The E's Flashcards
What is effort syndrome?
term proposed in 1917 by [Sir] Thomas Lewis to categorise servicemen suffering from functional cardiac disorders hitherto called disordered action of the heart, soldier’s heart or irritable heart.
Until when effort syndrome remained an an acceptable diagnosis?
It remained an acceptable and widely used diagnosis until 1941 when Paul Wood, an eminent cardiologist working at the Effort Syndrome Unit of Mill Hill Hospital, showed that sufferers had significantly higher levels of psychiatric morbidity than controls. He also demonstrated that the same patterns of symptoms were found in the civilian population so that effort syndrome could not be regarded solely as a post-combat disorder (Wood, 1941a; Wood, 1941b).
What came after effort syndrome?
servicemen with the symptoms of effort syndrome were reclassified as ‘psychoneurosis’ or ‘cardiac neurosis’ by military doctors during World War Two.
What are evacuation syndromes?
clusters of symptoms that mimic genuine medical disorders and result in a serviceman being invalided from active duty. For example, cardiac disease was a legitimate cause of medical discharge during World War One at the time when large numbers of servicemen were evacuated to hospitals in the UK with disordered action of the heart (DAH), a functional disorder that presented with the features of a serious organic condition. If the soldier is invalided to a base hospital, his symptoms commonly persist or even worsen.
Where was the term exhaustion in military psychiatry employed?
a) in British Forces chosen in summer 1942 and applied to the Eighth Army then fighting in the Western Desert (Crew, 1957, p. 487).
b) in US Forces the American First Army landed in North Africa in November 1942 and
engaged the German Africa Corps in Tunisia in January 1943.
Why was the term exhaustion in military psychiatry employed?
It was employed to describe men unable to function in combat zones who were not suffering from a wound or organic disease.
Where did the term exhaustion in military psychiatry come from?
It probably owed its origin to Brigadier G.W.B.James, consultant in psychiatry to the Middle East Force, who concluded that two years of wearying campaigning (which James described as ‘campaign neurosis’) in the desert culminating in the retreat to the Alamein line had exhausted the Eighth Army both mentally and physically (James, 1955, pp. 98–99).
What did the term exhaustion in military psychiatry mean?
The terms ‘exhaustion’ or ‘battle exhaustion’ were chosen to imply that this was a temporary physical and mental state from which men would recover naturally.
What was the treatment for exhaustion in military psychiatry ?
Treatment units were described as ‘exhaustion centres’. The term was part of the ‘PIE’ treatment strategy and referred in particular to the ‘expectation’ element.
What was the problem in using the term exhaustion in military psychiatry ?
In addition, the term exhaustion avoided use of medical terminology, such as ‘shell shock’ or ‘disordered action of the heart’, which implied an organic disorder or disease. It did not immediately win favour perhaps because some regarded it as a euphemism for malingering. For example, the handbook issued to medical officers in September 1942 (Psychiatric Casualties, Hints to Medical Officers in the Middle East Forces) still referred to combat stress casualties as cases of ‘battle neurosis’.
When did the US military first use the term exhaustion?
When faced with mounting psychiatric casualties in the hard fighting that followed, in April 1943 the US military also adopted the term ‘exhaustion’ (Grinker and Spiegel, 1943, p. 152).
What was the US definition of exhaustion?
As Colonel Long recalled: [O]f the possible diagnostic terms discussed, this word was chosen because it was thought to convey the least implication of neuropsychiatric disturbance and it came closest to describing the way the patients really felt (Drayer and Glass, 1973, pp. 9–10).
Which term for exhaustion is better, the US or the UK one?
It was not surprising that the British term should have been adopted given that the Eighth Army had by then greater experience in treating combat stress reactions, while the Americans had neglected forward psychiatry in the belief that their psychological screening programmes would prevent such casualties.
Why did the US use the term exhaustion?
US armed forces continued to use the term ‘exhaustion’ in other theatres. In part, it was designed to avoid the term ‘psychoneurosis’, which implied an internal vulnerability to the stress of battle and a pre-service, constitutional weakness and was sometimes abbreviated to ‘psycho’. Glass subsequently wrote that with the widespread use of the term ‘exhaustion’, ‘a quantitative and sensible approach to the etiology of psychiatric breakdown developed as a logical consequence, manifested by the commonly accepted statement that “everyone has his breaking point’” (Drayer and Glass, 1973, p. 18).
