A
Access to care community-based outpatient clinics, 7, 158
facility locations, 163
integrated primary and mental health care, 163
medical records, 163, 166
specialty care access network, 4, 6, 7, 9, 159-160, 185, 187, 188, 189, 191
VA enrollment priority groups, 162, 164-165
wait time for appointment, 163
Acetaminophen, 38, 99
Acupuncture, 9, 35, 76, 78, 80-81, 97, 100, 102, 107, 120, 121, 191
Afghanistan veterans, defined, 1 n.1
Agency for Healthcare Research and Quality (AHRQ), 9, 30, 32, 34, 37, 40, 41, 55, 73, 78, 79, 191
Agent Orange, 12, 164
American Academy of Sleep Medicine, 102
American Academy on Communication in Healthcare (AACH), 145
American College of Gastroenterology, 105
American College of Physicians (ACP), 30, 32, 33
American College of Rheumatology, 94
American Psychiatric Association, 100, 108, 110, 111, 116, 118
Amitriptyline, 38, 95, 120
Anticonvulsants, 39, 96, 120
Antidepressants, 39, 40, 46-47, 66-67, 68-69, 70-71, 86, 96, 101, 105, 107, 108, 118, 120, 143, 144, 207-208, 210
Antipsychotics, 39, 107
Anxiety biofeedback interventions, 72, 74-75, 108, 120
causes, 17, 203
and CMI, 1, 3, 4, 11, 16, 17, 18, 24, 29, 32, 108, 185, 205
cognitive behavioral therapy, 108, 113, 120
comorbid conditions, 49, 93, 94, 100, 101, 103-104, 105, 106, 108, 109, 112, 113, 114
diagnosis, 16, 17, 100, 108, 109
exercise therapy, 77, 80-81, 84-85
and pain, 205
pharmacologic interventions, 39, 42-43, 44-45, 46-47, 72, 86, 101, 104, 105, 108, 118, 119, 120, 121
prevalence, 16, 24, 108
psychodynamic therapy, 52, 53, 54, 64-65, 66-67, 108, 121
psychotherapy, 50, 51, 58-59, 60-61, 62-63, 108, 113, 120, 121
relaxation techniques, 100, 108, 121
St. John’s wort treatment, 77-78, 82-83
suicide and suicidal ideation, 118-119
Assessment of Multiple Systematic Reviews (AMSTAR), 32, 53, 54
Australian National Health and Medical Research Council Guideline, 111
Autogenic training (self-hypnosis), 57
B
Benefits Delivery at Discharge program (BDD), 166
Biofeedback, 37, 56
anxiety, 72, 74-75, 108, 120
chronic pain, 120
depression, 74-75
effectiveness, 66-67, 72-73, 74-75, 101
fibromyalgia, 66-67
plus pharmacotherapy, 72, 74-75
research needs, 9, 191
somatic symptom disorders, 57, 72-73, 74-75, 101, 120
strength of evidence, 73
Buprenorphine, 115, 122
Bupropion, 115, 122
C
Centers for Disease Control and Prevention (CDC), 22, 23, 97
Characterizing CMI
causes/underlying factors, 1, 11-13, 203-205
management vs curing, 26-27
prevalence, 2, 23-26
risk factors, 26
symptoms, 1, 16, 21-22, 23
terminology, 21-22
veteran vs civilian populations, 26
working definition, 1, 23
Charge to committee, 2-3, 13-14
approach to, 3
Chronic fatigue syndrome clinician–patient communication, 140
and CMI, 1, 3, 4, 15, 18, 23, 29, 32, 97, 99, 185, 203
cognitive behavioral therapy, 54, 68-69, 99, 120
comorbid conditions, 97, 100
definitions, 22, 97, 98
and depression, 100, 119
diagnosis, 23, 97
exercise therapy, 99
prevalence, 97
sensitivity to medications, 99
symptoms, 11, 97, 99
treatments, 4, 32, 33, 54, 99-100, 120, 205
Chronic pain (see also Fibromyalgia) acupuncture, 97, 100, 120, 173
alternative therapies, 100, 116
biofeedback, 120
in civilians, 22
clinician education, 160
and CMI, 1, 4, 11, 22, 95-96, 107, 114, 118, 159, 185, 186, 205
comorbid conditions, 32, 93, 96, 98, 99, 101, 103, 106, 110, 112, 114, 119, 185, 186
defined, 95
exercise interventions, 84-85, 99, 116, 120, 158
eye movement desensitization and reprocessing, 70-71
facial, 107
low back pain, 16, 120
