[Ivan Pavlov (1849-1935): His life and conditional reflexes story revisited]. / Ivan Pavlov (1849-1936) : l'histoire revisitée de sa vie et des réflexes conditionnels.

Historiography of IP Pavlov and his description of conditional reflexes has been thoroughly specified by the records collected between 1990-2000 by DP Todes, an American science historian specializing in Russia. The Pavlov's intent was to study the nervous processes underlying psychical activity by the conditional reflexes, not the conditioning theory. In his modeling of the higher nervous activity, he highlighted the dynamic and greatly plastic character of brain functioning as well as the functional character of some long-term behavioral disorders in dogs. Far from the Soviet dogmatic presentation of the "Pavlovian doctrine", the complexity of the Pavlov's thought also paved the way to innovative conceptions in opposition with his former modeling developed by Soviet physiologists such as NA Bernstein and PK Anokhin, and psychologists such as LS Vygotski and AR Luria.

The effect of sexual counseling on depression, anxiety, stress, sexual knowledge and sexual quality of life in men who have undergone invasive coronary interventions: An RCT.

BACKGROUND: Sexual dysfunctions are common in men with ischemic heart disease, especially in men undergoing therapeutic interventions. OBJECTIVE: This study intended to assess the effect of counseling on depression, anxiety, stress, sexual knowledge and sexual quality of life in men after invasive coronary interventions in the post catheterization department of Kashan Shahid Beheshti Hospital during 2018. MATERIALS AND METHODS: The study population consisted of 54 male participants who had undergone an invasive coronary intervention. The intervention group received counseling and the control group underwent the standard ward routine. Data were collected using the depression anxiety stress scales, Abraham's sexual quality of life, and the Yi-Hung Sexual Knowledge questionnaires before discharge and also two months later. RESULTS: Within two months, the intervention group's mean score of sexual knowledge significantly increased, compared with the control group, from 12.37 to 14.81 (p ≤ 0.001). The intervention group's mean score of sexual quality of life also significantly increased, compared with the control group, from 48.2 to 60.7 (p ≤ 0.001). Moreover, the mean anxiety score changed in the intervention group from 11.18 to 5.25, again a significant difference compared with the control group (p = 0.01). But, the differences in the depression and stress scores were not significant. CONCLUSION: Our findings suggest that sexual counseling may improve sexual knowledge, sexual quality of life and anxiety in men following invasive coronary intervention, but might not reduce their stress or depression. Further studies are needed to confirm these findings.

[Doctrine of psychopathies: the concept of M.O. Gurevich and M.Ja. Serejskij]. / K evolyutsii kontseptsii «psikhopatii¼ v otechestvennoi psikhiatrii: vzglyady M.O. Gurevicha i M.Ya. Sereiskogo.

Understanding of psychopathies in the concept of Russian psychiatrists M.O. Gurevich and M.Ja. Serejskij is analyzed. These authors considered that the principal difference exists between neuroses and psychopathies (neurosis is a reversible disorder capable for development in normal personality). They used two systematics of psychopathies: the first one was focused on the rubric «Psychopathic personalities¼ of the last lifetime edition of E. Kraepelin's Textbook of Psychiatry, herewith the authors negated the existence of the «antisocial¼ psychopathy type, instead reckoning to psychopathies the perversions of drives. The second systematics of psychopathies represented the development of E. Kretschmer's constitutional typology, however, M.O. Gurevich, M.Ja. Serejskij, besides the psychopathies of schizoid and cycloid circles, also singled out epileptoid, hysteroid psychopathies, psychasthenia and sexual perversions. The authors believed that the polarity and contrast of character's properties are inherent to four types of constitutional psychopathies, including schizoid, cycloid, epileptoid and hysteroid. The concept of M.O. Gurevich and M.Ja. Serejskij is compared with preceding concepts of psychopathies, including P.B. Gannushkin and their contemporary V.A. Gilyarovsky.

