@2024 Afarand., IRAN
ISSN: 2008-2630 Iranian Journal of War & Public Health 2015;7(4):207-215
ISSN: 2008-2630 Iranian Journal of War & Public Health 2015;7(4):207-215
Mental Health Status in Severe Lung Chemical Injured Veterans Exposed to Sulfur Mustard
ARTICLE INFO
Article Type
Descriptive & Survey StudyAuthors
Sedighi Moghadam M.R. (1)Afshar H. (2)
Khateri Sh. (1)
Soroush M. (1)
Mousavi B. (*)
Mousavi S.J. (1)
Modirian E. (3)
Hosseini M. (1)
(*) Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran
(1) Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran
(2) “Psychosomatics Research Center” and “Psychiatry Department, Medicine Faculty”, Isfahan university of Medical Sciences, Isfahan, Iran
(3) Emergency Department, Medical Faculty, Qazvin University of Medical Sciences, Qazvin, Iran
Correspondence
Address: Janbazan Medical and Engineering Research Center (JMERC), No. 17, Farokh Street, Moghadas Ardabili Street, Yaman Street, Shahid Chamran Highway, Tehran, IranPhone: +982122416699
Fax: +982122416699
mousavi.b@gmail.com
Article History
Received: February 3, 2015Accepted: April 19, 2015
ePublished: November 21, 2015
ABSTRACT
Aims
Severe pulmonary chemically injured veterans experience more physical and environmental problems than other war victims that might lead to more difficult life conditions. The aim of this study was to assess the psychological health statuses of the severe pulmonary chemically injured veterans exposed to mustard gas.
Materials & Methods 292 severe pulmonary chemically injured veterans from all around Iran, exposed to mustard gas, were cross-sectionally studied in Isfahan in 2015. Demographic and appearance information of the patients was recorded. Using Psychiatric Disorder Assessment Form, each veteran was assessed in 5 different axes through a semi-structured clinical interview. Data was analyzed in SPSS 22 software using Pearson correlation coefficient and Chi-square tests.
Findings 213 veterans (72.9%) were with mental disorders. Anxiety disorder was the most prevalent disorder in Axis I, with posttraumatic stress disorder (90%). 123 veterans (42.1%) were with different types of depression. In Axis III, 49 veterans (16.8%) were suffering other physical illnesses affecting mental health. In Axis IV, 51 veterans (17.5%) were with a variety of environmental problems. In GAF scale, more than 90% of the veterans received 60 scores or less. There was an inverse correlation between psychiatric disorder and efficiency level (p<0.001).
Conclusion The prevalence of psychiatric disorders, including depression, anxiety, and PTSD, in severe pulmonary chemically injured veterans is higher than other veterans and is 3-5 times higher than Iranian normal population.
Materials & Methods 292 severe pulmonary chemically injured veterans from all around Iran, exposed to mustard gas, were cross-sectionally studied in Isfahan in 2015. Demographic and appearance information of the patients was recorded. Using Psychiatric Disorder Assessment Form, each veteran was assessed in 5 different axes through a semi-structured clinical interview. Data was analyzed in SPSS 22 software using Pearson correlation coefficient and Chi-square tests.
Findings 213 veterans (72.9%) were with mental disorders. Anxiety disorder was the most prevalent disorder in Axis I, with posttraumatic stress disorder (90%). 123 veterans (42.1%) were with different types of depression. In Axis III, 49 veterans (16.8%) were suffering other physical illnesses affecting mental health. In Axis IV, 51 veterans (17.5%) were with a variety of environmental problems. In GAF scale, more than 90% of the veterans received 60 scores or less. There was an inverse correlation between psychiatric disorder and efficiency level (p<0.001).
Conclusion The prevalence of psychiatric disorders, including depression, anxiety, and PTSD, in severe pulmonary chemically injured veterans is higher than other veterans and is 3-5 times higher than Iranian normal population.
CITATION LINKS
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[26]Karami GR, Ameli J, Roeintan R, Jonaidi-Jafari N, Saburi A. Impacts of mustard gas exposure on veterans mental health: A study on the role of education. Ind Psychiatry J. 2013;22(1):22-5.
[27]Falahati F, Khateri Sh, Soroush MR, Salamat A. Late psychological impacts of wartime low level exposure to sulfur mustard on civilian population of direh (17 years after exposure). Glob J Med Res. 2010;1(1):42-6.
[28]Coelho R, Santos AS, Maia D, Rosa R, Caldeira V, Sá T, et al. Symptoms for anxiety and depression in COPD patients. Eur Respir J. 2014;44(Suppl 58):981-6.
[29]Teixeira P, Porto L, Kristensen C, Santos A, Lima P, Menna Barreto S. Association of post-traumatic stress disorder and number of exacerbations in COPD patients. Eur Respir J. 2012;40(Suppl 56):4816-20.
[30]Vafaee B, Seidy A. Prevalence of depression among physically-disabled veterans in Northwestern Iran. Iran J Med Sci. 2004;29(1):43-4.
[31]Hashemian F, Khoshnood K, Desai MM, Falahati F, Kasl S, Southwick S. Anxiety, depression, and posttraumatic stress in Iranian survivors of chemical warfare. JAMA. 2006;296(5):560-6.
[32]Ohayon MM. Chronic obstructive pulmonary disease and its association with sleep and mental disorders in the general population. J Psychiatr Res. 2014;54:79-84.
[33]National Survey of Mental Health Symposium, Prevalence of psychiatric disorders in Iran (2010-2011). Available from: http://incas.tums.ac.ir/files/site1/files/Rahimi-Symposium-all_abstracts-1392.pdf
[34]Mostafaloo A, Gazmeh J. The relationship between job satisfaction and mental health in chemical veterans. Iran J War Public Health. 2013;5(4):43-50. [Persian]
[35]Masoumi M, Soroush MR, Modirian E, Mousavi B, Hemmati M, Shokoohi H, et al. The relationship between depression and anxiety symptoms and activity of daily living in landmine explosion adolescent survivors. Int J India Psychol. 2014;2(1):12-21.
[36]Mohseni M, Farnia MR, Taghva A, Dehghan Manshadi Z, Rezaei Fard A. Effect of having a post-traumatic stress disorder man on the quality of life, depression, stress, anxiety and structure of the family. Iran J War Public Health. 2014;6(5):207-14. [Persian]
[37]Jafari F, Moien L, Soroush M, Mosavi B. Quality of life in chemical warfare victims with ophthalmic damage's spouses. Iran J War Public Health. 2011;3(3):8-12. [Persian]
[2]Ghazanfari T, Sajjadi M, Kavandi E, Yaraee R, Poorfarzam Sh, Rezaii A, et al. Assessment of Serum level of IL-19 in chemical victims with pulmonary complications. Iran J War Public Health. 2011;3(4):6-14. [Persian]
[3]Zarchi K, Akbar A, Naieni KH. Long-term pulmonary complications in combatants exposed to mustard gas: A historical cohort study. Int J Epidemiol. 2004;33(3):579-81.
[4]Zafarghandi MR, Soroush MR, Mahmoodi M, Naieni KH, Ardalan A, Dolatyari A, et al. Incidence of cancer in Iranian sulfur mustard exposed veterans: a long-term follow-up cohort study. Cancer Causes Control. 2013;24(1):99-105.
[5]Hosseini-Khalili A, Haines DD, Modirian E, Soroush M, Khateri S, Joshi R, et al. Mustard gas exposure and carcinogenesis of lung. Mutat Res. 2009;678(1):1-6.
[6]Khateri, S, Ghanei M, Keshavarz S, Soroush M, Haines D. Incidence of lung, eye, and skin lesions as late complications in 34,000 Iranians with wartime exposure to mustard agent. J Occup Environ Med. 2003;45(11):1136-43.
[7]Ghanei M, Harandi AA. Long term consequences from exposure to sulfur mustard: A review. Inhal Toxicol. 2007;19(5):451-6.
[8]Karami G. Addiction relapses in Iranian veterans: Determination of etiologies and solutions. Iran J War Public Health. 2010;2(4):40-4. [Persian]
[9]DE Hert M, Correll CU, Bobes J, Cetkovich-Bakmas M, Cohen D, Asai I, et al. Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry. 2011;10(1):52-77.
[10]Jankowski MK, Schnurr PP, Adams GA, Green BL, Ford JD, Friedman MJ. A mediational model of PTSD in World War II veterans exposed to mustard gas. J Trauma Stress. 2004;17(4):303-10.
[11]Molgaard CA, Poikolainen K, Elder JP, Nissinen A, Pekkanen J, Golbeck AL, et. al. Depression late after combat: a follow-up of Finnish World War Two veterans from the seven countries east-west cohort. Mil Med. 1991;156(5):219-22.
[12]Karami GR, Amiri M, Ameli J, Kachooei H, Ghodoosi K, Saadat AR, et al. Psychological hcalth status of mustard gas cxposcd vctcrans . J Mil Med. 2006;8(1):1-7.
[13]Mohaghegh-Motlagh SJ, Momtazi S, Musavi-Nasab SN, Arab A, Saburi E. Post-traumatic stress disorder in male chemical injured war veterans compared to non-chemical war veterans. Med J Mashhad Univ Med Sci. 2014;56(6):361-8. [Persian]
[14]Abbasi S, Mehdizadeh S, Payami Bousari M. Relationship between general health level and sleep quality in chemical warfare victims with bronchiolitis obliterans. J Mil Med. 2012;14(1):15-9. [Persian]
[15]Behdani F, Fayazi Bordbar MR, Heirani P, Talebi M, Kohestani L. The prevalence of psychiatric symptoms in physical and chemical veterans. J Mil Med. 2009;11(1):31-5. [Persian]
[16]Madarshahiean F. Comparison of coping with direct and indirect consequences of war stress in later life between chemical and physical war injureds. J Mil Med. 2003;5(2):117-20. [Persian]
[17]Khademi M, Gharib M, Rashedi V. Prevalence of depression in the amputated patients concerning demographic variables. Iran J War Public Health. 2012;4(2):12-7. [Persian]
[18]Szinicz L. History of chemical and biological warfare agents. Toxicol. 2005;214(3):167-81.
[19]Khateri S, Wangerin R. The open wound: Consequences of the use of chemical weapons against Iran during the Iran-Iraq war. Tehran: Tehran Peace Museum; 2009.
[20]Zargar M, Araghizadeh H, Soroush M, Khaji A. Iranian casualties during the eight years of Iraq-Iran conflict. Rev Saúde Pública. 2007;41(6):1065-6.
[21]American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-IV). 4th edition. Washington, DC: American Psychiatric Association; 1994.
[22]Sharifi V, Asadi SM, Mohammadi MR, Amini H, Kaviani H, Semnani Y, et al. Reliability and feasibility of the Persian version of the structured diagnostic interview for DSM-IV (SCID). Adv Cogn Sci. 2004;6(1-2):10-22. [Persian]
[23]Jafari F, Guitynavard F, Soroush M, Muosavi B. Quality of life in chemical war victims with severe pulmonary damage. Iran J War Public Health. 2012;4(1):46-52. [Persian]
[24]Razavi SM, Negahban Z, Pirhosseinloo M, Razavi MS, Hadjati G, Salamati P. Sulfur mustard effects on mental health and quality-of-life: A review. Iran J Psychiatry Behav Sci. 2014;8(3):11-21.
[25]Ahmadi Kh, Reshadatjoo M, Karami GhR, Anisi J. Evaluation of secondary post traumatic stress disorder in chemical warfare victims' children. J Mil Med. 2010;12(3):153-9. [Persian]
[26]Karami GR, Ameli J, Roeintan R, Jonaidi-Jafari N, Saburi A. Impacts of mustard gas exposure on veterans mental health: A study on the role of education. Ind Psychiatry J. 2013;22(1):22-5.
[27]Falahati F, Khateri Sh, Soroush MR, Salamat A. Late psychological impacts of wartime low level exposure to sulfur mustard on civilian population of direh (17 years after exposure). Glob J Med Res. 2010;1(1):42-6.
[28]Coelho R, Santos AS, Maia D, Rosa R, Caldeira V, Sá T, et al. Symptoms for anxiety and depression in COPD patients. Eur Respir J. 2014;44(Suppl 58):981-6.
[29]Teixeira P, Porto L, Kristensen C, Santos A, Lima P, Menna Barreto S. Association of post-traumatic stress disorder and number of exacerbations in COPD patients. Eur Respir J. 2012;40(Suppl 56):4816-20.
[30]Vafaee B, Seidy A. Prevalence of depression among physically-disabled veterans in Northwestern Iran. Iran J Med Sci. 2004;29(1):43-4.
[31]Hashemian F, Khoshnood K, Desai MM, Falahati F, Kasl S, Southwick S. Anxiety, depression, and posttraumatic stress in Iranian survivors of chemical warfare. JAMA. 2006;296(5):560-6.
[32]Ohayon MM. Chronic obstructive pulmonary disease and its association with sleep and mental disorders in the general population. J Psychiatr Res. 2014;54:79-84.
[33]National Survey of Mental Health Symposium, Prevalence of psychiatric disorders in Iran (2010-2011). Available from: http://incas.tums.ac.ir/files/site1/files/Rahimi-Symposium-all_abstracts-1392.pdf
[34]Mostafaloo A, Gazmeh J. The relationship between job satisfaction and mental health in chemical veterans. Iran J War Public Health. 2013;5(4):43-50. [Persian]
[35]Masoumi M, Soroush MR, Modirian E, Mousavi B, Hemmati M, Shokoohi H, et al. The relationship between depression and anxiety symptoms and activity of daily living in landmine explosion adolescent survivors. Int J India Psychol. 2014;2(1):12-21.
[36]Mohseni M, Farnia MR, Taghva A, Dehghan Manshadi Z, Rezaei Fard A. Effect of having a post-traumatic stress disorder man on the quality of life, depression, stress, anxiety and structure of the family. Iran J War Public Health. 2014;6(5):207-14. [Persian]
[37]Jafari F, Moien L, Soroush M, Mosavi B. Quality of life in chemical warfare victims with ophthalmic damage's spouses. Iran J War Public Health. 2011;3(3):8-12. [Persian]