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The neurological and psychological manifestations of trauma, confinement, and terror became apparent throughout Europe as soldiers were evacuated from the trenches of the Western Front. The response in the UK evolved as a result of the experience of medical staff embedded with the troops in base hospitals and the philosophy of those treating returned soldiers in specialist establishment. There were widely disparate approaches to the management encompassing simple supportive care, a psychanalytic approach and radical electric shock therapy. The latter was partially driven by the Queen Square experience in the UK but was also concurrently widely pursued throughout Europe. With experience, care was increasingly undertaken close to the front lines using a philosophy of immediacy and expectation of recovery. Post-war analysis was startlingly unsympathetic, yet the experiences and management of shell shock have guided psychiatric and medical understanding of functional illness and post-traumatic stress over the subsequent century. In this historical review, we have sought to present features of the UK response to the neurological manifestations of trauma, the way in which these changed as the war proceeded and the political and medical response in the aftermath of war., (© 2021 The Author(s). Published by S. Karger AG, Basel.)

This is the first nursing journal article to introduce the pioneering work of American psychiatric nurse leader, Adele S. Poston. Poston supervised a team of nurses as they cared for soldiers serving with the American Expeditionary Forces during World War I in France. Poston and her nurses worked in the first American specialized neuropsychiatric hospital in a war. The soldiers they treated primarily had functional nervous disorders described at that time as "shell shock" or "war neuroses." The traumatized officers and enlisted men were considered capable of being cured and returned to active duty based on research done by American psychiatrists among British troops during the first 3 years of the war. The story of Poston's career prior, during, and after the war and her work with other nurses during a global war are significant in psychiatric nursing history. Bringing this hitherto missing piece of psychiatric and nursing history into the light gives us a unique opportunity to recognize Poston and the nurses who served with her, even as today we recognize the nurses who serve during the global COVID-19 pandemic. [ Journal of Psychosocial and Mental Health Services, 59 (6), 37-47.].

Arthur Hurst was a British First World War physician, best known for his films of shell shock, 'War Neuroses'. He has often been portrayed an innovative pioneer of somewhat mysterious 'suggestion' techniques for functional motor disorders but also as an ambitious clinician who exaggerated the effectiveness of his treatments and failed to address psychological factors. His use of suggestion, persuasion and re-education together with occupational therapy, for chronic or severe cases of shell shock stirred controversy at the time because of the dramatic nature of some of his treatment responses and lack of outcome data. In part, this was a turf war between neurologists and psychiatrists for a dominant therapeutic model. A re-evaluation of his publications and new research into soldiers treated at Seale Hayne in Devon show that Hurst pioneered multidisciplinary and empathetic treatments for functional motor disorders with good short-term outcomes, though insufficient data survives to assess longer term outcomes., Competing Interests: No conflict of interests declared

Treatment of functional symptoms has a long history, and interventions were often used in soldiers returning from battle. On the 75th anniversary of the end of the Second World War, I review the portrayal of neurology in documentary film. Two documentaries were released in 1946 and 1948 ( Let There Be Light and Shades of Gray, respectively), which showed a number of soldiers with functional neurology including paralysis, stuttering, muteness, and amnesia. The films showed successful treatments with hypnosis and sodium amytal by psychoanalytic psychiatrists. These documentaries link neurology with psychiatry and are remarkable examples of functional neurology and its treatment on screen., (© 2020 American Academy of Neurology.)

Case reports of the abrupt recovery of hysterical disorders during World War I (1914-18), though undoubtedly subject to publication bias, raise both aetiological and treatment issues regarding pseudo-neurological conversion symptoms. Published clinical anecdotes report circumstantial, psychotherapeutic, hypnotic, persuasive (and coercive) methods seemingly inducing recovery, and also responses to fright and alterations of consciousness. The ethics of modern medical practice would not allow many of these techniques, which were reported to be effective, even in the chronic cases.

The English electrophysiologist Edgar Adrian (1889-1977) was the recipient of the Nobel Prize for physiology in 1932 for his research on the functions of neurons. During World War I, at Queen Square in London, he devised an intensive electrotherapeutic treatment for shell-shocked soldiers. The procedure, developed with Lewis Yealland (1884-1954), was similar to "torpillage," the faradic psychotherapy used in France. Adrian and Yealland considered that the pain accompanying the use of faradic current was necessary for both therapeutic and disciplinary reasons, especially because of the suspicion of malingering. According to Adrian, this controversial electric treatment was only able to remove motor or sensitive symptoms. After the war, he finally admitted that war hysteria was a complex and difficult phenomenon., (© 2018 S. Karger AG, Basel.)

