Chronic Multisymptom Illness Among Iraq/Afghanistan-Deployed US Veterans and Their Healthcare Utilization Within the Veterans Health Administration

doi:10.1007/s11606-018-4479-6

. 2018 Sep;33(9):1419-1422.

doi: 10.1007/s11606-018-4479-6.

Chronic Multisymptom Illness Among Iraq/Afghanistan-Deployed US Veterans and Their Healthcare Utilization Within the Veterans Health Administration

April F Mohanty^{1

2}, Lisa M McAndrew^{3

4}, Drew Helmer³, Matthew H Samore^{5

6

7}, Adi V Gundlapalli^{5

6

7}

Affiliations

¹ Informatics, Decision-Enhancement, and Analytic Sciences Center (IDEAS 2.0), VA Salt Lake City Health Care System, Salt Lake City, UT, USA. april.mohanty@utah.edu.
² Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA. april.mohanty@utah.edu.
³ Department of Veteran Affairs, War Related Illness and Injury Study Center, New Jersey Health Care System, East Orange, NJ, USA.
⁴ Department of Education and Counseling Psychology, University of Albany, Albany, NY, USA.
⁵ Informatics, Decision-Enhancement, and Analytic Sciences Center (IDEAS 2.0), VA Salt Lake City Health Care System, Salt Lake City, UT, USA.
⁶ Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.
⁷ Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, UT, USA.

PMID: 29797218
PMCID: PMC6109005
DOI: 10.1007/s11606-018-4479-6

Chronic Multisymptom Illness Among Iraq/Afghanistan-Deployed US Veterans and Their Healthcare Utilization Within the Veterans Health Administration

April F Mohanty et al. J Gen Intern Med. 2018 Sep.

. 2018 Sep;33(9):1419-1422.

doi: 10.1007/s11606-018-4479-6.

Authors

April F Mohanty^{1

2}, Lisa M McAndrew^{3

4}, Drew Helmer³, Matthew H Samore^{5

6

7}, Adi V Gundlapalli^{5

6

7}

Affiliations

¹ Informatics, Decision-Enhancement, and Analytic Sciences Center (IDEAS 2.0), VA Salt Lake City Health Care System, Salt Lake City, UT, USA. april.mohanty@utah.edu.
² Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA. april.mohanty@utah.edu.
³ Department of Veteran Affairs, War Related Illness and Injury Study Center, New Jersey Health Care System, East Orange, NJ, USA.
⁴ Department of Education and Counseling Psychology, University of Albany, Albany, NY, USA.
⁵ Informatics, Decision-Enhancement, and Analytic Sciences Center (IDEAS 2.0), VA Salt Lake City Health Care System, Salt Lake City, UT, USA.
⁶ Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.
⁷ Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, UT, USA.

PMID: 29797218
PMCID: PMC6109005
DOI: 10.1007/s11606-018-4479-6

No abstract available

Keywords: chronic disease; chronic pain; deployment health; utilization; veterans.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

**Fig. 1**
Veterans Health Administration outpatient care utilization by OEF/OIF/OND veterans after their last deployment end date, fiscal years 2002–2011. a CMI-related visits/veteran by setting and sex*†. b All outpatient visits/veteran by CMI-related diagnosis status and sex. a *CMI-related visits defined as VHA outpatient encounters associated with one or more ICD-9-CM code of chronic fatigue (780.71), fibromyalgia (729.1), or irritable bowel (564.1) syndrome. †Primary care visits defined by primary stop codes: primary care (342, 348, 350, and 323) and women’s primary care (322, 339, 404, 525, 704). Specialty care visits defined by primary stop codes: gastrointestinal (307, 321, 337); pain clinic (420); rheumatology/arthritis (314). All CMI-related encounters are counted in the numerator, including those occurring on the same day. Denominator includes veterans with ≥ 1 CMI-related ICD-9-CM code in the corresponding fiscal year. b Outpatient encounters counted as no more than one/day. Denominator includes all veterans with ≥ 1 VHA outpatient encounter during the corresponding fiscal year. CMI, chronic multisymptom illness; ICD-9-CM, International Classification of Diseases, 9th revision, Clinical Modification; OEF, Operation Enduring Freedom; OIF, Operation Iraqi Freedom; OND, Operation New Dawn; VHA, Veterans Health Administration.

