War pensions (1900-1945): changing models of psychological understanding.

摘要

BACKGROUND: War pensions are used to examine different models of psychological understanding. The First World War is said to have been the first conflict for which pensions were widely granted for psychological disorders as distinct from functional, somatic syndromes. In 1939 official attitudes hardened and it is commonly stated that few pensions were awarded for post-combat syndromes. AIMS: To re-evaluate the recognition of psychiatric disorders by the war pension authorities. METHOD: Official statistics were compared with samples of war pension files from the Boer War and the First and Second World Wars. RESULTS: Official reports tended to overestimate the number of awards. Although government figures suggested that the proportion of neurological and psychiatric pensions was higher after the Second World War, our analysis suggests that the rates may not have been significantly different. CONCLUSIONS: The acceptance of psychological disorders was a response to cultural shifts, advances in psychiatric knowledge and the exigencies of war. Changing explanations were both a consequence of these forces and themselves agents of change.