models of care, 135, 139, 141, 144, 158, 159, 168, 173, 208, 209
musculoskeletal, 11, 16, 22, 24, 25-26, 98, 107
patient education, 158
pharmacologic interventions, 42-43, 44-45, 95, 96, 99, 105, 114, 116, 119, 120, 210
physiological mechanisms, 203-204, 205
prevalence in veterans, 16, 24, 25-26, 95-96
Project ECHO, 160
psychodynamic therapy, 64-65
psychotherapy interventions, 54, 60-61, 68-69, 116, 120
radiofrequency ablation of branch nerves, 96, 120
REAC-BS treatment, 40, 48-49
relaxation techniques, 100, 120
and substance-use disorders, 114, 116, 122
transcutaneous electric nerve stimulation, 96-97, 120
Classical Acupuncture Treatment for People with Unexplained Symptoms (CACTUS) study, 76
Clinical practice guidelines (CPGs), 5, 7, 29, 30, 32-33, 94, 102, 111, 115, 155, 158-159, 161, 169, 172, 173, 186
Clinician-Administered PTSD Scale, 109
Cochrane Risk of Bias Tool, 32
Cognitive behavioral therapy, 4, 86
for anxiety disorders, 108, 113, 120
for chronic fatigue syndrome, 54, 68-69, 99, 120
for chronic pain, 120
clinical guidelines, 159
clinician training, 135
components, 49
consultation letter, 70-71
for depression and suicide risk, 107, 113, 119, 121, 122
effectiveness, 41, 46-47, 49, 50, 53, 54-55, 56-63, 95, 115, 120-122, 184, 185
exercise plus, 38, 50-51, 60-61, 79, 84-85, 99, 120, 169, 184
for fibromyalgia, 54, 68-69, 95, 120
for functional gastrointestinal disorders, 106, 121
group, 50-51, 55, 58-59, 60-61, 62-63, 70-71, 79, 111, 184
Gulf War Veterans’ Illnesses, 60-61, 84-85
individual, 49-50, 55, 70-71, 111, 184
medically unexplained symptoms, 60-63, 70-71
multimodal therapy, 95
psychiatric consultation intervention with, 56-57, 135
and psychodynamic psychotherapies, 52
for sleep disorders, 49, 102, 121
somatic-focused, 41, 49, 51, 55-56
somatoform disorders, 41, 46-47, 50, 51, 53, 56-59, 62-63, 68-69, 70-71, 72, 108, 113, 120, 184
for substance-abuse disorders, 115, 122
telephone or Internet implementation, 107
trauma-focused, for PTSD, 50, 111, 121
Cognitive rehabilitation therapy (CRT), 37, 38, 73, 76-77, 113
Columbia-Suicide Severity Rating Scale, 116-117
Combat fatigue, 11
Comorbid and related conditions anxiety, 1, 3, 4, 11, 16, 17, 18, 24, 29, 32, 108, 185, 205
chronic fatigue syndrome, 1, 3, 15, 18, 23, 29, 32, 97, 99, 185, 203
chronic pain, 1, 4, 11, 22, 95-96, 107, 114, 118, 159, 185, 186, 205
depression, 1, 3, 4, 11, 16, 18, 24, 29, 32, 106-107, 118, 185
fibromyalgia, 1, 18, 23, 29, 32, 94, 97
functional gastrointestinal disorders, 1, 102-106
general therapeutic approach, 119-122
posttraumatic stress disorder, 4, 11, 26, 32, 109-111, 185
self-harm, 117-118
sleep disorders, 4, 16, 21, 25-26, 101-102, 107, 159, 185
somatic symptom disorders, 4, 22, 32, 97, 99, 100-101, 185, 203, 204, 205
substance-use disorders, 113-116
traumatic brain injury, 111-113
Compensation (see Disability compensation for undiagnosed illnesses)
Complementary and alternative medicine, 4
acupuncture, 9, 35, 76, 78, 80-81, 97, 100, 102, 107, 120, 121, 191
continuous positive airway pressure, 99, 120
defined, 73, 76
Kampo, 76, 77, 78, 82-83
movement therapies, 63, 76-77, 78
outcomes and results, 80-83
for PTSD, 111
research recommendations, 9, 191
St. John’s wort, 9, 76, 77-78, 80-81, 82-83, 184, 191
strength of evidence, 78
Tai Chi, 63, 100, 120
yoga, 63, 100, 120
Composite International Diagnostic Interview, 72
Consolidated Standards of Reporting Trials, 9, 191
Consultations with mental health experts, 12, 46-47, 49, 53, 66-67, 68-69, 70-71, 72, 101, 120, 135-136
