Under-recognition of medically unexplained symptom conditions among US Veterans with Gulf War Illness

Conditions defined by persistent "medically unexplained" physical symptoms and syndromes (MUS) are common and disabling. Veterans from the Gulf War (deployed 1990-1991) have notably high prevalence and disability from MUS conditions. Individuals with MUS report that providers do not recogn...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:PloS one 2021-12, Vol.16 (12), p.e0259341
Hauptverfasser: Kane, Naomi S, Anastasides, Nicole, Litke, David R, Helmer, Drew A, Hunt, Stephen C, Quigley, Karen S, Pigeon, Wilfred R, McAndrew, Lisa M
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page
container_issue 12
container_start_page e0259341
container_title PloS one
container_volume 16
creator Kane, Naomi S
Anastasides, Nicole
Litke, David R
Helmer, Drew A
Hunt, Stephen C
Quigley, Karen S
Pigeon, Wilfred R
McAndrew, Lisa M
description Conditions defined by persistent "medically unexplained" physical symptoms and syndromes (MUS) are common and disabling. Veterans from the Gulf War (deployed 1990-1991) have notably high prevalence and disability from MUS conditions. Individuals with MUS report that providers do not recognize their MUS conditions. Our goal was to determine if Veterans with MUS receive an ICD-10 diagnosis for a MUS condition or receive disability benefits available to them for these conditions. A chart review was conducted with US Veterans who met case criteria for Gulf War Illness, a complex MUS condition (N = 204, M = 53 years-old, SD = 7). Three coders independently reviewed Veteran's medical records for MUS condition diagnosis or service-connection along with comorbid mental and physical health conditions. Service-connection refers to US Veterans Affairs disability benefits eligibility for conditions or injuries experienced during or exacerbated by military service. Twenty-nine percent had a diagnosis of a MUS condition in their medical record, the most common were irritable colon/irritable bowel syndrome (16%) and fibromyalgia (11%). Slightly more Veterans were service-connected for a MUS condition (38%) as compared to diagnosed. There were high rates of diagnoses and service-connection for mental health (diagnoses 76% and service-connection 74%), musculoskeletal (diagnoses 86%, service-connection 79%), and illness-related conditions (diagnoses 98%, service-connection 49%). Given that all participants were Gulf War Veterans who met criteria for a MUS condition, our results suggest that MUS conditions in Gulf War Veterans are under-recognized with regard to clinical diagnosis and service-connected disability. Veterans were more likely to be diagnosed and service-connected for musculoskeletal-related and mental health conditions than MUS conditions. Providers may need education and training to facilitate diagnosis of and service-connection for MUS conditions. We believe that greater acknowledgement and validation of MUS conditions would increase patient engagement with healthcare as well as provider and patient satisfaction with care.
doi_str_mv 10.1371/journal.pone.0259341
format Article
fullrecord <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_2607595612</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A685742462</galeid><doaj_id>oai_doaj_org_article_7b748b54d1cf45f1ba160e29edf44231</doaj_id><sourcerecordid>A685742462</sourcerecordid><originalsourceid>FETCH-LOGICAL-c692t-404ae46d9367d576360d4fec112f3e0b54dafae0d7cc503dcce83a8d5c6350fa3</originalsourceid><addsrcrecordid>eNqNklFrFDEUhQdRbK3-A9EBQfBh12SSycy8CKVoXSgUrFsfQza5mU3JJGsyo91_b3Z3WnZAQfKQcPPdk-TkZNlrjOaYVPjjnR-CE3a-8Q7mqCgbQvGT7BQ3pJixApGnR-uT7EWMdwiVpGbseXZCaF3RhjSnGSydgjALIH3rTG-8y73OO1BGCmu3-eDgfmOFcaDyuO02ve9y6Z3aozEXnXdtvrzJb6GHIFLlt-nX-eVgdf5DhHxhrYMYX2bPtLARXo3zWbb88vn7xdfZ1fXl4uL8aiZZU_QziqgAylRDWKXKihGGFNUgMS40AbQqqRJaAFKVlCUiSkqoiahVKRkpkRbkLHt70N1YH_noUOQFQ1XZlAwXiVgcCOXFHd8E04mw5V4Yvi_40HIReiMt8GpV0Xp3JpaalhqvBGYIigaUprQgOGl9Gk8bVskxCa4Pwk5EpzvOrHnrf_GalelJJAm8GwWC_zlA7P9x5ZFqRbqVcdonMdmZKPk5q8uKFpTtqPlfqDQUdCb9GGiT6pOGD5OGxPRw37diiJEvbr79P3t9O2XfH7FrELZfR2-HfWCmID2AMvgYA-hH5zDiu4g_uMF3EedjxFPbm2PXH5seMk3-AGEx-Dc</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2607595612</pqid></control><display><type>article</type><title>Under-recognition of medically unexplained symptom conditions among US Veterans with Gulf