See this image and copyright information in PMC

Cited by

Medically Unexplained Physical Symptoms: What They Are and Why Counseling Psychologists Should Care about Them.
McAndrew LM, Friedlander ML, Litke D, Phillips LA, Kimber J, Helmer DA. McAndrew LM, et al. Couns Psychol. 2019 Jul 1;47(5):741-769. doi: 10.1177/0011000019888874. Couns Psychol. 2019. PMID: 32015568 Free PMC article.
Progression of intervention-focused research for Gulf War illness.
Chester JE, Rowneki M, Van Doren W, Helmer DA. Chester JE, et al. Mil Med Res. 2019 Oct 18;6(1):31. doi: 10.1186/s40779-019-0221-x. Mil Med Res. 2019. PMID: 31627737 Free PMC article. Review.
Impact of Deployment on Reproductive Health in U.S. Active-Duty Servicewomen and Veterans.
Gawron LM, Mohanty AF, Kaiser JE, Gundlapalli AV. Gawron LM, et al. Semin Reprod Med. 2018 Nov;36(6):361-370. doi: 10.1055/s-0039-1678749. Epub 2019 Apr 19. Semin Reprod Med. 2018. PMID: 31003251 Free PMC article. Review.
A Supplemental Women's Health Questionnaire for Women Veterans With Military Environmental Exposures: Project Development and Implementation.
Eizadi LN, Assefa MT, Nechvatal JM, Veltkamp GM, Ibrahim-Biangoro A, Adamson MM, Jennings JS. Eizadi LN, et al. JMIR Form Res. 2025 Jul 24;9:e73223. doi: 10.2196/73223. JMIR Form Res. 2025. PMID: 40705400 Free PMC article.
Under-recognition of medically unexplained symptom conditions among US Veterans with Gulf War Illness.
Kane NS, Anastasides N, Litke DR, Helmer DA, Hunt SC, Quigley KS, Pigeon WR, McAndrew LM. Kane NS, et al. PLoS One. 2021 Dec 7;16(12):e0259341. doi: 10.1371/journal.pone.0259341. eCollection 2021. PLoS One. 2021. PMID: 34874939 Free PMC article.

See all "Cited by" articles

References

1. McAndrew LM, Phillips LA, Helmer DA, Maestro K, Engel CC, Greenberg LM, et al. High healthcare utilization near the onset of medically unexplained symptoms. J Psychosom Res. 2017;98:98–105. doi: 10.1016/j.jpsychores.2017.05.001. - DOI - PubMed
1. Smith TC, Powell TM, Jacobson IG, Smith B, Hooper TI, Boyko EJ, et al. Chronic multisymptom illness: a comparison of Iraq and Afghanistan deployers with veterans of the 1991 Gulf War. American journal of epidemiology. 2014;180(12):1176–87. doi: 10.1093/aje/kwu240. - DOI - PubMed
1. VA/DoD Clinical Practice Guideline for the Management of Chronic Multisymptom Illness. Version 2.0 ed: Department of Veterans Affairs and the Departoment of Defense; 2014.
1. Vincent A, Lahr BD, Wolfe F, Clauw DJ, Whipple MO, Oh TH, et al. Prevalence of fibromyalgia: a population-based study in Olmsted County, Minnesota, utilizing the Rochester Epidemiology Project. Arthritis Care Res (Hoboken). 2013;65(5):786–92. doi: 10.1002/acr.21896. - DOI - PMC - PubMed
1. Vincent A, Brimmer DJ, Whipple MO, Jones JF, Boneva R, Lahr BD, et al. Prevalence, incidence, and classification of chronic fatigue syndrome in Olmsted County, Minnesota, as estimated using the Rochester Epidemiology Project. Mayo Clin Proc. 2012;87(12):1145–52. doi: 10.1016/j.mayocp.2012.08.015. - DOI - PMC - PubMed