ConsumerSphere, 34
Continuity of care, 144, 159, 169
Continuous quality improvement, 149, 170, 176
Coordination of care, 5, 7, 8, 12, 96, 107, 159, 161, 168, 169, 186, 187, 188, 189-190
Cyclobenzaprine, 95
D
Da Costa’s syndrome, 11, 22
Data collection and quality, 3, 8, 142, 183, 190
Department of Veterans Affairs Health Care System
clinical practice guidelines, 158-159
educational materials, 158
Office of Patient Centered Care and Cultural Transformation, 160
post-deployment patient-aligned care team, 4, 5, 157-158, 185, 186, 187
specialty care access network, 4, 6, 7, 9, 159-160, 185, 187, 188, 189, 191
summary of models of care, 161
War-Related Illness and Injury Study Centers (WRIISC), 4, 6, 7, 9, 160, 169, 173, 185, 188, 190, 191
Depression acupuncture for, 107, 121
biofeedback interventions, 74-75
causes, 203
chronic fatigue syndrome and, 100, 119
chronic pain and, 93, 94
and CMI, 1, 3, 4, 11, 16, 18, 24, 29, 32, 106-107, 118, 185
cognitive behavioral therapy, 107, 113, 119, 121, 122
comorbid conditions, 49, 93, 94, 97, 100, 101, 103-104, 105, 108, 109, 112, 113, 114, 120, 121
diagnosis, 16, 106, 116
electroconvulsive therapy, 107, 121
exercise interventions, 77, 80-81, 84-85, 107, 121
major depressive disorder, 16, 106, 118-119, 121
models of care, 176, 207-208, 210
pharmacologic interventions, 38, 39, 42-43, 44-45, 46-47, 86, 95, 105, 107, 118, 119, 120, 121
prevalence, 16, 106
psychodynamic therapy, 66-67, 68-69, 70-71, 121
psychotherapy, 50, 58-59, 60-61, 62-63, 107, 113, 121
St. John’s wort treatment, 82-83
suicide and suicidal ideation, 106, 107, 116, 118-119
symptoms, 106-107
Disability compensation for undiagnosed illnesses, 23, 166-167
Dissemination of information on CMI, 3, 7-8, 171, 174, 183, 188-190
DocCom, 145
Doxycycline, 38, 39, 40, 41, 42-43, 184
Duloxetine, 38, 95, 120
E
Education (see Patient education; Training of clinicians)
Electroconvulsive therapy, 107, 121
Electronic health records (EHRs), 5, 134, 146, 147, 163-164, 176, 186
Enhanced medical care (EMC), 52, 66-67
Escitalopram, 39, 40, 41, 46-47
Exercise
aerobic, 9, 46-47, 60-61, 68-69, 79, 84-85, 95, 120, 159
anxiety, 77, 80-81, 84-85
chronic fatigue syndrome, 99
chronic pain, 84-85, 99, 116, 120, 158
cognitive behavioral therapy plus, 38, 50-51, 60-61, 79, 84-85, 95, 99, 120, 159, 169, 184
depression, 77, 80-81, 84-85, 107, 121
effectiveness, 79, 84-85
fibromyalgia, 95, 120
Gulf War Veterans’ Illnesses, 60-61, 84-85
research needs, 9, 191
sleep disorders, 102
somatic symptom disorders, 46-47, 53, 68-69, 77, 78, 80-81, 84-85
strength of evidence, 79, 84
substance-use disorders, 116, 122
Eye movement desensitization and reprocessing (EMDR), 54, 70-71
F
Family support, 116
Fibromyalgia
biofeedback intervention, 66-67
cause, 94, 203, 205
clinician–patient communication, 140
and CMI, 1, 4, 18, 23, 29, 32, 94, 97
cognitive behavioral therapy, 54, 68-69, 95, 120
comorbid conditions, 104
diagnostic criteria, 22, 23, 94
exercise therapy, 95, 120
multimodal therapy, 95, 120
pharmacologic interventions, 33, 38, 40, 94-95, 119, 120
prevalence, 94
symptoms, 3, 22, 94
Functional dyspepsia, 4, 102-103, 104, 105, 121, 185, 204
Functional gastrointestinal disorders (see also Functional dyspepsia; Irritable bowel syndrome)
and CMI, 102-104
nonpharmacologic treatments, 105-106
pharmacologic treatments, 105
G
Gabapentin, 38, 95, 120
Gulf War syndrome, 22
Gulf War veteran population defined, 1 n.1
prevalence of CMI, 2, 24-26
Gulf War Veterans’ Illnesses, 22, 40, 60-61, 84-85