War Illness</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>PubMed (Medline)</source><source>Free E-Journal (出版社公開部分のみ)</source><source>PLoS_OA刊</source><source>Free Full-Text Journals in Chemistry</source><creator>Kane, Naomi S ; Anastasides, Nicole ; Litke, David R ; Helmer, Drew A ; Hunt, Stephen C ; Quigley, Karen S ; Pigeon, Wilfred R ; McAndrew, Lisa M</creator><contributor>Chao, Linda</contributor><creatorcontrib>Kane, Naomi S ; Anastasides, Nicole ; Litke, David R ; Helmer, Drew A ; Hunt, Stephen C ; Quigley, Karen S ; Pigeon, Wilfred R ; McAndrew, Lisa M ; Chao, Linda</creatorcontrib><description>Conditions defined by persistent "medically unexplained" physical symptoms and syndromes (MUS) are common and disabling. Veterans from the Gulf War (deployed 1990-1991) have notably high prevalence and disability from MUS conditions. Individuals with MUS report that providers do not recognize their MUS conditions. Our goal was to determine if Veterans with MUS receive an ICD-10 diagnosis for a MUS condition or receive disability benefits available to them for these conditions. A chart review was conducted with US Veterans who met case criteria for Gulf War Illness, a complex MUS condition (N = 204, M = 53 years-old, SD = 7). Three coders independently reviewed Veteran's medical records for MUS condition diagnosis or service-connection along with comorbid mental and physical health conditions. Service-connection refers to US Veterans Affairs disability benefits eligibility for conditions or injuries experienced during or exacerbated by military service. Twenty-nine percent had a diagnosis of a MUS condition in their medical record, the most common were irritable colon/irritable bowel syndrome (16%) and fibromyalgia (11%). Slightly more Veterans were service-connected for a MUS condition (38%) as compared to diagnosed. There were high rates of diagnoses and service-connection for mental health (diagnoses 76% and service-connection 74%), musculoskeletal (diagnoses 86%, service-connection 79%), and illness-related conditions (diagnoses 98%, service-connection 49%). Given that all participants were Gulf War Veterans who met criteria for a MUS condition, our results suggest that MUS conditions in Gulf War Veterans are under-recognized with regard to clinical diagnosis and service-connected disability. Veterans were more likely to be diagnosed and service-connected for musculoskeletal-related and mental health conditions than MUS conditions. Providers may need education and training to facilitate diagnosis of and service-connection for MUS conditions. We believe that greater acknowledgement and validation of MUS conditions would increase patient engagement with healthcare as well as provider and patient satisfaction with care.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0259341</identifier><identifier>PMID: 34874939</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Aged ; Chronic fatigue syndrome ; Coders ; Colon ; Criteria ; Diagnosis ; Female ; Fibromyalgia ; Gulf War ; Gulf War syndrome ; Health aspects ; Health care ; Health care policy ; Humans ; Illnesses ; International Classification of Diseases ; Irritable bowel syndrome ; Male ; Medical records ; Medically Unexplained Symptoms ; Medicine and health sciences ; Mental disorders ; Mental health ; Middle Aged ; Migraine ; Military ; Military personnel ; Patients ; Persian Gulf Syndrome - epidemiology ; Persian Gulf War ; Persian Gulf War veterans ; Prevalence ; Problem Solving ; Social Sciences ; Somatoform disorders ; United States - epidemiology ; United States Department of Veterans Affairs ; Veterans ; Veterans Disability Claims ; War</subject><ispartof>PloS one, 2021-12, Vol.16 (12), p.e0259341</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication: https://creativecommons.org/publicdomain/zero/1.