Predictors of incident chronic widespread pain among veterans following the first Gulf War

Dennis C. Ang, Paul M. Peloso, Robert F. Woolson, Kurt Kroenke, Bradley N. Doebbeling

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


OBJECTIVE: We sought to determine the predictors of incident chronic widespread pain (CWP), specifically, the effect of preexisting symptoms, stress, and psychosocial factors in the subsequent development of CWP among veterans from the first Gulf War (GW). METHODS: We conducted a structured telephone survey (baseline) of military personnel originally from Iowa who were either eligible for or deployed to Operation Desert Shield/Desert Storm, approximately 5 years postconflict. We conducted a follow-up, clinical, in-person study of those who met a priori-defined outcomes of symptoms of cognitive dysfunction, depression, or CWP, and also a sample of those who did not meet any of the outcomes of interest. RESULTS: A total of 370 of 602 evaluated GW veterans were free of CWP 5 years postconflict. At follow-up, 69 (19%) of these had developed CWP. A positive family history of medically unexplained persistent symptoms [odds ratio (OR)=4.8 (2.3, 13.2)] was strongly associated with CWP. At baseline, individuals who reported preexisting symptoms of bronchitis [OR=4.9 (1.9, 12.3)] and cognitive dysfunction [OR=2.1 (1.1, 4.2)] were more likely to develop CWP. Alcohol use [OR=0.2 (0.1, 0.7)] was protective against CWP. Rather than combat-related exposure per se, the perception of stress at the time of the GW [OR=1.6 (1.1, 2.3)] correlated with CWP. DISCUSSION: Among the GW veterans evaluated longitudinally in this study, family history, predeployment symptoms, and the level of perceived stress during the GW were associated with subsequent development of CWP.

Original languageEnglish (US)
Pages (from-to)554-563
Number of pages10
JournalClinical Journal of Pain
Issue number6
StatePublished - Jul 2006
Externally publishedYes


  • Chronic widespread pain
  • Epidemiology
  • Gulf War veterans
  • Predictors

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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