Am J Psychiatry 1994; 151:71-75
Copyright © 1994 by American Psychiatric Association
Impact of the Gulf War on the anxiety, cortisol, and growth hormone levels of Israeli civilians
R Weizman, N Laor, Y Barber, A Selman, A Schujovizky, L Wolmer, Z Laron and I Gil- Ad
Tel Aviv-Brull Community Mental Health Center, Israel.
OBJECTIVE: The authors investigated the impact of continuous and repeated
stress on Israeli civilians exposed to missile attacks during the Gulf War.
METHOD: Study 1 included 26 healthy volunteers aged 28-59 years. Their
scores on the Hamilton Anxiety Rating Scale and levels of plasma cortisol
and growth hormone (GH) were evaluated before, during, and after the war.
Study 2 included 13 healthy volunteers aged 25-59 years. Their scores on
the state portion of the State-Trait Anxiety Inventory and levels of
cortisol and GH were measured three times daily (8:00 a.m., noon, and 6:00
p.m.) at two time points (during and after the war). RESULTS: Anxiety
levels of civilians exposed to the threat of war and later to actual
missile attacks were significantly higher before and during the war than
afterward. Anxiety during the war reached a peak in the evening. The
increase in anxiety was not accompanied by any change from basal morning
cortisol and GH levels or by diurnal variations in these hormones.
CONCLUSIONS: Anxiety levels during the war were similar to those 1 day
before its onset, which can be explained by the nature of coping processes.
During the war, anxiety levels were highest in the evening, reflecting the
war routine (missile attacks occurred mostly at night). The unaltered
hormone levels and their normal diurnal variations despite the subjects'
persistent anxiety were probably due to adaptation of the
hypothalamic-pituitary- adrenal and hypothalamic-somatotropin axes to
continuous stress.