H
HEROES study, 26
Hypervigilance, 25, 105, 109, 110, 205
Hypnosis, 46-47, 68-69, 72, 106, 121
Hypochondriasis, 50, 60-61, 68-69
I
Image rehearsal therapy, 102, 121
Institute for Healthcare Communication, 145
Institute for Healthcare Improvement, 170
Institute of Medicine (IOM), 2-3, 9, 12, 13, 14, 15, 22, 30, 113, 191
Integrated Disability Evaluation System (IDES), 166, 167
International and Interagency Initiative toward Common Data Elements for Research on Traumatic Brain Injury and Psychological Health, 112
International Society for Traumatic Stress Studies Guidelines, 111
Iraqi War veterans, defined, 1 n.1
Irritable bowel syndrome (IBS) cause, 203, 204
clinician–patient communication, 140, 210
and CMI, 1, 3, 18, 22, 23, 29, 97, 103-104, 185, 205
diagnosis, 23, 103, 203
hypnosis and, 106
pharmacologic treatments, 105, 119
prevalence, 103
psychodynamic interventions, 53-54, 66-67
psychotherapy, 54, 68-69, 105-106
symptoms, 103, 104, 204
treatments, 4, 33, 53-54, 66-67, 68-69, 104, 105-106, 119, 121
Irritable colon syndrome, 50
Irritable heart, 11, 22
J
Jungian therapy, 52, 64
K
Kampo, 76, 77, 78, 82-83
L
Learning networks, 7-8, 149, 170, 175, 189
Levosulpiride, 40, 41, 42-43
M
Management of care (see Patient-centered care for CMI)
Methadone, 115, 122
Methods of review
comorbid conditions with shared symptoms, 32-34
current research, 35
data abstraction and assessment, 32
generalizability of studies, 4, 39, 86, 184
health outcomes assessed, 15
information sources, 29-30, 32-35
public meetings and social media review, 32-35
selection of evidence, 31
summary of literature search and study selection process, 31-32, 33
systematic review of treatments, 30-32
Mind–body approached (see Biofeedback; Cognitive rehabilitation therapy; Complementary and alternative medicine)
Mirtazapine, 39, 42-43
Models of care (see also Department of Veterans Affairs Health Care System)
civilian settings, 173
clinician behavior change, 175-176
committee approach, 3
depression, 176, 207-208, 210
disseminating evidence-based guidelines, 173-175
implementation of changes, 171-173, 174
organization of services for veterans with CMI, 167-173
PACTs, 5-6, 7, 9, 157-158, 167-170, 187, 188, 189, 191
Plan Do Study Act (PDSA), 170-171, 172
postseparation comprehensive health assessment, 167-169
Monoamine oxidase inhibitors, 38
Motivational interviewing (MI), 9, 115, 138-139, 191
Movement therapies, 63, 76-77, 78
Myalgic encephalomyelitis (see Chronic fatigue syndrome)
N
Naltrexone, 35, 115, 122
National Collaborating Center for Primary Care, 108
National Institute for Health and Clinical Excellence, 108
Nefazodone, 39, 40, 41, 44-45
Nonsteroidal anti-inflammatory drugs, 38, 96, 99, 120
O
Operation Desert Storm, 1 n.1, 15
Operation Enduring Freedom, 1 n.1, 15, 25
Operation Iraqi Freedom, 1 n.1, 15, 25
Operation New Dawn, 1 n.1, 15, 25
Opioid analgesics, 25, 38, 96, 114, 115, 116, 120, 122
Opipramol, 39, 40, 41, 46-47
P
Pain (see Chronic pain)
Paroxetine, 39, 40, 41, 44-45
Patient-aligned care teams (PACTs), 5-6, 7, 9, 157-158, 167-170, 187, 188, 189, 191
Patient-centered care for CMI (see also Patient–clinician relationship)
consultations with mental health experts, 12, 135-136
coordination of care, 5, 7, 8, 12, 96, 107, 159, 161, 168, 169, 186, 187, 188, 189-190
information and communication technologies, 146-149
rationale for, 17
training of clinicians, 7, 8, 47, 69, 79, 133-136, 138, 145, 149, 160, 161, 162, 170, 188-190, 207-210