Realidade neurótica, recusa da realidade e realidade da renúncia / Neurotic reality, reality refusal, and renunciation reality / Realidad neurótica, renegación de la realidad y realidad de la renuncia

Após a segunda tópica, Freud se refere a uma perda da realidade para diferenciar as neuroses das psicoses. Na realidade neurótica, o papel dos imperativos ativos antes da instauração do Supereu mostra que se trata da perda do processo de enlutamento pelos objetos edípicos, responsável pelo advento da objetalidade madura. Isso explica a regressão a uma objetalidade infantil. As duas realidades, externa e intrapsíquica, mantêm relações de transposição e cooptação. A transposição das tendências pulsionais extintivas ocorre para as ameaças ouvidas e as ausências vistas. Instala-se o complexo de castração com seus dois tempos ligados ao conflito entre a recusa e as renúncias a serem feitas. Na recusa, a libido de renúncia é perdida para o funcionamento psíquico ideal. Ela serve para a formação de substitutos da realidade. A prova de realidade e o juízo do Eu são afetados (AU)

After the second topic, Freud refers to a loss of reality, in order to differentiate neurosis from psychosis. In neurotic reality, the role of active imperatives before the installment of the Superego reveals that it refers to the loss of the bereavement process by the oedipal objects, responsible for the emergence of mature objectality, hence the regression to an infantile objectality. Both realities, external and intrapsychic, maintain transposition and cooptation reports. The transposition of extinctive drive tendencies happens over the threats heard and the absences seen. The castration complex is thus installed with its two moments linked to the conflict between refusal and renunciation to be made. In refusal, the renunciation libido is lost to the ideal psychic functioning. It is useful to construct surrogate realities. The proof of reality and value judgement are affected (AU)

Después de la segunda tópica, Freud se refiere a la pérdida de la realidad para diferenciar las neurosis de las psicosis. En la realidad neurótica, el rol de los imperativos activos antes de instalar el Superyó muestra que la pérdida en cuestión es la del proceso de poner de luto los objetos edípicos, responsables por el advenimiento de la objectalidad madura; de ahí una regresión a la objectalidad infantil. Las dos realidades, externa e intrapsíquica, mantienen relaciones de transposición y cooptación. La transposición de las tendencias pulsionales extintivas ocurre sobre las amenazas escuchadas y las ausencias vistas. El complejo de castración se instala con sus dos etapas vinculadas al conflicto entre la renegación y teniendo en cuenta las renuncias por realizar. Durante la renegación, la libido de la renuncia se pierde al funcionamiento psíquico ideal. Ella sirve para constituir sustitutos a la realidad. La prueba de la realidad y el juicio del yo se ven afectados (AU)

Railway spine: The advent of compensation for concussive symptoms.

The introduction of railway transportation in Great Britain in the early-nineteenth century saw an increased frequency of trauma cases involving persisting symptoms without objective evidence of injury. In 1866, a prominent surgeon, Sir John Eric Erichsen, attributed such symptoms to concussion of the spine (popularized as "railway spine") that involved an organic pathology, inflammation of the spinal cord in the absence of spinal fracture, with potential psychological overlay. This was widely accepted within the medico-legal context throughout the 1870s, whereby passengers sought compensation for collision-related injuries. In 1883, a railway surgeon named Herbert William Page countered the assertion that many of Erichsen's cases likely had sustained direct physical injury to the spine, the cord, and/or the spinal nerves; and in cases without such injury, the symptoms were psychogenic, as in traumatic neurasthenia and/or hysteria. Similarities between Erichsen's and Page's medico-legal positions, such as conscious and unconscious forms of symptom exaggeration that would both resolve upon settlement of the case, ushered in the era of medical injury compensation.

Hurst Rehabilitated: the treatment of functional motor disorders by Arthur Hurst during the First World War.

Arthur Hurst was a British First World War physician, best known for his films of shell shock, 'War Neuroses'. He has often been portrayed an innovative pioneer of somewhat mysterious 'suggestion' techniques for functional motor disorders but also as an ambitious clinician who exaggerated the effectiveness of his treatments and failed to address psychological factors. His use of suggestion, persuasion and re-education together with occupational therapy, for chronic or severe cases of shell shock stirred controversy at the time because of the dramatic nature of some of his treatment responses and lack of outcome data. In part, this was a turf war between neurologists and psychiatrists for a dominant therapeutic model. A re-evaluation of his publications and new research into soldiers treated at Seale Hayne in Devon show that Hurst pioneered multidisciplinary and empathetic treatments for functional motor disorders with good short-term outcomes, though insufficient data survives to assess longer term outcomes.

Historical perspectives on evolving operational definitions of concussive brain injury: From railway spine to sport-related concussion.

