Thomas, Hollie V, Stimpson, Nicola J, Weightman, Alison L et al. · Psychological medicine · 2006 · DOI
This review examined 23 studies comparing health problems in Gulf War veterans to people who were not deployed. Veterans who served in the Gulf War were nearly 4 times more likely to develop chronic fatigue syndrome and about 3.5 times more likely to report multiple chemical sensitivities or other multi-symptom illnesses. The review suggests that deployment to the Gulf War is connected with higher rates of these conditions.
This systematic review establishes that environmental or occupational exposures during military deployment can trigger multi-symptom illnesses including chronic fatigue syndrome. Understanding the Gulf War context provides insights into potential triggers and mechanisms that may be relevant to ME/CFS in other populations, and demonstrates that post-exposure multi-symptom conditions warrant serious investigation.
This review does not establish causation—only association between Gulf deployment and multi-symptom illness. It cannot identify the specific exposures or mechanisms responsible for these conditions, nor does it prove that Gulf War exposures would trigger identical outcomes in non-veteran populations. The studies reviewed were also not designed to assess post-exertional malaise (PEM), a core ME/CFS feature.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Thomas, Hollie V, Stimpson, Nicola J, Weightman, Alison L, Dunstan, Frank, & Lewis, Glyn (2006). Systematic review of multi-symptom conditions in Gulf War veterans.. Psychological medicine. https://doi.org/10.1017/S0033291705006975
BibTeX
@article{mecfsatlas-thomas-2006-systematic-review,
author = {Thomas, Hollie V and Stimpson, Nicola J and Weightman, Alison L and Dunstan, Frank and Lewis, Glyn},
title = {Systematic review of multi-symptom conditions in Gulf War veterans.},
journal = {Psychological medicine},
year = {2006},
doi = {10.1017/S0033291705006975},
note = {PubMed: 16438740},
url = {https://www.mecfsatlas.com/evidence/thomas-2006-systematic-review},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/thomas-2006-systematic-review
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