The issue of First World War shell shock has been documented mainly from a medical perspective. Many medical texts dealing with war psychoneuroses and their aggressive treatments, such as electrotherapy, were published during the war. Accounts from shell-shocked soldiers are rare. Nevertheless, shell shock was described from a non-medical point of view by a few writers who had undergone or witnessed this pathology. Their texts deal mainly with the psychiatric forms, the most striking ones, but also with the more common concepts of commotion, emotion and pathological fear. The French philosopher Émile Chartier (1868-1951), alias Alain, described the commotional syndrome from which he suffered. The German writer Ernst Jünger (1895-1998), a brave officer and an example for his men, reported his emotional shock. Some psychiatric forms of shell shock are present in the work of the pacifist writer Jean Giono (1895-1970), the naturalist Maurice Genevoix (1890-1980), who suffered himself from a section of the left median and ulnar nerves, or the British poet Siegfried Sassoon (1886-1967). War hysteria and pathological fear have been described, on several occasions, by Blaise Cendrars (1887-1961) or the German writer Erich Maria Remarque (1898-1970). Electrotherapy has been scarcely reported except by Louis-Ferdinand Céline (1894-1961)., (© 2018 S. Karger AG, Basel.)

Many artists were involved in the First World War. Some of them were mobilized, like millions of soldiers, others enlisted to fight on the battlefield. The stories of writers who returned neurologically wounded from the war, such as Guillaume Apollinaire (1880-1918) or Blaise Cendrars (1887-1961), are well-known. The cases of painters and sculptors who suffered from First World War neurological wounds are scarce. Nevertheless, their injuries led to intense modifications of artistic practice. We detail four examples of artists whose creative mind was impacted by their First World War neurological wounds or diseases. The painter Jean-Julien Lemordant (1878-1968), who suffered from blindness after his injury, stopped his artistic work and became an icon of Franco-American friendship. The sculptor Maurice Prost (1894-1967), suffering from a neuroma due to the loss of his arm, built a special device to continue his work as a wildlife artist. The painter Georges Braque (1882-1963) was trepanned but carried on with his cubist work without ever mentioning the conflict. Conversely, the painter Fernand Léger (1881-1955), who suffered from a war neurosis, produced a significant war testimony through drawings and letters., (© 2018 S. Karger AG, Basel.)

The First World War was a global war, beginning on 28 July 1914, until 11 November 1918. Soon after the beginning of the war, there was an "epidemic" of neurological conversion symptoms. Soldiers on both sides started to present in large numbers with neurological symptoms, such as dizziness, tremor, paraplegia, tinnitus, amnesia, weakness, headache and mutism of psychosomatic origin. This condition was known as shell shock, or "war neurosis". Because medically unexplained symptoms remain a major challenge, and considering the close relationship of symptoms described in shell shock with clinical neurology, we should study their history in order to improve future care.

Combat stress cases were traced in historical texts and military manuals on warfare from the Middle Byzantine period; they were mainly labelled as cowardice. Soldiers suffered from nostalgia or exhaustion; officers looked stunned, or could not speak during the battle. Cruel punishments were often enforced. Suicide and alcohol abuse were rarely mentioned. The Byzantines' evacuation system for battle casualties was well organized. Psychological operations were conducted and prisoners-of-war were usually part of them. The Byzantine army had 'parakletores', officers assigned to encourage soldiers before combat. The leaders dealt with combat stress by using their rhetoric skills and emphasizing religious faith in eternal life. The treatment of the 'cowards' was rather similar to modern war psychiatry principles of treatment. No description of PTSD was found., (© The Author(s) 2016.)

World War I was the archetype of an industrial conflict and its consequences have been million dead, some heavily disabling physical traumatisms beside serious neurological/psychological suffering. Some of the sequels had been noticed during previous wars such as Crimea War, Civil War, Franco-Prussian War, and were labeled as shellshock. In literature (Céline, Virginia Woolf, William, March, Gughenno and so on) some situations or characters evoked disorders, which have been described later as post-traumatic syndrome.