Publication types

Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Other Literature Sources
- scite Smart Citations
Medical
- MedlinePlus Health Information

[1] McAndrew LM, Phillips LA, Helmer DA, Maestro K, Engel CC, Greenberg LM, et al. High healthcare utilization near the onset of medically unexplained symptoms. J Psychosom Res. 2017;98:98–105. doi: 10.1016/j.jpsychores.2017.05.001. - DOI - PubMed

[2] McAndrew LM, Phillips LA, Helmer DA, Maestro K, Engel CC, Greenberg LM, et al. High healthcare utilization near the onset of medically unexplained symptoms. J Psychosom Res. 2017;98:98–105. doi: 10.1016/j.jpsychores.2017.05.001. - DOI - PubMed

[3] Smith TC, Powell TM, Jacobson IG, Smith B, Hooper TI, Boyko EJ, et al. Chronic multisymptom illness: a comparison of Iraq and Afghanistan deployers with veterans of the 1991 Gulf War. American journal of epidemiology. 2014;180(12):1176–87. doi: 10.1093/aje/kwu240. - DOI - PubMed

[4] Smith TC, Powell TM, Jacobson IG, Smith B, Hooper TI, Boyko EJ, et al. Chronic multisymptom illness: a comparison of Iraq and Afghanistan deployers with veterans of the 1991 Gulf War. American journal of epidemiology. 2014;180(12):1176–87. doi: 10.1093/aje/kwu240. - DOI - PubMed

[5] VA/DoD Clinical Practice Guideline for the Management of Chronic Multisymptom Illness. Version 2.0 ed: Department of Veterans Affairs and the Departoment of Defense; 2014.

[6] VA/DoD Clinical Practice Guideline for the Management of Chronic Multisymptom Illness. Version 2.0 ed: Department of Veterans Affairs and the Departoment of Defense; 2014.

[7] Vincent A, Lahr BD, Wolfe F, Clauw DJ, Whipple MO, Oh TH, et al. Prevalence of fibromyalgia: a population-based study in Olmsted County, Minnesota, utilizing the Rochester Epidemiology Project. Arthritis Care Res (Hoboken). 2013;65(5):786–92. doi: 10.1002/acr.21896. - DOI - PMC - PubMed

[8] Vincent A, Lahr BD, Wolfe F, Clauw DJ, Whipple MO, Oh TH, et al. Prevalence of fibromyalgia: a population-based study in Olmsted County, Minnesota, utilizing the Rochester Epidemiology Project. Arthritis Care Res (Hoboken). 2013;65(5):786–92. doi: 10.1002/acr.21896. - DOI - PMC - PubMed

[9] Vincent A, Brimmer DJ, Whipple MO, Jones JF, Boneva R, Lahr BD, et al. Prevalence, incidence, and classification of chronic fatigue syndrome in Olmsted County, Minnesota, as estimated using the Rochester Epidemiology Project. Mayo Clin Proc. 2012;87(12):1145–52. doi: 10.1016/j.mayocp.2012.08.015. - DOI - PMC - PubMed

[10] Vincent A, Brimmer DJ, Whipple MO, Jones JF, Boneva R, Lahr BD, et al. Prevalence, incidence, and classification of chronic fatigue syndrome in Olmsted County, Minnesota, as estimated using the Rochester Epidemiology Project. Mayo Clin Proc. 2012;87(12):1145–52. doi: 10.1016/j.mayocp.2012.08.015. - DOI - PMC - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Chronic Multisymptom Illness Among Iraq/Afghanistan-Deployed US Veterans and Their Healthcare Utilization Within the Veterans Health Administration

Affiliations

Chronic Multisymptom Illness Among Iraq/Afghanistan-Deployed US Veterans and Their Healthcare Utilization Within the Veterans Health Administration

Authors

Affiliations

Conflict of interest statement

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical