Deployment-related toxic exposures, mental health problems, and suicide outcomes among Gulf War era U.S. veterans

Exposure to toxins, such as pesticides, smoke from burning oil fields, and nerve gas, during military operations have been linked to poor physical health among veterans. However, less is known about how these exposures may affect mental health outcomes, especially those relevant to military populations (e.g., posttraumatic stress disorder [PTSD], depression, alcohol use disorder, suicide). The goal of the present study was to examine how any toxic exposure and total toxic exposures were associated with probable current diagnoses of PTSD, major depressive disorder, and alcohol use disorder as well as lifetime history of suicidal ideation and suicide attempts among a large national sample of Gulf War-Era veterans (N = 1153). Notably, when covarying for demographic factors, any toxic exposure was associated with increased odds of probable PTSD (AOR = 2.66), probable depression (AOR = 1.92), and suicidal ideation (AOR = 1.75), but these associations, except for suicidal ideation (AOR = 1.50), were no longer present once accounting for military covariates (i.e., combat exposure and Gulf War illness). Further, higher total number of deployment-related toxic exposures were associated with increased odds of meeting criteria for probable PTSD (AOR = 1.83), probable depression (AOR = 1.28), probable alcohol use disorder (AOR = 1.22), and of reporting suicidal ideation (AOR = 1.22), even after accounting for both demographic and military covariates. Our findings suggest that self-reported toxic exposures are uniquely related to worse mental health problems after military service.