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-404ae46d9367d576360d4fec112f3e0b54dafae0d7cc503dcce83a8d5c6350fa3</citedby><cites>FETCH-LOGICAL-c692t-404ae46d9367d576360d4fec112f3e0b54dafae0d7cc503dcce83a8d5c6350fa3</cites><orcidid>0000-0002-1350-8773</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8651123/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8651123/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34874939$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Chao, Linda</contributor><creatorcontrib>Kane, Naomi S</creatorcontrib><creatorcontrib>Anastasides, Nicole</creatorcontrib><creatorcontrib>Litke, David R</creatorcontrib><creatorcontrib>Helmer, Drew A</creatorcontrib><creatorcontrib>Hunt, Stephen C</creatorcontrib><creatorcontrib>Quigley, Karen S</creatorcontrib><creatorcontrib>Pigeon, Wilfred R</creatorcontrib><creatorcontrib>McAndrew, Lisa M</creatorcontrib><title>Under-recognition of medically unexplained symptom conditions among US Veterans with Gulf War Illness</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Conditions defined by persistent "medically unexplained" physical symptoms and syndromes (MUS) are common and disabling. Veterans from the Gulf War (deployed 1990-1991) have notably high prevalence and disability from MUS conditions. Individuals with MUS report that providers do not recognize their MUS conditions. Our goal was to determine if Veterans with MUS receive an ICD-10 diagnosis for a MUS condition or receive disability benefits available to them for these conditions. A chart review was conducted with US Veterans who met case criteria for Gulf War Illness, a complex MUS condition (N = 204, M = 53 years-old, SD = 7). Three coders independently reviewed Veteran's medical records for MUS condition diagnosis or service-connection along with comorbid mental and physical health conditions. Service-connection refers to US Veterans Affairs disability benefits eligibility for conditions or injuries experienced during or exacerbated by military service. Twenty-nine percent had a diagnosis of a MUS condition in their medical record, the most common were irritable colon/irritable bowel syndrome (16%) and fibromyalgia (11%). Slightly more Veterans were service-connected for a MUS condition (38%) as compared to diagnosed. There were high rates of diagnoses and service-connection for mental health (diagnoses 76% and service-connection 74%), musculoskeletal (diagnoses 86%, service-connection 79%), and illness-related conditions (diagnoses 98%, service-connection 49%). Given that all participants were Gulf War Veterans who met criteria for a MUS condition, our results suggest that MUS conditions in Gulf War Veterans are under-recognized with regard to clinical diagnosis and service-connected disability. Veterans were more likely to be diagnosed and service-connected for musculoskeletal-related and mental health conditions than MUS conditions. Providers may need education and training to facilitate diagnosis of and service-connection for MUS conditions. We believe that greater acknowledgement and validation of MUS conditions would increase patient engagement with healthcare as well as provider and patient satisfaction with care.</description><subject>Adult</subject><subject>Aged</subject><subject>Chronic fatigue syndrome</subject><subject>Coders</subject><subject>Colon</subject><subject>Criteria</subject><subject>Diagnosis</subject><subject>Female</subject><subject>Fibromyalgia</subject><subject>Gulf War</subject><subject>Gulf War syndrome</subject><subject>Health aspects</subject><subject>Health care</subject><subject>Health care policy</subject><subject>Humans</subject><subject>Illnesses</subject><subject>International Classification of Diseases</subject><subject>Irritable bowel syndrome</subject><subject>Male</subject><subject>Medical records</subject><subject>Medically Unexplained Symptoms</subject><subject>Medicine and health sciences</subject><subject>Mental disorders</subject><subject>Mental health</subject><subject>Middle Aged</subject><subject>Migraine</subject><subject>Military</subject><subject>Military personnel</subject><subject>Patients</subject><subject>Persian Gulf Syndrome - epidemiology</subject><subject>Persian Gulf War</subject><subject>Persian Gulf War veterans</subject><subject>Prevalence</subject><subject>Problem Solving</subject><subject>Social Sciences</subject><subject>Somatoform disorders</subject><subject>United States - epidemiology</subject><subject>United States Department of Veterans Affairs</subject><subject>Veterans</subject><subject>Veterans Disability