War Traumas Are Not All the Same, Says President of Royal College of Psychiatrists

Posttraumatic stress disorder (PTSD) is not just another term for shell shock, Sir Simon Wessely, M.D., Ph.D., said at APA’s 2015 annual meeting in Toronto yesterday. Both the symptoms and the context in which they arise are different.

Wessely, a professor of psychological medicine at the Institute of Psychiatry at King's College London and president of the Royal College of Psychiatrists, combed through medical records of British soldiers diagnosed in World War I with shell shock and found that they had complained about low mood, depression, insomnia, frequent weeping, nightmares, and what today would be called conversion reactions, but never mentioned flashbacks, a core symptom of PTSD.

“Today, 60 percent of PTSD patients refer to flashbacks,” he said. “And we see almost no cases today of acute classic shell shock presentations [among British troops who fought in Iraq or Afghanistan].”

“British soldiers entering the trenches in France a century ago were also physically, psychologically, and socially different from their counterparts today,” said Wessely.

Given those differences, it should be no surprise that presentation of reactions to war should change, said Wessely. Disorders change in all areas of medicine because of the impact of cultural changes, and disorders of trauma appear to be no exception.

To learn more about differences between shell-shock and PTSD, click here.