Just before and after the end of World War I, Sigmund Freud took on an activist role and in his writings and speeches, redirected the concept of war trauma from individual failure to a larger issue of community responsibility. Testifying in Vienna as an expert witness for the state, Freud said that the military psychiatrists-not the soldiers-had "acted like machine guns behind the front" and were the "immediate cause of all war neurosis." Freud was called on by the legal community when Julius Wagner-Jauregg, a future Nobel Prize winner (and also future Nazi Party adherent), head of the municipal Clinic for Psychiatry and Nervous Diseases, was accused of the lethal use of electrotherapy on shell-shocked soldiers. As sociological as psychoanalytic in his responses, Freud's withering critique came just 2years after he avowed that "it is possible to foresee that the conscience of society will awake." That speech on the human right to mental health care affirmed Freud's alliance to the social democratic position and inspired the second generation of psychoanalysts to develop community-based clinics throughout Europe where treatment was free of cost, for war neurosis and beyond., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Shell shock was an important object of diagnostic and therapeutic concern in Oxford during the Great War. The efforts of three Oxford physicians--Thomas Saxty Good, William McDougall, and James Arthur Hadfield--are of particular significance to our story. All worked on the problem at various sites throughout the city. They often collaborated. All were committed to employing innovative techniques such as psychotherapy and hypnosis. Each rose, to differing extents, to prominence in the field of psychological medicine during the succeeding decades. Yet all have been neglected in the current historiography. I argue that a close examination of their practices reveals a curious combination of therapeutic pragmatism and psychoanalytically informed techniques that later helped inform clinical psychology's challenge to psychiatry's dominance over the concept and care of mental disorder.

During the 20th century, the management of war-related psychological trauma shifted from neurology to psychiatry. After September 11, 2001, the French forces participated in a multinational force deployed in Afghanistan to fight against terrorism. Post-traumatic stress disorder (PTSD) became a priority. We report the daily work of the psychiatrists involved in this mission and the organization developed to psychologically support wounded military personnel. The doctrine of early intervention psychiatrization and the technique of collective debriefing are the key points of this procedure. The psychiatrist is also responsible for the healthcare community, particularly vulnerable when confronted with severe ballistic injuries. One aim of this organization is also to screen PTSD in soldiers returning from Afghanistan. The military general practitioner is a pivotal point of this procedure built to detect PTSD, anxiety, depressive reaction and behavioral problems. The French health service has developed a genuine care strategy aimed at identifying patients, accompanying them in the formalities for recognition and compensation, and offering them treatment locally by arranging clinical psychology consultations near their home., (© 2016 S. Karger AG, Basel.)

Camillo Negro, Professor in Neurology at the University of Torino, was a pioneer of scientific film. From 1906 to 1908, with the help of his assistant Giuseppe Roasenda and in collaboration with Roberto Omegna, one of the most experienced cinematographers in Italy, he filmed some of his patients for scientific and educational purposes. During the war years, he continued his scientific film project at the Military Hospital in Torino, filming shell-shocked soldiers. In autumn 2011, the Museo Nazionale del Cinema, in partnership with the Faculty of Neurosciences of the University of Torino, presented a new critical edition of the neuropathological films directed by Negro. The Museum's collection also includes 16 mm footage probably filmed in 1930 by Doctor Fedele Negro, Camillo's son. One of these films is devoted to celebrating the effects of the so-called "Bulgarian cure" on Parkinson's disease.

The Great War accelerated the development of neurological knowledge. Many neurological signs and syndromes, as well as new nosological entities such as war psychoneuroses, were described during the conflict. The period between 1914 and 1918 was the first time in which many neurologists were concentrated in wartime neurology centres and confronted with a number of neurological patients never seen before. This concentration led to the publication of papers concerning all fields of neurological sciences, and these reports pervaded scientific journals during the conflict and the post-war years. The careers of French neurologists during the war were highly varied. Some were mobilised, whilst others enlisted voluntarily. They worked as regiment physicians at the front or in wartime neurology centres at the front or at the rear. Others were academics who were already authoritative names in the field of neurology. Whilst they were too old to be officially mobilised, they nevertheless worked in their militarised neurology departments of civil hospitals. We present here the careers of a few French neurologists during the Great War, including Charles Foix (1882-1927), René Cruchet (1875-1959), Georges Guillain (1876-1961), Jean Lhermitte (1877-1959), Clovis Vincent (1879-1947), Gustave Roussy (1874-1948), and Paul Sollier (1861-1933)., (© 2016 S. Karger AG, Basel.)

