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Investigators surveyed health care providers (N = 250) deployed to the Persian Gulf on the USNS Comfort hospital ship days before the beginning of the Persian Gulf War in 1990. In this article, we identify factors associated with the development of depression during deployment. Age, gender, negative life events, stress from trauma-related work demands, and occupational experience with the dying and the dead were significant predictors of depression. Military training, although not associated with the experience of depression, was negatively correlated with concern about injury.

Acute treatment records of all medical and surgical patients evacuated to Walter Reed Army Medical Center in Washington, D.C., from the Persian Gulf theater (N = 161) were examined to better understand the relationship of injury to psychiatric symptoms. A total of 110 (68 percent) sustained a traumatic injury. They were significantly more likely to have an axis I disorder or psychiatric symptoms of concern than participants in the Persian Gulf War who did not sustain traumatic injuries but who were evacuated for medical conditions. The results indicate that traumatically injured veterans are at greater risk of psychiatric symptoms than veterans who are not injured and that they should be referred for psychiatric evaluation.