Psychology of War and Schizophrenia1

When this war is viewed from a psychiatric standpoint one of the prominent features is that many persons have been unable to meet the new conditions of the service and have suffered from that mental disturbance, which for the want of a better term we call schizophrenia and even dementia praecox. From a rough estimate of the statistics now available it seems to have constituted from 25 to 40 percent, of all admissions. There is also a very great increase in the number of cases with a clinical diagnosis of epilepsy, with no history of previous seizures. The close resemblance between schizophrenia and epileptiform syndromes occurring with acute onset and no previous attacks or mental equivalents, suggests that the actual percentage assigned to the dementia praecox group will eventually be increased by the addition of many of these epilpetiform cases.

Various causes have been assigned to this psychic phenomenon of inversion and regression, such as “stress of war,” “concussion of high powered shell,” “fatigue,” etc. These so-called causes are at once recognized as not being the basic cause, as merely incidents, else all persons instead of one of a group subjected to the strain or concussion of the great guns or bursting shells would end in a psychiatric ward. But these discussions of the conditions at the front give us much valuable material, since they lead eventually to an analysis of the mental condition of these patients previous to the war and discover the predisposing and basic causes in conditions antedating induction into the service. Such analyses just as surely demonstrate the stress of the service as the exciting or “proximate” cause; but this stress is intelligible only when it is viewed as a new internal conflict.

Poor adaptability, stubbornness, disregard for rules and open rebellion in Army life should be regarded as symptoms of a poorly integrated individual. Careful examination of histories of praecox cases shows that just these individuals had conflicts a