Multiple symptoms in veterans could indicate PTSD, study finds

A pattern of symptoms in veterans has emerged in a University of Otago study that researchers say should be taken seriously by health professionals.

The study, led by Professor David McBride and published in this week's New Zealand Medical Journal, investigated the relationship between exposure to traumatic events and multiple symptom illness (MSI)—more than one medically unexplained symptom not fitting within a specific medical diagnosis.

MSI was first described in veterans of the 1991 Persian Gulf War and occurs in both military personnel and civilians.

"The aim of this study was to describe the pattern of reporting of MSI among New Zealand veterans and investigate the relationship with PTSD as a risk factor," he says.

The symptoms fall into three groups labeled arthro-neuro-muscular (joint/nerve/muscle pains) cognitive (sleeping problems, dreams, loss of concentration) and psycho/physiological (sore throat/nausea/glands).

The study looked at a sample of 1,672 New Zealand veterans—59% of whom had served in a war zone and 29% who had at least some signs of PTSD. On average those with signs of PTSD reported 20 symptoms, while those without reported having nine symptoms. The number of symptoms also tended to increase with age.

"In summary, multiple symptom illness, rather than being an inexplicable pattern of health effects, remains stable across time and is linked to both chronic illness and poorer quality of life. Because of the pattern of symptom reporting and the veteran group reporting it, there is a plausible association between MSI and PTSD.

"This research tends to confirm that PTSD is associated with MSI, as did the finding that those veterans with PTSD had more severe symptoms," he says.

If such a pattern of symptoms is found in a veteran, it should be further investigated.

"In Australian veterans, those with MSI developed more health conditions over time, the symptoms became more severe, and they had higher health service use, suggesting that it is important to catch these conditions early, and treat the underlying condition," Professor McBride says.

"Health practitioners might find that a patient presenting with multiple symptoms including muscle and joint aches and pains, cognitive problems, disorders or sleep and avoidance is worthy of further investigation, including whether or not they have military service and enquiry about PTSD symptoms."