This article presents the origins of Polish psychotherapy with a special focus on psychotherapy development in Krakow and at the Jagiellonian University. The history of Krakow psychotherapy starts with the foundation of the Psychiatry and Neuropathology Clinic of the Jagiellonian University in 1905. Doctors working in the Department of psychotherapy developed their skills through contacts with the Zurich University Psychiatric Clinic Burgholzli. At the same time psychotherapy, and psychoanalysis in particular, were raising more and more interest in Poland. The most dynamic development of psychoanalysis reflected in the number of scientific publications, occurs in the years leading to the outbreak of War World I. This article presents brief portraits of the first Polish psychoanalysts ( Ludwik Jekels, Herman Nunberg, Ludwika Karpińska, Stefan Borowiecki, Jan Nelken, Kraol de Beaurain). Many of them worked in Psychiatry and Neuropathology Clinic of the Jagiellonian University. Their scientific achievements and contribution to the development of the international psychoanalytic movement are described, as well as relationships with leading psychoanalysts of this period (Freud, Jung). With the outbreak of World War I the research on and treatment of war neurosis was initiated in the Psychiatry and Neuropathology Clinic. Professor Piltz, the director of the clinic, together with his assistants (Borowiecki, de Beuarain, Artwiński) devised a unique in European psychiatry and highly efficient method of post-traumatic disorders treatment, in which psychotherapy was of key importance.

Studies of trauma commonly concentrate on the psychological and physiological effects of recent violent events. Although today connections are becoming more explicitly drawn, early studies of the aftermath of amputation serve to shed light on modern understanding of the interaction of the physical and emotional. The study of combat amputation, dissociation, and related posttraumatic stress largely began with the work of 19th-century Philadelphia physician Silas Weir Mitchell, who brought attention to the phenomenon of phantom limb pain. Less known, however, are the data he and his son, John K. Mitchell, also collected on the mental outcomes of trauma. Using an archived collection of original surveys of double-amputee patients dating largely from 1893 housed at the Historical Medical Library at the College of Physicians of Philadelphia, an interdisciplinary team explored the historical, anthropological, and psychological background of the study of combat trauma. Almost 30 years following the end of hostilities, the majority of the sample of U.S. Civil War veterans indicated that their general disposition, general health, and sleeping or eating patterns had changed following limb amputation. More telling, possibly, are the written comments on the surveys and letters that indicate frustration with the continuous suffering and the knowledge of their mental and physical changes. These data illustrate the value of historical archives in documenting the development of the study of trauma and modern concepts of combat experiences.

Between 1914 and 1918, war strain appeared under a number of guises and affected, to varying extents, the majority of French soldiers. The most frequent form of war strain was war psychoneurosis, but war strain also induced more paroxystic disorders, such as acute episodes of terror, self-mutilation, induced illnesses and even suicide. Fear was the constant companion of soldiers of the Great War: soldiers were either able to tame it or overwhelmed by an uncontrollable fear. Nonetheless, over the course of the war, some aspects of fear were recognised as syndromes. The French health service poorly anticipated the major consequences of war strain, as with many other types of injuries. After the establishment of wartime neuropsychiatric centres, two main medical stances emerged: listening to soldiers empathetically on the one hand and applying more repressive management on the other. For many physicians, the psychological consequences of this first modern war were synonymous with malingering or cowardice in the face of duty. The stance of French military physicians in relation to their command was not unequivocal and remained ambivalent, swaying between medico-military collusion and empathy towards soldiers experiencing psychological distress. The ubiquity of suspected malingering modified the already porous borders between neuropsychiatric disorders and disobedience. Several war psychoneurotic soldiers were sentenced by councils of war for deserting their posts in the face of the enemy and were shot. Many soldiers suspected of self-mutilation or suffering from induced illnesses were also sentenced and executed without an expert assessment of their wound or their psychological state., (© 2016 S. Karger AG, Basel.)

When the Red Cross opened its new convalescent home at Russell Lea in Sydney in 1919, it contained a coloured room designed for treating ‘nerve cases’. This room was painted by Roy de Maistre, a young artist, and was modelled on the Kemp Prossor colour scheme trialled at the McCaul Convalescent Hospital in London for the treatment of shell shock. Dubbed the ‘colour cure’ by the popular press, this unconventional treatment was ignored by the Australian medical profession. The story of de Maistre's colour experiment is not widely known outside the specialist field of Australian art history. Focusing on the colour room as a point of convergence between art and medicine in the context of the First World War, this article investigates Red Cross activities and the care of soldiers suffering from nervous conditions.