VHA Office of Patient Centered Care and Cultural Transformation, 160
Patient–clinician relationship
communication skills, 7, 8, 136-137, 138-139, 140, 207-210
determinants of good interactions, 138-139
patient perceptions of, 137-138
recommendations for improving, 139-145
resources for clinicians, 145
Patient education Internet and social media use, 17, 147
pain management, 158
substance-use disorders, 116
VHA-provided materials, 158
Patient experiences of care, 6, 16-17, 32, 59, 136, 143, 161-162, 187, 190
Patient satisfaction, 161-162
Persian Gulf War Veterans Act of 1998, 12
Pharmacologic interventions (see also specific agents)
anxiety, 39, 42-43, 44-45, 46-47, 72, 86, 101, 104, 105, 108, 118, 119, 120, 121
chronic pain, 42-43, 44-45, 95, 96, 99, 105, 114, 116, 119, 120, 210
depression, 38, 39, 42-43, 44-45, 46-47, 86, 95, 105, 107, 118, 119, 120, 121
effectiveness, 42-48
fibromyalgia, 33, 40, 94-95, 119, 120
functional gastrointestinal disorders, 105, 119
PTSD, 102, 111, 119, 121
sleep disorders, 95, 99, 102, 105, 120, 121
somatic symptom disorders, 39, 40, 42-47, 53, 72, 74-75, 101, 119, 120
strength of evidence, 41
substance-use disorders, 115, 122
traumatic brain injury, 113
Posttraumatic stress disorder (PTSD) clinical practice guidelines, 111, 158
and CMI, 4, 11, 26, 32, 109-111, 185
cognitive behavioral therapy, 50, 111, 121
comorbidities, 96, 101, 102, 104, 109, 186
complementary and alternative medicine, 111
diagnostic criteria, 109, 110
patient–clinician communication, 144
pharmacotherapy, 102, 111, 119, 121
post-Vietnam syndrome, 22
prevalence, 16, 25, 110
screening tools, 109
Prazosin, 102, 121
Preferred Reporting Items for Systematic Reviews and Meta-Analyses, 9, 191
Pregabalin, 38, 95, 96, 120
Psychiatric consultation, 56-57, 135
Psychodynamic interpersonal therapy (PIT), 53, 66-67, 106, 107, 119, 121, 122
Psychodynamic psychologic interventions anxiety, 52, 53, 54, 64-65, 66-67, 108, 121
biopsychosocial intervention, 64-65
cognitive behavioral therapy with, 52
depression, 66-67, 68-69, 70-71, 121
dynamic psychotherapy, 64-65
group, 53, 55, 64-65
individual, 52-53, 55
outcomes and results, 64-67
somatic symptom disorders, 52-53, 54, 64-65, 66-67
strength of evidence, 55
studies, 51
Psychotherapies (see also Cognitive behavioral therapy; Psychodynamic psychologic interventions)
anxiety, 50, 51, 58-59, 60-61, 62-63, 108, 113, 120, 121
chronic pain, 64-65
reviews, 53-54
strength of evidence, 55
for substance-use disorders, 115-116
summary of, 54-56
systematic reviews, 66-71
Pyridostigmine bromide, 13
Q
Quick Start program, 166
R
Radioelectric asymmetric conveyer brain stimulation (REAC-BS), 40-41, 48-49
Radiofrequency ablation of branch nerves, 96, 120
Reattribution training, 69, 135
Recommendations (see also Research recommendations)
data collection and quality improvements, 8, 190
dissemination of information, 7-8, 188-190
improving care, 5-7, 186-188
treatments for CMI, 4-5, 183-185
Relaxation interventions, 41, 49, 51, 57, 60-61, 66-67, 72, 74-75, 100, 102, 106, 108, 120-121
Research recommendations evaluation of programs, 9, 191-192
treatments for CMI, 8-9, 191
S
Selective serotonin reuptake inhibitors (SSRIs), 4, 38, 105, 107, 111, 118, 119, 120, 121, 185
Self-harm
and CMI, 4, 32, 117-118
screening measures, 116-117
treatments, 118-119
Serotonin–norepinephrine reuptake inhibitors (SNRIs), 4, 38, 95, 96, 105, 108, 119, 120, 121, 185
Shell shock, 11, 22
Sleep disorders
acupuncture, 102
circadian-rhythm sleep disorders, 101-102
