Warfare , Humans , Mental Disorders/epidemiology , Mental Disorders/etiology , Morbidity , Multiple Chemical Sensitivity , Persian Gulf Syndrome/epidemiology , Persian Gulf Syndrome/etiology , Stress, Psychological/epidemiology , Stress, Psychological/etiology , VeteransABSTRACT
Eighty-two Persian Gulf War veterans seen in clinic were referred for neuropsychological evaluation. Relatedness of neuropsychological and neurological functioning to subjective complaint, exposure, a clinical signs index, and possible interference variables was examined in a subsample of 49 who completed assessment. The subsample was representative of the entire group with respect to symptom severity. Variables representing sustained attention, grip strength, motor coordination, vibratory sense, finger-tip number writing perception, executive functioning, memory functioning, and subjective complaint were considered. Neuropsychological performance appeared to be more related to emotional functioning than demographic variables or variables associated with the war. Individual differences may be contributing to different emotional reactions to illnesses, perceptions of exposure risks and cognitive functioning, and responses to stress.
Subject(s)
Neuropsychological Tests , Persian Gulf Syndrome/psychology , Adult , Female , Humans , MMPI , Male , Middle Aged , Regression Analysis , Somatoform Disorders/psychology , VeteransABSTRACT
In response to ongoing complaints of memory, attention, and problem-solving difficulties among veterans of Operation Desert Storm and Shield (ODSS), a sample of 44 male veterans of ODSS underwent a comprehensive neuropsychological evaluation. Deficits relative to normative data were observed only on finger dexterity (Grooved Pegboard, bilaterally) and the Stroop Color and Word Test. Those with impaired Pegboard performance had lower performance on other tasks requiring psychomotor speed. Those with impaired Stroop had significantly lower motor and set-shifting performance. Scores of both impaired groups were higher on many clinical and supplemental scales of the MMPI. Despite subjective cognitive complaints reported in 39% of the overall sample, veterans with cognitive complaints differed from their peers primarily in greater psychological distress as depicted on the MMPI. The data are presented as preliminary clinical findings.
Subject(s)
Persian Gulf Syndrome/psychology , Veterans/psychology , Adult , Humans , Intelligence Tests , Learning , MMPI , Male , Memory/physiology , Neuropsychological Tests , Problem Solving , Psychomotor PerformanceABSTRACT
The safety and short-term effectiveness of home detoxification (HD) was investigated by contrasting rates of treatment completion and of complications of 41 service users with those of a retrospectively matched inpatient comparison group. The latter comprised patients of a detoxification unit matched for age, sex and degree of alcohol dependence with HD subjects. HD subjects had severe problems with alcohol--they averaged 28.7 on the SADQ, 4.6 serious alcohol-related problems in the previous 2 months, a GGT of 123.8 and 174.6 reported units of alcohol consumed in the week before treatment. A high follow-up rate was achieved for both HD subjects and their relatives; there was close agreement between clients' reports, carers' reports and breathalyser readings with regard to further alcohol consumption. The HD subjects were visited at home an average of 6.9 times over 6.15 days. Chlormethiazole was prescribed in 36 cases at an average maximum daily dose of 6.3 capsules--significantly fewer than for the inpatient group. Both rates of completion and complication were virtually identical in the 2 groups. It is concluded that these data suggest HD is equivalent in both its safety and immediate efficacy to more expensive inpatient care.
Subject(s)
Alcohol Withdrawal Delirium/rehabilitation , Alcoholism/rehabilitation , Home Care Services , Hospitalization , Adult , Ethanol/pharmacokinetics , Female , Humans , Male , Neurologic Examination , Outcome and Process Assessment, Health CareABSTRACT
The value of a new Home Detoxification service was assessed in a variety of ways employing data collected from 41 clients of the service, their family and GP's. By 60 days from the start of treatment, 11 clients were abstinent, two were controlling their drinking with relatively few problems, 13 had 'improved', 14 were not 'improved' and one had an unknown outcome. Subsequent involvement in treatment by both clients and their partners was high in comparison with other studies. Significant predictors of 'Good' outcome included attendance for after-care by client and by spouse/partner and a low Alcohol Problems Inventory score. High levels of satisfaction were expressed with the HD service by clients, their carers and GP's. The great majority of clients gave 'home' as their preferred place of treatment and nearly half claimed they would have been unwilling to accept hospital care. There was evidence of significant, though modest, shifts in GP's management practices towards less use of hospitals and greater use of the patient's home after 15 months of the programme.
