Disordered society.

The concept of post-traumatic stress disorder (PTSD) was to be verified considering World War I soldiers suffering from psychiatric and neurologic diseases. According to hypotheses, relevant circumstances of the case history and significance of the direct military action had to be examined. In 2002, medical histories dating from 1914 to 1921 of male soldiers in Jena, Germany, were analyzed. Statistical examination carried out by means of the chi2 test revealed mental illness more frequently in soldiers with relevant family anamnesis, previous psychiatric treatment, or degree of voluntariness than in soldiers not so characterized. The accumulation of mental illnesses was lower in soldiers involved in military actions or directly with firing weapons than in soldiers never involved in battles. These results are in accord with historical but not current literature on PTSD. The author is of the opinion that psychiatric anamnesis is not given enough consideration in the concept of PTSD.

Combat Disorders↗

PubMed2006

Waking up to shell shock: psychiatry in the US military during World War II.

During World War I, military officers encountered a new and puzzling phenomenon: soldiers emerged from the trenches stuttering, crying, trembling and at times were even paralysed and blind. Those in charge were convinced these soldiers were cowards or malingerers who deserved stern discipline or to be court-martialled. A number of physicians, by contrast, initially assumed that these alarming symptoms resulted from close exposure to explosions and called it shell shock. Later, they realized that it was a psychological reaction and came up with psychotherapeutic treatments. But it was only in World War II that military psychiatrists, particularly those in the USA, began to implement treatment methods for this phenomenon in a systematic way. Their thinking and the treatments they devised had significant consequences for the future of American psychiatry, which in turn influenced the development of psychiatry and military psychiatry world-wide.

Combat Disorders↗

PubMed2006

Historical approaches to post-combat disorders.

Almost every major war in the last century involving western nations has seen combatants diagnosed with a form of post-combat disorder. Some took a psychological form (exhaustion, combat fatigue, combat stress reaction and post-traumatic stress disorder), while others were characterized by medically unexplained symptoms (soldier's heart, effort syndrome, shell shock, non-ulcer dyspepsia, effects of Agent Orange and Gulf War Syndrome). Although many of these disorders have common symptoms, the explanations attached to them showed considerable diversity often reflected in the labels themselves. These causal hypotheses ranged from the effects of climate, compressive forces released by shell explosions, side effects of vaccinations, changes in diet, toxic effects of organophosphates, oil-well fires or depleted-uranium munitions. Military history suggests that these disorders, which coexisted in the civilian population, reflected popular health fears and emerged in the gaps left by the advance of medical science. While the current Iraq conflict has yet to produce a syndrome typified by medically unexplained symptoms, it is unlikely that we have seen the last of post-combat disorders as past experience suggests that they have the capacity to catch both military planners and doctors by surprise.

Combat Disorders↗