Shell shock: an outcome study of a First World War ‘PIE’ unit

Jones, Edgar; Thomas, Adam G.; Ironside, Stephen

doi:10.1017/s0033291706009329

Cited by 29 publications

(20 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of those soldiers admitted, 21% "broke down" within 3 months of going overseas. Less than 20% of these soldiers directly returned to their combat units (22).…”

Section: Long-term Physical and Mental Health Problems In Selected Warsmentioning

confidence: 99%

Health Effects of Combat: A Life-Course Perspective

Levy

Sidel

2009

Annu. Rev. Public Health

View full text Add to dashboard Cite

Armed combat (also termed war or armed conflict) has profound direct and indirect impacts on the long-term physical and mental health of both military personnel and noncombatant civilians. Although most research has focused on immediate and short-term health consequences of war, an increasing number of studies have focused on the long-term health consequences for both veterans of military service and noncombatant civilians. However, these long-term studies focus almost entirely on posttraumatic stress disorder and other mental health problems; relatively few long-term studies have focused on physical injuries due to war and the impact of those injuries on relationships, work, and other aspects of life. This article reviews illustrative examples of the existing literature on these long-term health consequences of war, focusing not only on military veterans of several different armed conflicts but also on noncombatant civilian populations, including spouses and children of military veterans as well as refugees and internally displaced persons. Public health professionals can help address these problems. 123

show abstract

“…Of those soldiers admitted, 21% "broke down" within 3 months of going overseas. Less than 20% of these soldiers directly returned to their combat units (22).…”

Section: Long-term Physical and Mental Health Problems In Selected Warsmentioning

confidence: 99%

Health Effects of Combat: A Life-Course Perspective

Levy

Sidel

2009

Annu. Rev. Public Health

View full text Add to dashboard Cite

show abstract

“…Brown claimed that while in charge of the NYDN for the 4 th Army he returned 70% of the shell shocked to the front line [25]; however, in the summer of 1917 it was suggested that servicemen discharged from the NYDN Centres simply proceeded through the wider hospital system. An audit of three NYDN Centres reported that only 10% of the patients had a second admission for shell shock [22]. Major D Carmalt-Jones RAMC published nine months' data from the NYDN at 4 Stationary Hospital, concluding that a second breakdown rendered a soldier incapable of return to the front line.…”

Section: Box 2 the Stages Of Dr F Kaufman's Methods Of Treating Shellmentioning

confidence: 99%

“…January 1917 saw the beginning of four British 'forward psychiatric units', called NYDN ("not yet diagnosed nervous") Centres [22] [23].…”

Section: Introductionmentioning

confidence: 99%

Anaesthetic and Other Treatments of Shell Shock: World War I and Beyond

McKenzie

2012

J R Army Med Corps

View full text Add to dashboard Cite

Post-traumatic stress disorder (PTSD) is an important health risk factor for military personnel deployed in modern warfare. In World War I this condition (then known as shell shock or 'neurasthenia') was such a problem that 'forward psychiatry' was begun by French doctors in 1915. Some British doctors tried general anaesthesia as a treatment (ether and chloroform), while others preferred application of electricity. Four British 'forward psychiatric units' were set up in 1917. Hospitals for shell shocked soldiers were also established in Britain, including (for officers) Craiglockhart War Hospital in Edinburgh; patients diagnosed to have more serious psychiatric conditions were transferred to the Royal Edinburgh Asylum. Towards the end of 1918 anaesthetic and electrical treatments of shell shock were gradually displaced by modified Freudian methods psychodynamic intervention. The efficacy of 'forward psychiatry' was controversial. In 1922 the War Office produced a report on shell shock with recommendations for prevention of war neurosis. However, when World War II broke out in 1939, this seemed to have been ignored. The term 'combat fatigue' was introduced as breakdown rates became alarming, and then the value of pre-selection was recognised. At the Maudsley Hospital in London in 1940 barbiturate abreaction was advocated for quick relief from severe anxiety and hysteria, using i.v. anaesthetics: Somnifaine, paraldehyde, Sodium Amytal. 'Pentothal narcosis' and 'narco-analysis' were adopted by British and American military psychiatrists. However, by 1945 medical thinking gradually settled on the same approaches that had seemed to be effective in 1918. The term PTSD was introduced in 1980. In the UK the National Institute for Health and Clinical Excellence (NICE) guidelines for management (2005) recommend trauma-focussed Cognitive Behavioural Therapy and consideration of antidepressants.

show abstract

“…They attracted the attention of the media and provided a focus for veterans' pressure groups. Similarly, mild traumatic brain injury (mTBI), a disorder brought to the fore by explosive devices in Iraq and Afghanistan, has much in common with shell-shock from World War 1 and post-concussional syndrome from World War 2 [7,8]. Earlier generations believed that research would distinguish between the physical and psychological causes of ill health in soldiers exposed to blast.…”

Section: The Twentieth Century View Of Operational Stress Injuriesmentioning

confidence: 99%

“…Under pressure during both World Wars to demonstrate an effective role, some military psychiatrists over-estimated the effectiveness of forward psychiatry, an intervention designed to treat disturbed personnel within the sound of battle as quickly as possible with the expectation of a return to duty [7,8]. When ambitious targets were not achieved during the campaign for Normandy, for example, not only were individual mental health officers undermined but the service as a whole came under scrutiny [4].…”

Section: The Twentieth Century View Of Operational Stress Injuriesmentioning

confidence: 99%

The injured mind in the UK Armed Forces

Greenberg

Jones

et al. 2011

Phil. Trans. R. Soc. B

View full text Add to dashboard Cite

The mental health of the UK Armed Forces is a topic much debated by healthcare professionals, politicians and the media. While the current operations in Afghanistan, and the recent conflict in Iraq, are relevant to this debate, much of what is known about the effects of war upon the psyche still derives from the two World Wars. This paper will examine the historical and contemporary evidence about why it is that some Service personnel suffer psychological injuries during their military service and others do not. The paper will also consider some of the strategies that today's Armed Forces have put in place to mitigate the effects of sending military personnel into danger.

show abstract

Shell shock: an outcome study of a First World War ‘PIE’ unit

Abstract: Forward psychiatry was not effective in returning combat troops to fighting units but, by allocating soldiers to support roles, it prevented discharge from the armed forces. Uncertainties remain about relapses, including other routes that servicemen used to escape from a combat zone.

Cited by 29 publications

References 23 publications

Health Effects of Combat: A Life-Course Perspective

Health Effects of Combat: A Life-Course Perspective

Anaesthetic and Other Treatments of Shell Shock: World War I and Beyond

The injured mind in the UK Armed Forces

Contact Info

Product

Resources

About