U.S. vets with Gulf War Syndrome need individualized treatment, report says

The Institute of Medicine calls the syndrome a 'very real, highly diverse' condition.

(HealthDay)—A one-size-fits-all approach to treating U.S. veterans with Gulf War Syndrome does not work, and therapy needs to be tailored to meet each patient's needs, according to a new Institute of Medicine report released Wednesday.

The document—written as part of the institute's congressionally mandated Gulf War and Health series—evaluates the various treatments for Gulf War Syndrome in veterans of the 1991 conflict and recommends best approaches to managing their care.

The official name for Gulf War Syndrome is chronic multisystem illness (CMI), which is defined as having symptoms in at least two of six categories—fatigue, mood and cognition (thinking ability and memory), musculoskeletal, gastrointestinal, respiratory and neurologic—for at least six months.

The condition affects at least one-third of veterans of the 1991 Persian Gulf War. Similar symptoms have been reported in many military personnel who served in the more recent wars in Iraq and Afghanistan.

"Based on the voluminous evidence we reviewed, our committee cannot recommend using one universal therapy to manage the health of veterans with chronic multi-symptom illness, and we reject a one-size-fits-all treatment approach," committee chairman Bernard Rosof, chairman of the board of directors at Huntington Hospital, in Huntington, N.Y., said in an institute news release. "Instead, we endorse individualized health care management plans as the best approach for treating this very real, highly diverse condition."

The report listed many treatment approaches that might help these veterans, including certain antidepressant drugs and cognitive behavioral therapy. Other possibilities mentioned for further research include biofeedback, aerobic exercise and acupuncture.

The U.S. Department of Veterans Affairs should adopt a new strategy of creating "CMI champions" to help its health care providers better assist Gulf War Syndrome patients, who often have complex symptoms and needs, the report said.

To improve the government's ability to identify veterans with Gulf War Syndrome, patients' electronic medical records should prompt health care providers to ask patients about possible symptoms, the report recommended.

In addition, veterans should undergo a comprehensive health examination immediately after they leave active duty, and the results of these exams should be available to health care providers both within and outside the VA health system to ensure continuity of care.

The cause or causes of Gulf War Syndrome will never fully be determined, the report said, but this does not mean that veterans' reports of symptoms are not legitimate.

More information: The U.S. Department of Veterans Affairs has more about Gulf War veterans' illnesses.

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"U.S. vets with Gulf War Syndrome need individualized treatment, report says." January 23rd, 2013. http://medicalxpress.com/news/2013-01-vets-gulf-war-syndrome-individualized.html

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Robert Karl Stonjek