and CMI, 4, 16, 21, 25-26, 101-102, 107, 159, 185
cognitive behavioral therapy, 49, 102, 121
comorbidities, 32, 94, 97, 98, 99, 101, 102, 105, 106, 107, 109, 120, 205
continuous positive airway pressure, 99, 120
exercise therapy, 102
insomnia, 98, 101, 102, 106, 121
mind–body approaches, 102
nightmare disorder, 101, 102
obstructive sleep apnea, 101
pharmacological treatments, 95, 99, 102, 105, 120, 121
prevalence, 16, 24, 25
rapid eye movement (REM) sleep behavior disorder, 101, 205
relaxation therapies, 60-61, 100, 121
symptoms, 100
treatments, 99, 102
Sleep hygiene, 49, 99-100, 102, 120
Social media use, 3, 34, 137, 146, 147, 148, 149
Somatic symptom disorders, 100
biofeedback, 57, 72-73, 74-75, 101, 120
and CMI, 4, 22, 32, 97, 99, 101, 185, 203, 204, 205
cognitive behavioral therapy, 41, 46-47, 50, 51, 53, 56-59, 62-63, 68-69, 70-71, 72, 108, 113, 120, 184
comorbidities, 104, 106, 110
diagnosis, 16, 22, 72
exercise interventions, 46-47, 53, 68-69, 77, 78, 80-81, 84-85
hypersensitivity, 205
hypnosis, 72
Kampo, 77, 78
pharmacologic treatments, 39, 40, 42-47, 53, 72, 74-75, 101, 119, 120
psychodynamic psychotherapies, 52-53, 54, 64-65, 66-67
relaxation interventions, 41, 49, 51, 57, 60-61, 66-67, 72, 74-75, 100, 102, 106, 108, 120-121
St. John’s wort, 77-78, 80-81, 82-83, 184-185
subthreshold, 72
suicide risk, 117
terminology, 100
Specialty Care Access Network-Extension for Community Healthcare Outcomes (SCAN-ECHO) programs, 4, 6, 7, 9, 159-160, 185, 187, 189, 191
St. John’s wort supplement, 9, 76, 77-78, 80-81, 82-83, 184, 191
Stimulus-control therapy, 102, 121
Substance-use disorders behavioral couples therapy, 115, 122
clinician resources, 145
and CMI, 4, 25, 32, 114, 185
cognitive behavioral therapy, 115, 122
comorbidities, 101, 109, 114
diagnostic criteria, 113-114
exercise programs, 116, 122
family support, 116
motivational interviewing, 138
opioid pain management therapy and, 114, 116, 122
patient education, 116
pharmacologic treatments, 115, 122
psychotherapy, 115-116
Suicide and suicidal ideation, 106, 107, 116, 118-119
Sulpiride, 39
T
Tai Chi, 63, 100, 120
Topiramate, 38, 39, 40, 41, 42-43, 115, 122
Toxic exposures, 12, 13
Training of clinicians, 7, 8, 47, 69, 79, 133-136, 138, 145, 149, 160, 161, 162, 170, 188-190, 207-210
Tramadol, 38, 95, 96
Transcutaneous electric nerve stimulation, 96-97, 120
Traumatic brain injury, 111-113
access to care, 173
clinical practice guidelines, 158
and CMI, 4, 32, 112, 185
cognitive behavioral therapy, 121
cognitive rehabilitation therapy, 113
comorbidities, 16, 109, 186
defined, 111-112
pharmacologic treatments, 113
prevalence, 16, 25, 96, 112
treatments, 113
stratification of severity, 112
symptoms, 93, 112
Treatments for CMI (see also individual treatment approaches)
adherence to, 43, 50-51, 52, 61, 79, 105, 116, 136, 138, 139, 141
general approach for medically unexplained physical symptoms, 12
multimodal approaches, 4, 9, 95, 96-97, 122, 185, 191
research recommendations, 8-9, 191
Tricyclic medications, 38, 95, 96, 105, 119, 120, 121, 185
U
US Food and Drug Administration (FDA), 95
UK National Health Service, 97
UK National Institute of Health and Clinical Excellence Guideline, 111, 118-119
University of New Mexico Health System, 148
V
Varenicline, 115, 122
Venlafaxine, 39, 40, 41, 42-43, 44-45, 101, 120
Veterans Benefits Act of 2010, 2, 13
Veterans Programs Enhancement Act of 1998, 12
W
War-Related Illness and Injury Study Centers (WRIISC), 4, 6, 7, 9, 160, 169, 173, 185, 188, 190, 191
Y
Yoga, 76, 100, 120
