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Somatic Symptoms in Gulf War Mortuary Workers

From the Department of Psychiatry (J.E.M., R.J.U., C.S.F., X.L.,), Uniformed Services University of the Health Sciences, Bethesda, Maryland; the Deployment Health Clinical Center (X.L.), Walter Reed Army Medical Center, Washington, DC; and the Department of Psychiatry (A.L.), Jefferson Medical College, Philadelphia, Pennsylvania.

Address reprint requests to: James E. McCarroll, Department of Psychiatry, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814-4799. Email: jmccarroll{at}usuhs.mil

OBJECTIVE: The objective of this article is to examine the relationship between exposures to the dead and the development of somatic symptoms.

METHODS: We studied the pre-post responses of 352 military men and women who worked in the mortuary that received the dead from the Persian Gulf War (Operation Desert Storm) in 1990 to 1991. Symptoms of somatization were measured before and after exposure to the dead. The respondents were volunteers and nonvolunteers for assignment to the mortuary; some had prior experience in handling the dead and some did not. Four groups of participants were examined based on the degree of exposure to remains. Age, sex, volunteer status, prior experience handling remains, and preexposure measures of depression and mutilation fear were statistically controlled.

RESULTS: Postexposure somatic symptoms increased significantly over preexposure levels for the two groups with the most exposure to the dead.

CONCLUSIONS: These results provide additional evidence that exposure to the dead is related to somatic distress.

Key Words: military, • psychiatry, • somatization, • death, • volunteers, • war.

Abbreviations: PTSD = posttraumatic stress disorder;; BSI = Brief Symptom Inventory;; MQ = Mutilation Questionnaire.

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