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.
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Front Neurol Neurosci. 2016 Apr 1;38:143-154
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