{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:59:24Z","timestamp":1790009964211,"version":"4.0.1"},"reference-count":40,"publisher":"BMJ","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J R Army Med Corps"],"published-print":{"date-parts":[[2012,3]]},"abstract":"<jats:p>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 \u2018neurasthenia\u2019) was such a problem that \u2018forward psychiatry\u2019 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 \u2018forward psychiatric units\u2019 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 \u2013 psychodynamic intervention. The efficacy of \u2018forward psychiatry\u2019 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 \u2018combat fatigue\u2019 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 IV anaesthetics: Somnifaine, paraldehyde, Sodium Amytal. \u2018Pentothal narcosis\u2019 and \u2018narco-analysis\u2019 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.<\/jats:p>","DOI":"10.1136\/jramc-158-01-07","type":"journal-article","created":{"date-parts":[[2013,3,19]],"date-time":"2013-03-19T19:43:32Z","timestamp":1363722212000},"page":"29-33","source":"Crossref","is-referenced-by-count":8,"title":["Anaesthetic and Other Treatments of Shell Shock: World War I and Beyond"],"prefix":"10.1136","volume":"158","author":[{"given":"Alistair","family":"McKenzie","sequence":"first","affiliation":[{"name":"Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA 0131 2423151 0131 2423174 alistair.mckenzie@luht.scot.nhs.uk"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2012,3,1]]},"reference":[{"key":"ref_1","article-title":"Adult Psychiatric Morbidity in England, 2007: results of a household survey. 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