Objective: Concussion is a clinical syndrome of biomechanically induced alteration in brain function. The historical derivation of current operational definitions of uncomplicated concussive brain injury based on acute injury variables especially posttraumatic amnesia (PTA) vs. symptom presence (no PTA) are reviewed.Methods: Major milestones from 150 plus years of concussion research include (a) railway spine; (b) traumatic neurosis; (c) duration of loss of consciousness predicting severity of brain injury; (d) early neuropsychological studies; (e) sport related concussion; and (f) chronic traumatic encephalopathy.Results: After initial organic explanations proved untenable, 19th century conceptions of concussion were operationally defined from symptom presence, attributed primarily to psychogenic (emotional, motivational, and/or predispositional) causes. In the 1930s, duration of PTA was linked to brain injury severity via outcome studies. Concussion (as defined by PTA < 1 h) was later found to cause a transient lowering of neuropsychological test scores in memory and executive function. In the 1990s, organizational definitions of sport-related concussion began to include biomechanical events without PTA that produced symptoms. Such events have not been linked to neuropsychological impairment.Conclusions: Two differing operational definitions of concussion are in the current use, involving the presence vs. absence of PTA. These two groupings are not clinically similar, although they are currently being widely treated as such. Operational definitions of concussion should address both minimum and maximums for duration of PTA, initial Glasgow Coma Scale score, complications, and symptom presence.

[A 70-year history of tricyclic antidepressants]. / 70-letniaia istoriia tritsiklicheskikh antidepressantov.

For the first time the facts from the history of tricyclic antidepressants (TCA) are systematized in Russian psychiatric literature. The authors describe the history of first TCA agents, analyze the history of TCA group development based on the increase of new agents, present the history of original TCA creation in the USSR and the Eastern block countries, systemize the history of TCA classification development and review the studies on TCA neurochemical activity. An impact of TCA history on formulation of hypotheses of the pathogenesis of depression and some forms of neuroses is demonstrated. It is shown that the history of TCA creation urged the development of new groups of antidepressants.

Considerações sobre as anorexias e as especificidades das neuroses contemporâneas / Considerations on anorexia and specificities of contemporary neuroses / Considérations sur l'anorexie et les spécificités des névroses contemporaines / Consideraciones sobre las anorexias y las especificidades de las neurosis contemporâneas

Partimos das anorexias como campo clínico para elucidar o que particulariza o modo neurótico contemporâneo de relação com os objetos. Demonstramos a acepção mais difundida do sintoma anoréxico na psicanálise como inscrição na literalidade do corpo da falta no viés da histeria, referida a uma resposta precária diante de um Outro que é frágil em sua função simbólica. Problematizamos essa leitura à luz das características da sociedade atual, destacando a incidência de uma posição fantasmática inclinada para a lógica do consumidor insatisfeito e para o desmentido banal da autoridade simbólica.

We chose anorexia as a clinical field to elucidate what particularizes the contemporary neurotic way of relating to objects. Based on a theoretical-conceptual survey on anorexia in Freud and Lacan's psychoanalysis, we find that anorexia is mostly defined as an inscription in the literalness of the body, of the lack that makes desire move towards hysteria. That psychopathology of the oral drive circuit refers to a precarious defensive response to an Other who is fragile in his symbolic function that transmits castration. We revisit and discuss this interpretation in the light of the features of today's society, highlighting the incidence — in contemporary neuroses — of a phantasmatic position inclined toward the logic of the unsatisfied consumer and the banal denial of symbolic authority.

Nous partons des anorexies comme champ clinique pour élucider ce qui particularise le mode névrotique contemporain du rapport aux objets. À partir d'un itinéraire théorico-conceptuel sur l'anorexie dans la psychanalyse de Freud et de Lacan, nous démontrons que la définition la plus répandue du symptôme anorexique en psychanalyse est l'inscription dans la littéralité du corps, du manque qui pousse le désir vers l'hystérie. Cette psychopathologie du circuit de la pulsion orale renvoie à une réponse défensive précaire à un Autre fragile dans sa fonction symbolique transmettant la castration. Nous avons revisité et problématisé cette lecture à la lumière des caractéristiques de la société actuelle, en soulignant l'incidence d'une position phantasmatique inclinée à la logique du consommateur insatisfait et au démenti banal de l'autorité symbolique.

