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As mandated in Public Law 103-446, the Department of Veterns Affairs (VA) asked the Institute of Medicine (IOM) to review its Uniform Case Assessment Protocol (UCAP) for Persian Gulf veterans. The purpose of the program is to provide a systematic, comprehensive medical protocol for the diagnosis of health problems of Persian Gulf veterans. This report is the third in a series of studies by IOM reviewing the protocols used by the VA and the Department of Defense to diagnose the health complaints of Gulf veterans. The committee reviews and makes recommendations concerning the adequacy of the medical protocol and its implementation by the VA, as well as the VA's outreach and education efforts aimed at informing Persian Gulf veterans and their care providers of the purpose and availability of this program. In addition, the report contains as appendixes the findings and recommendations of the previous reports, as well as those of two related IOM reports on Health Consequences of Service During the Persian Gulf War.

Ten years after the end of the Gulf War, questions continue to be raised about the health of U.S. service personnel who fought in that war. A primary concern is whether Gulf War veterans are receiving effective treatments for their health problems. Section 105 of the Veterans Program Enhancement Act of 1998 mandates that the Department of Veterans Affairs (VA) ask the Institute of Medicine (IOM) to convene a committee that would identify a method for assessing treatment effectiveness and describe already-validated treatments for Gulf War veterans' health problems, including the problem of medically unexplained symptoms. The specific charge to the committee is to (1) identify and describe approaches for assessing treatment effectiveness; (2) identify illnesses and conditions among veterans of the Gulf War, using data obtained from the VA and the Department of Defense (DoD) Gulf War Registries, as well as information in published articles; and (3) for these identified conditions and illnesses, identify validated models of treatment (to the extent that such treatments exist), or identify new approaches, theories, or research on the management of patients with these conditions if validated treatment models are not available.

Pain is the most common physical complaint while depression is the second most debilitating chronic medical condition. The co-occurrence of pain and depression is well known but a detailed understanding of their phenomenology, interrelationship, and effective therapies remains speculative. This book provides a synthetic approach to the evaluation and treatment of patients with chronic pain and depression that will generate therapeutic optimism and lead clinicians to improve quality of life and restore function. The recognition that depression is not just an affective disorder or demoralization is discussed in detail in the contributions: Function, Disability, and Psychological Well-Being and in Structural Models of Comorbidity among Common Mental Disorders: Connections to Chronic Pain. Other articles review the complex regional pain syndrome and the Gulf War syndrome. Further papers discuss issues relating to the use of opioids in the treatment of chronic pain. This book will doubtlessly prove to be essential reading for researchers investigating chronic nonmalignant pain as well as physicians dealing with patients suffering from chronic pain.