World War I erupted at a time when artistic avant-gardes were particularly thriving across Europe. Young poets, writers, painters and sculptors were called to arms or voluntary enrolled to fight, and several of them died during the conflict. Among others, it dramatically changed their creative output, either through specific wounds or through personal encounters and experiences. These individual events then significantly modified the course of the literary and artistic avant-garde movements. Three particularly illustrative examples of avant-garde French poets are presented here: André Breton (1896-1966), Guillaume Apollinaire (1880-1918) and Blaise Cendrars (1887-1961). The deep source of the surrealist movement can indeed be found in André Breton's involvement as an auxiliary physician with critical interest in neuropsychiatry, which caused him to discover automatic writing. Guillaume Apollinaire's right temporal subdural hematoma strongly modified his emotional state and subsequent artistic activities. Alternatively, after losing his right, writing hand, Blaise Cendrars not only substituted it with a phantom but also rapidly switched from poetry to novels after he learnt to write with his left hand., (© 2016 S. Karger AG, Basel.)

A critical analysis of the historical involvement of neurology and neurosurgery in military emergency care services enables us to better contextualize and appreciate the development of modern neurology at large. Wartime neurosurgery and civil brain science during the German Nazi period tightly coalesced in examining the specific injury types, which military neurosurgeons such as Wilhelm Toennis, Klaus Joachim Zuelch, and Georg Merrem encountered and treated based on their neurophysiological understanding gained from earlier peacetime research. Collaborative associations with Dr. Toennis in particular proved to be highly beneficial to other military neurologists and neurosurgeons during World War II and beyond. This article also discusses the prewar developments and considers the fate of German neurosurgeons and military neurologists after the war. The envisaged dynamic concepts of fast action, reaction, and recycling, which contemporary physicians had intensively studied in the preceding scientific experiments in their neurophysiological laboratories, had already been introduced into neurological surgery during the interwar period. In retrospect, World War II emergency rescue units greatly strengthened military operations through an active process of 'recycling' indispensable army personnel. Neurosurgical emergency chains thereby introduced another decisive step in the modernization of warfare, in that they increased the momentum of military mobility in the field. Notwithstanding the violence of warfare and the often inhumane ways in which such knowledge in the field of emergency neurology was gained, the protagonists among the group of experts in military neurology and neurosurgery strongly contributed to the postwar clinical neuroscience community in Germany. In differing political pretexts, this became visible in both East Germany and West Germany after the war, while the specific military and political conditions under which this knowledge of emergency medicine was obtained have largely been forgotten., (© 2016 S. Karger AG, Basel.)

People died from nostalgia in the army in the 17th-19th centuries. The term 'nostalgia', created by the doctor Johannes Hofer (1669-1752), from Mulhouse, came from the Germanic Heimweh, or 'homesickness'. It affected the young people enrolled in the army, such as Swiss mercenaries. Longing for their native land, they were consumed by an ongoing desire to return home. If it was impossible to do so, they sank into 'a sadness accompanied with insomnia, anorexia and other unpleasant symptoms' that could lead to death. Nostalgia became classified as a disease during the last quarter of the 18th century and ravaged the French army during the Revolution and the Napoleonic wars. However, as soon as the wars ended, it ceased to exist in the army (except the colonial army). It was removed from the nosology in the first half of the 19th century. Rapidly explained as an example of a misdiagnosis or a confusion between 'connection and cause', nostalgia needs to be assessed in regard to the medical debate between 'alienists' and 'organicists'. Creating much concern, nostalgia needs to be considered in the historical context of a society destabilized by modernity, with some individuals uprooted by the sudden transition from civil society to military life. It raises questions about the role that the army played in the creation of the French national union. Nostalgia may have also covered psychic traumatisms later designated as combat fatigue, war neurosis, or post-traumatic stress disorder., (© 2016 S. Karger AG, Basel.)

