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Of 898 former Far East prisoners of war, assessed between 1968 and 1981, 49 (5.5%) had evidence of persisting symptomatic neurological disease dating back to their periods of malnutrition in captivity. The commonest syndromes were peripheral neuropathy (often of "burning foot" type), optic atrophy, and sensori-neural deafness. Though nutritional neuropathies disappeared soon after release in most ex-Far East prisoners of war, in some they have persisted up to 36 years since exposure to the nutritional insult.
An ex-Far East prisoner of war (FEPOW) treated with corticosteroids for severe polymyositis died from multisystem strongyloidiasis and pyogenic meningitis. At necropsy larvae were widely disseminated in the lungs, liver, heart and brain.
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Five former war prisoners of the Japanese were clinically evaluated and intensively investigated for evidence of neurological disease. On release from imprisonment 36 years previously they were known to have a single neurological problem each, attributable to nutritional damage to the nervous system (four had optic atrophy and one a peripheral neuropathy). The present assessment confirmed these persisting neurological problems; but in addition two patients were found to have extrapyramidal and one pyramidal disease, one was demented, and two had evidence of non-dominant hemisphere damage on psychometric testing. Nutritional damage to the nervous system may be permanent, and more extensive than usually recognized.
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US Army veterans taken prisoner (POW's) in World War II and in the Korean War are compared with controls as to hospital admissions from 1946 to 1965 (1954-1965 for Korean War POW's), and as to symptoms, disability, and maladjustments in 1966-1967. Sequelae of the POW experience are both somatic and psychiatric, and are of greatest extent and severity among Pacific World War II POW's. Among European World War II POW's only psychiatric sequelae are apparent. Somatic sequelae were most prevalent in the early years after liberation, but for Pacific World War II POW's they persist in the form of higher hospital admission rates for many specific causes in the most recent period. Nevertheless, persistent psychiatric sequelae (especially psychoneurosis but also schizophrenia) are the more notable and pervasive for both Pacific World War II POW's and Korean War POW's as seen not only in elevated hospital admission rates but also in VA disability awards and in symptoms reported on the cornell Medical Index Health Questionnaire. The excess morbidity appears to correlate well with retrospective accounts of weight-loss and nutritional deficiency diseases and symptoms during the POW period.
A study of Australian male World War II veterans was conducted to assess clinically the gastrointestinal ill-effects which were present 40 years after the stress of internment as prisoners of war of the Japanese. A random sample of 170 surviving members of the captured Eighth Army Division resident in Sydney in 1983 (ex-POW) was compared with a similar sample of veterans who fought in Southeast Asia during the War, but were not imprisoned (non-POW). Duodenal ulcers and strongyloidiasis were more prevalent in the ex-POW group than in the non-POW group. The increased rate of duodenal ulcer (24.7%, compared with 10.5%; P = 0.0005) was confirmed by a higher proportion of ex-POWs currently taking cimetidine (9.0%, compared with 2.3%; P = 0.008). Strongyloidiasis had been found in 9.7% of all veterans, but in 15% of ex-POWs and in 19% of those who had worked on the Burma-Thailand railway. No other significant differences in gastrointestinal disease were found.
OBJECTIVE: To assess immune reactivity in men just released from a war prisoner camp. PARTICIPANTS: Random sample of 29 men from a group of 764 liberated detainees in war prisoner camp in Bosnia, 15 matched healthy control subjects, and pre-war historical control subjects. MAIN OUTCOME MEASURES: Report on immune reactivity parameters, such as lymphocyte immunophenotypes, natural killer cell and phagocyte function, serum cytokines, and hormones. RESULTS: Compared with control subjects, detainees had significantly lowered red blood cell count, hemoglobin mass concentration, hematocrit, total serum proteins, and albumin level, while the percentage and count of monocytes and non-segmented neutrophils were increased. Flow cytometry revealed a significant increase in percentage of activated lymphocytes, activated T lymphocytes, Tc/s lymphocytes, B lymphocytes, and total HLA-DR lymphocytes. The absolute counts of activated lymphocytes and activated T lymphocytes were also significantly increased. The percentages of naive Th/i lymphocytes and the ratio of CD4:CD8 lymphocytes were decreased. The in vitro natural killer cell cytotoxic activity and phagocytic functions of ingestion and digestion were significantly depressed. Serum interferon, serum cortisol, and prolactin were also significantly lowered. Serum tumor necrosis factor was increased. CONCLUSIONS: Alterations in the main parameters of the immune system and depression of important immune effector functions may have resulted from the psychological stress, physical deprivation, and malnutrition experienced by these war camp prisoners during their detainment.
To characterize the effects of trauma sustained more than 40 years ago, prevalence of psychiatric disorders and personality dimensions were examined in a sample of 62 former World War II POWs. The negative effects of their experiences are reflected in their multiple lifetime diagnoses and in their current personality profiles. Fifty percent met DSM-III posttraumatic stress disorder (PTSD) criteria within 1 year of release; 18 (29%) continued to meet the criteria 40 years later at examination (chronic PTSD). A lifetime diagnosis of generalized anxiety disorder was found for over half the entire sample; in 42% of those who never had PTSD, 38% of those with recovery from PTSD, and 94% of those with chronic PTSD. Ten percent of those without a PTSD diagnosis had experienced a depressive disorder, as had 23% of those with recovery from PTSD and 61% of the POWs with chronic PTSD. The combination of depressive and anxiety disorders also was frequent in the total sample (61%). Current MMPIs of three groups with psychiatric diagnosis were compared with those of POWs who had no diagnoses and with a group of Minnesota normal men. Profile elevations for the groups, from highest to lowest, were: POWs with chronic PTSD, POWs with recovery from PTSD, POWs with other psychiatric diagnoses, POWs with no disorders, and Minnesota normal men. Symptoms of anxiety, depression, and somatic concerns combined with the personality styles of suppression and denial characterize the current adjustment of negatively affected POWs.
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