Claims</subject><subject>War</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNklFrFDEUhQdRbK3-A9EBQfBh12SSycy8CKVoXSgUrFsfQza5mU3JJGsyo91_b3Z3WnZAQfKQcPPdk-TkZNlrjOaYVPjjnR-CE3a-8Q7mqCgbQvGT7BQ3pJixApGnR-uT7EWMdwiVpGbseXZCaF3RhjSnGSydgjALIH3rTG-8y73OO1BGCmu3-eDgfmOFcaDyuO02ve9y6Z3aozEXnXdtvrzJb6GHIFLlt-nX-eVgdf5DhHxhrYMYX2bPtLARXo3zWbb88vn7xdfZ1fXl4uL8aiZZU_QziqgAylRDWKXKihGGFNUgMS40AbQqqRJaAFKVlCUiSkqoiahVKRkpkRbkLHt70N1YH_noUOQFQ1XZlAwXiVgcCOXFHd8E04mw5V4Yvi_40HIReiMt8GpV0Xp3JpaalhqvBGYIigaUprQgOGl9Gk8bVskxCa4Pwk5EpzvOrHnrf_GalelJJAm8GwWC_zlA7P9x5ZFqRbqVcdonMdmZKPk5q8uKFpTtqPlfqDQUdCb9GGiT6pOGD5OGxPRw37diiJEvbr79P3t9O2XfH7FrELZfR2-HfWCmID2AMvgYA-hH5zDiu4g_uMF3EedjxFPbm2PXH5seMk3-AGEx-Dc</recordid><startdate>20211207</startdate><enddate>20211207</enddate><creator>Kane, Naomi S</creator><creator>Anastasides, Nicole</creator><creator>Litke, David R</creator><creator>Helmer, Drew A</creator><creator>Hunt, Stephen C</creator><creator>Quigley, Karen S</creator><creator>Pigeon, Wilfred R</creator><creator>McAndrew, Lisa M</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-1350-8773</orcidid></search><sort><creationdate>20211207</creationdate><title>Under-recognition of medically unexplained symptom conditions among US Veterans with Gulf War Illness</title><author>Kane, Naomi S ; Anastasides, Nicole ; Litke, David R ; Helmer, Drew A ; Hunt, Stephen C ; Quigley, Karen S ; Pigeon, Wilfred R ; McAndrew, Lisa M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-404ae46d9367d576360d4fec112f3e0b54dafae0d7cc503dcce83a8d5c6350fa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Chronic fatigue syndrome</topic><topic>Coders</topic><topic>Colon</topic><topic>Criteria</topic><topic>Diagnosis</topic><topic>Female</topic><topic>Fibromyalgia</topic><topic>Gulf War</topic><topic>Gulf War syndrome</topic><topic>Health aspects</topic><topic>Health care</topic><topic>Health care policy</topic><topic>Humans</topic><topic>Illnesses</topic><topic>International Classification of Diseases</topic><topic>Irritable bowel syndrome</topic><topic>Male</topic><topic>Medical records</topic><topic>Medically Unexplained Symptoms</topic><topic>Medicine and health sciences</topic><topic>Mental disorders</topic><topic>Mental health</topic><topic>Middle Aged</topic><topic>Migraine</topic><topic>Military</topic><topic>Military personnel</topic><topic>Patients</topic><topic>Persian Gulf Syndrome - epidemiology</topic><topic>Persian Gulf War</topic><topic>Persian Gulf War veterans</topic><topic>Prevalence</topic><topic>Problem Solving</topic><topic>Social Sciences</topic><topic>Somatoform disorders</topic><topic>United States - epidemiology</topic><topic>United States Department of Veterans Affairs</topic><topic>Veterans</topic><topic>Veterans Disability Claims</topic><topic>War</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kane, Naomi S</creatorcontrib><creatorcontrib>Anastasides, Nicole</creatorcontrib><creatorcontrib>Litke, David R</creatorcontrib><creatorcontrib>Helmer, Drew A</creatorcontrib><creatorcontrib>Hunt, Stephen C</creatorcontrib><creatorcontrib>Quigley, Karen S</creatorcontrib><creatorcontrib>Pigeon, Wilfred R</creatorcontrib><creatorcontrib>McAndrew, Lisa M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Opposing Viewpoints Resource Center</collection><collection>Science in Context</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>ProQuest Nursing and Allied Health Source</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological &amp; Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>ProQuest_Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science &amp; Engineering Collection</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Advanced Technologies &amp; Aerospace Collection</collection><collection>Agricultural &amp; Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Meteorological &amp; Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agriculture Science Database</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>ProQuest Biological Science Journals</collection><collection>Engineering Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>ProQuest advanced technologies &amp; aerospace journals</collection><collection>ProQuest Advanced Technologies &amp; Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials science collection</collection><collection>ProQuest - Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kane, Naomi S</au><au>Anastasides, Nicole</au><au>Litke, David R</au><au>Helmer, Drew A</au><au>Hunt, Stephen C</au><au>Quigley, Karen S</au><au>Pigeon, Wilfred R</au><au>McAndrew, Lisa M</au><au>Chao, Linda</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Under-recognition of medically unexplained symptom