Between December 1965 and December 1971, the United States maintained armed forces in Vietnam never less than 180,000 men and women in support of the war. At one time, this commitment exceeded half a million soldiers, sailors, and airmen from both the United States and its allies. Such forces required an extensive medical presence, including 19 neurologists. All but two of the neurologists had been drafted for a 2-year tour of duty after deferment for residency training. They were assigned to Vietnam for one of those 2 years in two Army Medical Units and one Air Force facility providing neurological care for American and allied forces, as well as many civilians. Their practice included exposure to unfamiliar disorders including cerebral malaria, Japanese B encephalitis, sleep deprivation seizures, and toxic encephalitis caused by injection or inhalation of C-4 explosive. They and neurologists at facilities in the United States published studies on all of these entities both during and after the war. These publications spawned the Defense and Veterans Head Injury Study, which was conceived during the Korean War and continues today as the Defense and Veterans Head Injury Center. It initially focused on post-traumatic epilepsy and later on all effects of brain injury. The Agent Orange controversy arose after the war; during the war, it was not perceived as a threat by medical personnel. Although soldiers in previous wars had developed serious psychological impairments, post-traumatic stress disorder was formally recognized in the servicemen returning from Vietnam., (© 2016 S. Karger AG, Basel.)

Objective: Australasians contributed to the medical literature on shell shock during and after World War I., Conclusions: AW Campbell, Elliot Smith, Carmalt Jones and AG Butler made significant contributions, and several 'frontline doctors' recorded astute observations., (© The Royal Australian and New Zealand College of Psychiatrists 2015.)

Objective: This paper outlines the substantial stigmatization of soldiers who suffered psychiatric disorders during World War I, and how there was little acceptance of the enduring impact of prolonged combat exposure once the war ended., Conclusion: Recent decades of research highlight the delayed impact of combat exposure and its long-term neurobiological consequences., (© The Royal Australian and New Zealand College of Psychiatrists 2015.)

This paper examines the relationship between 'world citizenship' and the new psychiatric research paradigm established by the World Health Organization in the early post-World War II period. Endorsing the humanitarian ideological concept of 'world citizenship', health professionals called for global rehabilitation initiatives to address the devastation after the war. The charm of world citizenship had not only provided theoretical grounds of international collaborative research into the psychopathology of psychiatric diseases, but also gave birth to the international psychiatric epidemiologic studies conducted by the World Health Organization. Themes explored in this paper include the global awareness of mental rehabilitation, the application of public health methods in psychiatry to improve mental health globally, the attempt by the WHO to conduct large-scale, cross-cultural studies relevant to mental health and the initial problems it faced., (© The Author(s) 2015.)

The history of mental disorders occasioned by World War I is a complex and important history, indelibly linked with social, political and cultural circumstances, and the history of the war itself. The Richmond War Hospital was a 32-bed establishment on the grounds of the large Richmond District Asylum in Dublin which, from 16 June 1916 until 23 December 1919, treated 362 soldiers with shell shock and other mental disorders, of whom more than half were considered to have recovered. Despite the limitations of the Richmond War Hospital, it was a generally forward-looking institution that pointed the way for future reform of Ireland's asylum system and, along with the other war hospitals, brought significant changes to the practice of psychiatry., (© The Author(s) 2014.)

During the five years before the outbreak of the First World War, Thomas Graham Brown (1882-1965) conducted research into the control of locomotion that gained him a deserved and long-lasting reputation as a neuroscientist and, in 1927, was recognized by election to the Fellowship of the Royal Society. In 1915, with the First World War raging, he agonized about continuing his research or joining the Royal Army Medical Corps (RAMC). Told by his father to seek a commission, he served two and half years in Macedonia with the British Salonika Force. Whilst in Greece, he kept a daily diary. The entries from June 1916 to May 1917 are extant. They are unpublished and provide the background to the narrative to follow. Casualties with traumatic injury to the brain and spinal cord afforded him the opportunity to carry out careful observations, particularly concerning sensory localization, which resulted in novel findings and his observations on shell shock led to him being called as an expert witness to the national inquiry into the nature and treatment of the condition. In 1920, Graham Brown was appointed to the Chair of Physiology in Cardiff, which he held until 1947.

