common diagnostic categories, together accounting for more than 50 percent of primary diagnoses (CDC, 1999).

Registry programs provided an early glimpse into veterans’ symptoms and the difficulties of fitting symptoms into standard diagnoses. As self-selected case series of veterans who presented for care, registries cannot, and were not intended to, be representative of the symptoms and illnesses of the entire group of Gulf War veterans. Nor were registries designed with control groups or with diagnostic standardization across the multiple sites at which examinations took place (Joseph, 1997; Roy et al., 1998). Finally, owing to their reliance on stan-

TABLE 2.2 Most Frequent Symptoms and Diagnoses Among 53,835 Participants in the VA Registry (1992–1997)

Symptoms or Diagnoses

Percentage

Self-Reported Symptoms

 

Fatigue

20.5

Skin rash

18.4

Headache

18.0

Muscle, joint pain

16.8

Loss of memory

14.0

Shortness of breath

7.9

Sleep disturbances

5.9

Diarrhea and other gastrointestinal symptoms

4.6

Other symptoms involving skin

3.6

Chest pain

3.5

No complaint

12.3

Diagnosis (ICD-9-CM)

 

No medical diagnosis

26.8

Musculoskeletal and connective tissue

25.4

Mental disorders

14.7

Respiratory system

14.0

Skin and subcutaneous tissue

13.4

Digestive system

11.1

Nervous system

8.0

Infectious diseases

7.1

Circulatory system

6.4

Injury and poisoning

5.3

Genitourinary system

3.0

Neoplasm

0.4

 

SOURCE: Murphy et al., 1999.

   

coded elsewhere in ICD-9-CM or without a distinct physiological or psychological basis (U.S. DHHS, 1998).



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