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Press Release
Exercise, Behavioral Therapy Improve Gulf War Veterans' Health
For Release on March 18, 2003
In the first major treatment trial of Gulf War veterans reporting serious health problems, researchers from the Department of Veterans Affairs (VA) and the Department of Defense (DoD) have found that cognitive behavioral therapy (CBT) and aerobic exercise improve several symptoms of Gulf War veterans' illnesses.
Reporting in the March 19 issue of the Journal of the American Medical Association, the scientists said the results indicate CBT and/or exercise provide modest but significant improvement in physical functioning, mental health functioning, cognitive symptoms, fatigue and distress. An accompanying editorial in the journal described the study as "a remarkable achievement" and noted it was one of the largest trials of psychological treatment ever published.
"This study is a great step forward in understanding how we can help Gulf War veterans reporting a variety of symptoms," said Dr. Nelda P. Wray, VA's Chief Research and Development Officer. "It offers veterans the prospect of improvement in the management of their disabling symptoms, and also will help veterans and others who suffer from similar chronic illnesses such as fibromyalgia or chronic fatigue syndrome. We are sharing the results immediately with our physicians so they use them to help our patients."
The $9.6 million study, conducted between 1999 and late 2001, involved 1,092 veterans at 18 VA and 2 DoD medical centers. Participants-Gulf War veterans who were experiencing fatigue, musculoskeletal pain, and/or cognitive difficulties-were randomly assigned to one of four 12-week treatment courses. All groups continued their usual health care. In addition to usual care, three groups received CBT, aerobic exercise or a combination of the two therapies.
CBT teaches patients active techniques for reducing the severity of symptoms and is commonly used to enhance traditional treatments for many chronic illnesses, including cancer, coronary artery disease, asthma and conditions marked by pain and fatigue. Aerobic exercise has been effective in improving the symptoms and functional status of individuals with chronic fatigue syndrome and fibromyalgia.
Among the study's findings:
The percentage of veterans with improvements in physical function one year after treatment began were 18.5 percent for CBT alone, 18.4 percent for CBT plus exercise, 11.7 percent for exercise alone, and 11.5 percent for usual care.
CBT, with or without aerobic exercise, led to modest but significant improvement in physical functioning: 18.3 percent of veterans receiving CBT showed significant improvement, compared to 11.6 percent of those who did not receive CBT.
CBT, with or without exercise, led to improvements in mental health functioning and cognitive symptoms.
Aerobic exercise, with or without CBT, led to improvements in mental health functioning, cognitive symptoms, fatigue and distress.
Neither CBT nor exercise led to improvement in pain symptoms.
The study, conducted under the VA's Cooperative Studies Program, was led by co-chairmen Dr. Sam Donta, formerly of the Boston VA Medical Center, Dr. Daniel Clauw of the Ann Arbor VA Medical Center and the University of Michigan, and Dr. Charles Engel of the Walter Reed Army Medical Center in Washington. The study is part of a substantial continuing commitment by VA and DoD to research into Gulf War veterans' illnesses. Those two departments and the Department of Health and Human Services spent $213 million between 1994 and 2002 to support 224 studies.
Additional information: Please contact Dan Bruneau, VA R&D Communications at 410-962-1800, ext. 289.
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