Objective: To identify the impact of the first world war on the lifespan of participating military personnel (including in veterans who survived the war)., Design: Comparison of two cohorts of military personnel, followed to death., Setting: Military personnel leaving New Zealand to participate in the first world war., Participants: From a dataset of the New Zealand Expeditionary Forces, we randomly selected participants who embarked on troopships in 1914 and a comparison non-combat cohort who departed on troopships in late 1918 (350 in each group)., Main Outcome Measures: Lifespan based on dates of birth and death from a range of sources (such as individual military files and an official database of birth and death records)., Results: A quarter of the 1914 cohort died during the war, with deaths from injury predominating (94%) over deaths from disease (6%). This cohort had a significantly shorter lifespan than the late 1918 "non-combat" cohort, with median ages of death being 65.9 versus 74.2, respectively (a difference of 8.3 years shown also in Kaplan-Meier survival curves, log rank P<0.001). The difference for the lifespan of veterans in the postwar period was more modest, with median ages of death being 72.6 versus 74.3, respectively (a difference of 1.7 years, log rank P=0.043). There was no evidence for differences between the cohorts in terms of occupational class, based on occupation at enlistment., Conclusions: Military personnel going to the first world war in 1914 from New Zealand lost around eight years of life (relative to a comparable military cohort). In the postwar period they continued to have an increased risk of premature death., (© Wilson et al 2014.)

Although recognized as a medical scientist, the work of Frederick Mott as a physician, educator and clinical policymaker has been overshadowed. As a late entrant to the asylum system, Mott questioned established practices of treating mentally-ill patients and campaigned for reform. During World War I, entrusted with the management of the Maudsley neurological section, he sought to raise clinical standards and experimented with a range of therapies designed to treat the most severe or intractable forms of shell shock. While Mott believed that psychiatric disorder was underwritten by inherited characteristics, he did not dismiss the impact of the environment. The diversity of his interests has led to an understatement of his contribution as a physician, not only to the design and founding of the Maudsley Hospital but also to the therapeutic regime practised there during the interwar period., (© The Author(s) 2014.)

This paper relates stage performances of dada artists to war neurosis and shell shock as sociocultural phenomena. The leitmotif of this investigation is the notion of simulation, as dada artists were referred to as malingerers (simulators) of madness by the press at the time. I hypothesize that the performers imitate/simulate with drums, shouting and 'bruitist' sound poems, the noises of war, staging themselves as war neurotics in a kind of shocking clinical demonstration. Both discourses intersect in the fact that many dadaists try to dodge the draft by simulating madness. The scandalizing anti-art of dada will be understood as contagious anti-pedagogy, trying to vaccinate against the madness of the era.

Based on the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders, there are 636,120 ways for an individual to qualify for a diagnosis of posttraumatic stress disorder (PTSD) (Galatzer-Levy & Bryant, 2013). To unravel this heterogeneity, we examine the historical trajectory of trauma-related diagnoses. Our review addresses four traumas (i.e., combat, natural disaster, life-threatening accident and sexual assault) that have contributed the most to conceptual models of PTSD. Although these trauma types are all subsumed under the same diagnostic label, our literature review indicates that the psychological consequences of different traumatic experiences are traditionally studied in isolation. Indeed, most research addresses hypotheses regarding specific trauma types using samples of individuals selected for their experience with that specific event. We consider the possibility that PTSD is not a single, unified construct and what this means for future research and clinical applications., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

The 100th anniversary of the outbreak of World War 1 could be viewed as a tempting opportunity to acknowledge the origins of military psychiatry and the start of a journey from psychological ignorance to enlightenment. However, the psychiatric legacy of the war is ambiguous. During World War 1, a new disorder (shellshock) and a new treatment (forward psychiatry) were introduced, but the former should not be thought of as the first recognition of what is now called post-traumatic stress disorder and the latter did not offer the solution to the management of psychiatric casualties, as was subsequently claimed. For this Series paper, we researched contemporary publications, classified military reports, and casualty returns to reassess the conventional narrative about the effect of shellshock on psychiatric practice. We conclude that the expression of distress by soldiers was culturally mediated and that patients with postcombat syndromes presented with symptom clusters and causal interpretations that engaged the attention of doctors but also resonated with popular health concerns. Likewise, claims for the efficacy of forward psychiatry were inflated. The vigorous debates that arose in response to controversy about the nature of psychiatric disorders and the discussions about how these disorders should be managed remain relevant to the trauma experienced by military personnel who have served in Iraq and Afghanistan. The psychiatric history of World War 1 should be thought of as an opportunity for commemoration and in terms of its contemporary relevance-not as an opportunity for self-congratulation., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

This article compares the gender and health politics of the German and the French medical professions, which incorporated military command structures into their civilian self-conception. Mobilized doctors committed themselves to the new circumstances and opportunities offered by the war. They applied the established military spatial 'map' which distinguished between the male-dominated front and the female-dominated home front and turned it into an epidemiological map, identifying danger zones which arose from points of contact between men and women. The analysis singles out two case studies: the rapid spread of venereal disease and psychiatric disorders. These case studies allow for a comparative analysis of the following questions: How did doctors assess the impacts of the war on the individual and the society as a whole? How did they view the war's impact on conventional gender orders, individual and national health? And how did they see their own role as a part of an independent civilian profession?