conditions among US Veterans with Gulf War Illness</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-12-07</date><risdate>2021</risdate><volume>16</volume><issue>12</issue><spage>e0259341</spage><pages>e0259341-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Conditions defined by persistent "medically unexplained" physical symptoms and syndromes (MUS) are common and disabling. Veterans from the Gulf War (deployed 1990-1991) have notably high prevalence and disability from MUS conditions. Individuals with MUS report that providers do not recognize their MUS conditions. Our goal was to determine if Veterans with MUS receive an ICD-10 diagnosis for a MUS condition or receive disability benefits available to them for these conditions. A chart review was conducted with US Veterans who met case criteria for Gulf War Illness, a complex MUS condition (N = 204, M = 53 years-old, SD = 7). Three coders independently reviewed Veteran's medical records for MUS condition diagnosis or service-connection along with comorbid mental and physical health conditions. Service-connection refers to US Veterans Affairs disability benefits eligibility for conditions or injuries experienced during or exacerbated by military service. Twenty-nine percent had a diagnosis of a MUS condition in their medical record, the most common were irritable colon/irritable bowel syndrome (16%) and fibromyalgia (11%). Slightly more Veterans were service-connected for a MUS condition (38%) as compared to diagnosed. There were high rates of diagnoses and service-connection for mental health (diagnoses 76% and service-connection 74%), musculoskeletal (diagnoses 86%, service-connection 79%), and illness-related conditions (diagnoses 98%, service-connection 49%). Given that all participants were Gulf War Veterans who met criteria for a MUS condition, our results suggest that MUS conditions in Gulf War Veterans are under-recognized with regard to clinical diagnosis and service-connected disability. Veterans were more likely to be diagnosed and service-connected for musculoskeletal-related and mental health conditions than MUS conditions. Providers may need education and training to facilitate diagnosis of and service-connection for MUS conditions. We believe that greater acknowledgement and validation of MUS conditions would increase patient engagement with healthcare as well as provider and patient satisfaction with care.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>34874939</pmid><doi>10.1371/journal.pone.0259341</doi><tpages>e0259341</tpages><orcidid>https://orcid.org/0000-0002-1350-8773</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1932-6203
ispartof PloS one, 2021-12, Vol.16 (12), p.e0259341
issn 1932-6203
1932-6203
language eng
recordid cdi_plos_journals_2607595612
source MEDLINE; DOAJ Directory of Open Access Journals; PubMed (Medline); Free E-Journal (出版社公開部分のみ); PLoS_OA刊; Free Full-Text Journals in Chemistry
subjects Adult
Aged
Chronic fatigue syndrome
Coders
Colon
Criteria
Diagnosis
Female
Fibromyalgia
Gulf War
Gulf War syndrome
Health aspects
Health care
Health care policy
Humans
Illnesses
International Classification of Diseases
Irritable bowel syndrome
Male
Medical records
Medically Unexplained Symptoms
Medicine and health sciences
Mental disorders
Mental health
Middle Aged
Migraine
Military
Military personnel
Patients
Persian Gulf Syndrome - epidemiology
Persian Gulf War
Persian Gulf War veterans
Prevalence
Problem Solving
Social Sciences
Somatoform disorders
United States - epidemiology
United States Department of Veterans Affairs
Veterans
Veterans Disability Claims
War
title Under-recognition of medically unexplained symptom conditions among US Veterans with Gulf War Illness
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T08%3A13%3A07IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Under-recognition%20of%20medically%20unexplained%20symptom%20conditions%20among%20US%20Veterans%20with%20Gulf%20War%20Illness&rft.jtitle=PloS%20one&rft.au=Kane,%20Naomi%20S&rft.date=2021-12-07&rft.volume=16&rft.issue=12&rft.spage=e0259341&rft.pages=e0259341-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0259341&rft_dat=%3Cgale_plos_%3EA685742462%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2607595612&rft_id=info:pmid/34874939&rft_galeid=A685742462&rft_doaj_id=oai_doaj_org_article_7b748b54d1cf45f1ba160e29edf44231&rfr_iscdi=true