Partimos de las anorexias, como campo clínico, para dilucidar lo que caracteriza el modo neurótico contemporáneo de relación con los objetos. A partir de un recorrido teórico y conceptual sobre el padecer anoréxico en el psicoanálisis de Freud y de Lacan, demostramos la acepción más difundida del síntoma anoréxico en el psicoanálisis, como la inscripción, en la literalidad del cuerpo, de la falta que mueve el deseo en dirección a la histeria. Dicha psicopatología del circuito de la pulsión oral, estaría relacionada a una respuesta defensiva precaria ante un Otro frágil en su función simbólica transmisora de castración. Revisitamos y problematizamos esa lectura a la luz de las características de la sociedad actual, destacando la incidencia, en las neurosis contemporáneas, de una posición fantasmática inclinada hacia la lógica del consumidor insatisfecho y hacia la desmentida banal de la autoridad simbólica.

Anorexien wurden als klinisches Feld benutzt, um festzustellen, wie sich die zeitgenössische neurotische Art der Beziehung zu Objekten charakterisiert. Aufgrund einer theoretisch-begrifflichen Studie über Anorexie in der Psychoanalyse von Freud und Lacan beschreibt der vorliegende Artikel den von der Psychoanalyse am häufigsten benutzten Begriff der Magersucht als eine Inschrift in die Literalität des Körpers, als Mangel, der das Begehren in Richtung Hysterie steuert. Diese Psychopathologie des Kreislaufs des oralen Triebes steht in Bezug zu einer prekären Abwehrreaktion gegen einen Anderen, der geschwächt ist in seiner symbolischen Funktion der Übertragung der Kastration. Wir betrachten diese Problematik im Lichte der Merkmale der heutigen Gesellschaft und stellen sie in Frage, indem wir das Vorkommen einer phantasmatischen Position in der zeitgenössischen Neurose hervorheben, die sich der Logik des unbefriedigten Verbrauchers und der banalen Verweigerung symbolischer Autorität angleicht.

Historical and conceptual aspects of motor disorders in the psychoses.

Historical epistemology is a useful method to understand the longitudinal construction of the movement disorders in psychiatry. Four periods can be identified in such a process. The first, extending from Classical times to the work of Griesinger, included disorders such as catalepsy, crocidism, epilepsy and paralysis. The second period, stretching from Griesinger to Kahlbaum, concentrated on the study of melancholia attonita, stupor and catatonia. The third period, covering the time from Kahlbaum to WWI, witnessed important conceptual shifts such as: the transformation of madness into psychoses; the redefinition of movement and motility in psychiatry; the appearance of self-contained syndromes as dyskinesias, tics, akathisia, complex disorders like the cases of encephalitis lethargica, etc.; the advent of functional and psychodynamic explanations; and the description by Wernicke, Kleist and others of the motility psychoses. The fourth period stretches from WWI to the present and since it corresponds to the views and work reported in the rest of this Special issue it has not been touched upon in this paper. In spite of an increasing methodological refinement, empirical research is yet to clarify what is the clinical meaning of the movement disorders in the context of the psychoses and to explain whether such disorders are primary (i.e. issuing directly from the brain and parallel to the rest of psychotic symptomatology) or secondary (i.e. mediated by cognitive and emotional phenomena characteristic of the psychoses).

Alfred Walter Campbell's return to Australia.

Alfred Walter Campbell (1868-1937) established the basic cytoarchitectonic structure of the human brain while he was working as a pathologist at the Rainhill Lunatic Asylum near Liverpool in the United Kingdom. He returned to Australia in 1905 and continued doing research while establishing a neurological practice. His research over the next 17 years focused on four topics: (a) localisation in the cerebellum, (b) the neuroses and psychoses in war, (c) localisation in the cerebral cortex of the gorilla, and (d) the causes and pathology of the mysterious Australian "X" Disease (later known as Murray Valley encephalitis). In this article, I elaborate on his research in these areas, which provided evidence (a) against Louis Bolk's thesis that variation in the size of the cerebellar cortex reflected variation in the amount of cortex controlling various groups of muscle, (b) against the view that the neuroses and psychoses in war were different from those in civilian life, (c) for a parcelation of the cortex of the gorilla brain that supported his earlier findings in the higher apes, and (d) on the cause and pathophysiology of Australian "X" disease. Much of this research was overlooked, but it remains of considerable value and historical significance.

[The abnomal personalities in the conception of H. Gruhle]. / Anomal'nye lichnosti v kontseptsii G. Grule.

Understanding of psychopathic personality in the conception of H. Gruhle, a famous German psychiatrist, is analyzed. The issue that the psychopathic personality is accidentally combined with mental illness, psychosis is contradictory to the conception of 'general degenerative constitution'; psychopathology can be isolated and transient. There is absence of age criteria in the diagnosis of psychopathy as well. The initial attempt of H. Gruhle to systematically consider all types of psychopathy was not well substantiated, therefore the author returned to Kraepelin's systematics of psychopathic personality according to prominent traid.