During the First World War combatants of all armies were prey to nervous disorders or psychological breakdown. These war neuroses were a response to the highly-industrialised nature of the warfare as well as to the fatigue engendered over four years of intense conflict. Yet while fear and mental breakdown were universal, national responses varied. A comparison of British and Belgian shell shock indicates that men suffered in very similar ways but that symptoms met with rather different responses: in Britain treatment and diagnostic regimes stressed the importance of class difference and shell shock was often linked to cowardice. These issues were not of overriding importance in the Belgian army. In the longer term shell shock became, and remained, a topic of political and social concern in Britain whereas in Belgium men suffering from kloppe (extreme fear) tended to be forgotten and the topic has not excited much popular interest or scholarly attention. Yet despite these differences one overarching theme remains clear, namely that despite the extensive experience of war neuroses during and after the First World War, there still remains a fierce stigma about the mental wounds of war.

During the First World War the National Hospital for the Paralysed and Epileptic, in Queen Square, London, then Britain's leading centre for neurology, took a key role in the treatment and understanding of shell shock. This paper explores the case notes of all 462 servicemen who were admitted with functional neurological disorders between 1914 and 1919. Many of these were severe or chronic cases referred to the National Hospital because of its acknowledged expertise and the resources it could call upon. Biographical data was collected together with accounts of the patient's military experience, his symptoms, diagnostic interpretations and treatment outcomes. Analysis of the notes showed that motor syndromes (loss of function or hyperkinesias), often combined with somato-sensory loss, were common presentations. Anxiety and depression as well as vegetative symptoms such as sweating, dizziness and palpitations were also prevalent among this patient population. Conversely, psychogenic seizures were reported much less frequently than in comparable accounts from German tertiary referral centres. As the war unfolded the number of physicians who believed that shell shock was primarily an organic disorder fell as research failed to find a pathological basis for its symptoms. However, little agreement existed among the Queen Square doctors about the fundamental nature of the disorder and it was increasingly categorised as functional disorder or hysteria.

Background: Little is known about the therapeutic uses of music during the First World War. This historical study provides a biography of Paula Lind Ayers (1891-1974), a vocalist, actress, and YMCA Entertainer who became known as "the girl who could sing away shell shock.", Objective: The purpose of this study is to describe Paula Lind Ayers' respite services during World War I and provide a contextual biography of her life., Methods: The author conducted an exhaustive search regarding Paula Lind Ayers' life and her activities during World War I. Numerous databases were used to locate print sources. Libraries, archives, and organizations were consulted to obtain unpublished primary sources. The author evaluated materials via a recursive process that included corroborating evidence, assessing source reliability, and contextualizing information. Data were synthesized and analyzed for emergent themes., Results: Findings suggest that Paula Lind Ayers developed a systematic approach using familiar, live singing that was effective in alleviating symptoms of shell shock. Her method was replicated by others overseas during World War I. After the war, she returned to a successful performance career until the Great Depression. No information was found about Ayers' life from the year 1929 until her death in 1974., Conclusions: Understanding Paula Lind Ayers' contribution to music therapy provides a deeper awareness of past therapeutic uses of music with soldiers who experienced shell shock. Such understanding helps shape the way we view the present conception of music therapy with veterans and how we might answer questions that will affect the future of the field., (© the American Music Therapy Association 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

During the First World War soldiers suffered from a wide range of debilitating nervous complaints as a result of the stresses and strains of modern warfare. These complaints--widely known as shell shock--were the subject of much medical-military debate during the war and became emblematic of the war and its sufferings afterwards. One hundred years after the war the diagnosis of PTSD has not resolved the issues initially raised by First World War shell shock. The stigma of mental illness remains strong and it is still difficult to commemorate and remember the mental wounds of war in a culture which tend to glory or glamorise military heroes., (Copyright © 2014. Published by Elsevier Ltd.)