A angústia nas neuroses atuais: uma questão para a clínica contemporânea? / The anguish in the current neuroses: an issue for contemporary clinic?

A investigação que culminou neste artigo diz respeito ao estatuto da angústia observadoem uma parte significativa dos sujeitos atendidos pelo NEPECC (UFRJ). Buscaremos destacara especificidade deste afeto nas neuroses atuais, principalmente, com respeito à interfaceentre uma invasão intensiva e uma insuficiência de elaboração psíquica. Nosso objetivo é examinara hipótese de que a neurose de angústia pode contribuir para uma maior compreenssãodeste afeto em algumas modalidades de sofrimento psíquico, com que nos deparamos na contemporaneidade

O afeto “angústia” em Freud e em Lacan: discussões para a clínica psicanalítica atua / The affection “anguish” in Freud and in Lacan: Discussions for the current psychoanalytical clinic

Este artigo aborda o afeto “angústia” nos diferentes momentos da teoria de Freud, emarticulação com as ideias de Lacan em seu seminário sobre o tema. Freud, inicialmente, destacaa angústia enquanto fenômeno que afeta diretamente o corpo, sem mediação psíquica, nas neurosesatuais. Adiante, atribui à angústia papel importante para o processo de recalcamento nas neuroses de defesa, aproximando-a dos processos psíquicos ao tomá-la por angústia de castra-ção. Lacan parece retomar as noções iniciais de Freud sobre a angústia como aquilo que afeta o corpo sem mediações, um sinal do real. Essa retomada teórica é pertinente frente às demandas da clínica psicanalítica atual.

The unconscious, myth, and the rule of law: Reflections on the persistence of gender inequality.

Social order, to remain stable, needs the voluntary compliance of the majority of the population. Such consent requires normative justification. The rational foundation of the rule of law and the democratic state rests on the presumption of the equality of every citizen. Male domination of females nevertheless remains universal even in the most advanced democratic nation states because it is legitimized by the shared assumption that patriarchy reflects the will of God or is dictated by nature. Freud's diagnosis of patriarchy as a collective neurosis of the group mind negates every possible normative justification that can be made for gender hierarchy. Freud made extensive references to myth in developing his analysis of the neurotic foundations of social order. An analysis of the structure of myth suggests that ideological seduction rather than God, nature or biology determines male dominance.

Study of Life Events and Personality Dimensions in Generalized Anxiety Disorder.

INTRODUCTION: Life events, recognized as stressors, due to their unanticipated nature, can cause psychiatric illness. Also there is some line of continuity between neurotic illness and antecedent personality traits. AIM: To study generalized anxiety disorder in relation to Life events and personality dimensions. MATERIALS AND METHODS: Certain hypotheses were tested in two groups, namely 30 Generalized Anxiety Disorder patients (GAD) and 30 matched controls, by utilizing assessment tools. These include: GAD patients experience more undesirable Life events than normal; GAD patients with high level of anxiety experience more undesirable Life events; Neuroticism is related to the severity of anxiety; Extroverts experience more anxiety; Level of anxiety in females is higher; GAD patients with higher education level experience more anxiety, while those with lower education level somatize more. The group differences were examined using Chi-Square test, Student t-test and ANOVA. Pearson's Correlation Co-efficient was used to find the correlation between anxiety and the undesirable Life events. The level of statistical significance was set at p<0.05. RESULTS: GAD patients experienced significantly more undesirable Life events than the matched controls. Patients with high level of anxiety experienced more undesirable Life events, with the coefficient of correlation being quite high. A significant association between Neuroticism scale and GAD was observed. CONCLUSION: The study suggests a possible causative link between the undesirable Life events and GAD; and a significant association between Neuroticism dimension and the anxiety disorder. Role of environmental stressors and personality traits in treatment outcome among GAD patients awaits further, prospective studies.

Non-Invasive Brain Stimulation in Conversion (Functional) Weakness and Paralysis: A Systematic Review and Future Perspectives.

Conversion (functional) limb weakness or paralysis (FW) can be a debilitating condition, and often causes significant distress or impairment in social, occupational, or other important areas of functioning. Most treatment concepts are multi-disciplinary, containing a behavioral approach combined with a motor learning program. Non-invasive brain stimulation (NIBS) methods, such as electroconvulsive therapy (ECT), and transcranial magnetic stimulation (TMS) have been used in the past few decades to treat FW. In order to identify all published studies that used NIBS methods such as ECT, TMS and transcranial direct current stimulation (tDCS) for treating FW patients a systematic review of the literature was conducted in PubMed and Web of Science. In a second step, narratives were used to retrospectively determine nominal CGI-I (Clinical Global Impression scale-Improvement) scores to describe approximate changes of FW symptoms. We identified two articles (case reports) with ECT used for treatment of FW, five with TMS with a total of 86 patients, and none with tDCS. In 75 out of 86 patients treated with repetitive (r)TMS a nominal CGI-I score could be estimated, showing a satisfactory short-term improvement. Fifty-four out of seventy-five identified patients (72%) had a CGI-I score of 1 (very much improved), 13 (17%) a score of 2 (much improved), 5 (7%) a score of 3 (minimally improved), and 3 (5%) remained unchanged (CGI-I = 4). In no case did patients worsen after rTMS treatment, and no severe adverse effects were reported. At follow-up, symptom improvement was not quantifiable in terms of CGI-I for the majority of the cases. Patients treated with ECT showed a satisfactory short-term response (CGI-I = 2), but deterioration of FW symptoms at follow-up. Despite the predominantly positive results presented in the identified studies and satisfactory levels of efficacy measured with retrospectively calculated nominal CGI-I scores, any assumption of a beneficial effect of NIBS in FW has to be seen with caution, as only few articles could be retrieved and their quality was mostly poor. This article elucidates how NIBS might help in FW and gives recommendations for future study designs using NIBS in this condition.

Freud with Charcot: Freud's discovery and the question of diagnosis.

Although Charcot's seminal role in influencing Freud is widely stated, although Freud's trip to Paris to study with Charcot is well recognized as pivotal in his shift from neurological to psychopathological work, a key fact of the Freudian heuristic remains largely underestimated: namely, that Freud's psychopathological breakthrough, which gave birth to psychoanalysis, cannot be separated from his 'diagnostic preoccupation', which is a crucial and at times the first organizing principle of his earliest writings. The purpose of this article is therefore to reopen the question of diagnosis by following its development along the path leading from Charcot to Freud. The authors demonstrate that Freud's careful attention to diagnostic distinctions follows strictly in the direction of Charcot's 'nosological method'. More importantly, the article intends to identify the precise way in which his ideas operate in Freud's own work, in order to understand how Freud reinvests them to forge his own nosological system. If the authors trace the destiny of Charcot's lessons as they reach Freud's hands, it is the importance granted to mixed neuroses in Freud's psychopathology that allows them to pinpoint the role played by the diagnostic process in the rationality of psychoanalysis.

Primary shame, mortal wound and tragic circularity: Some new reflections on shame and shame conflicts.

Invited to contribute some thoughts on recent developments in psychoanalytic thinking about shame, the author starts off with Aristotle's prescient analysis of shame and then focuses on accumulating experiences in the psychoanalytic treatment of patients with severe neuroses, in particular the close relationship of severe traumatization and chronic states of shame, and how this is reflected in shelfdestructive repetitions. Reminiscent of what we know from tragedy and the tragic dimension of human existence, this repetition compulsion shows a built-in circularity. These circular dynamics have at their core struggles with deep woundedness that can variably be conceived of as primary pain, primary shame and primary anxiety. Consequently, throughout the experiences with these patients goes the absoluteness both of their conscience and of their ideal, what we know as the "archaic superego:".

Shell Shock and the Kloppe: war neuroses amongst British and Belgian troops during and after the First World War.

During the First World War combatants of all armies were prey to nervous disorders or psychological breakdown. These war neuroses were a response to the highly-industrialised nature of the warfare as well as to the fatigue engendered over four years of intense conflict. Yet while fear and mental breakdown were universal, national responses varied. A comparison of British and Belgian shell shock indicates that men suffered in very similar ways but that symptoms met with rather different responses: in Britain treatment and diagnostic regimes stressed the importance of class difference and shell shock was often linked to cowardice. These issues were not of overriding importance in the Belgian army. In the longer term shell shock became, and remained, a topic of political and social concern in Britain whereas in Belgium men suffering from kloppe (extreme fear) tended to be forgotten and the topic has not excited much popular interest or scholarly attention. Yet despite these differences one overarching theme remains clear, namely that despite the extensive experience of war neuroses during and after the First World War, there still remains a fierce stigma about the mental wounds of war.