Study analyzes physical and mental scars of Civil War vets

Some ailments were not unlike those seen in soldiers in the years after the Vietnam War and in those coming home from Iraq.

By — Posted Feb. 27, 2006

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In the War Between the States, soldiers dealt with cannons firing at them, hand-to-hand combat in open fields and the deaths of family and friends who served in the same military unit. The mental and physical scars of battle ran deep long after the firing stopped, with the traumatic experiences of the Civil War translating into a lifetime of increased physical and mental diseases for soldiers, according to a new study.

The youngest men and those who witnessed the most deaths had higher rates of postwar problems.

In fact, it appears that Civil War veterans had similar health effects as have Americans in other wars.

"There can be serious mental and physical health costs of traumatic war exposure," said Roxane Cohen Silver, PhD, co-author of the study in the February issue of Archives of General Psychiatry. The mental impact "was quite consistent with what we've seen in more recent wars."

Dr. Silver and fellow researchers analyzed the military and medical records of 15,027 Union Army veterans from the Civil War. They looked at cardiac, gastrointestinal and mental illnesses during the soldiers' lifetimes. Confederate soldiers did not have a comparable database for study, but researchers suspect that those troops had similar problems.

Civil War soldiers were vulnerable due to close-up combat, bloody battles and other reasons, researchers said. For one thing, family members and friends were often assigned to the same company, and when there were casualties, survivors were left with few remaining friends.

"It was very, very different from the [war] experience today," Dr. Silver said.

Researchers noted that the Civil War marked the beginning of recognition of mental health problems caused by war, a condition that was then labeled "irritable heart syndrome."

Impact of war

Dr. Silver said "85% of [soldiers in the study] had at least one sign of physical or mental difficulties" following the war. Of those veterans, about 40% had both physical and mental conditions. Cardiac and gastrointestinal ailments plagued about 18%.

The age of the soldier, extent of war horrors he witnessed and prisoner-of-war experiences were among the factors that contributed to increased postwar problems.

For example, soldiers who were ages 9 to 17 when they enlisted, were 93% more likely than soldiers 31 and older to have physical and mental disorders. They also were more likely to die early.

"They showed the greatest health problems over their lives," said Dr. Silver, professor of psychology and social behavior at the University of California at Irvine. "The combination of the trauma of being in the war so young and of witnessing death had [mortal] effects."

Soldiers in military companies with larger percentages of fatalities were 51% more likely to have cardiac, gastrointestinal and mental diseases, the study showed.

Prisoners of war were at greater risk of having physical and nervous diseases later in life, too.

However, wounded troops had an increased risk of mental disease but a lower risk of physical disease.

Dr. Silver said that may be because those who survived battle injuries were physically hardier in the first place.

"They were probably physically stronger people, but the strain did affect them mentally," she said.

In an editorial in the same issue of Archives of General Psychiatry, Roger K. Pitman, MD, said the study's findings echo results of previous research into the mental health status of Vietnam veterans, including posttraumatic stress disorder.

"Posttraumatic stress disorder did not begin with Vietnam. It was present in previous wars," said Dr. Pitman, a psychiatrist at Massachusetts General Hospital and professor of psychiatry at Harvard Medical School in Boston.

He said combat's effects on mental health most likely apply to modern soldiers, including troops now serving in Iraq.

"It's still a problem and it's going to be a problem as long as there's combat," he said.

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Civil War diagnoses

85% of Union Army veterans had some type of mental or physical disease. The breakdown:

Physical and mental illnesses 39%
Cardiac ailments only 18%
Gastrointestinal and cardiac diseases 17%
Gastrointestinal ailments only 6%
Mental disease, including nervous ailments 5%

Note: Percentages are rounded.

Source: "Physical and Mental Health Costs of Traumatic War Experiences Among Civil War Veterans," Archives of General Psychiatry, February

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External links

"Physical and Mental Health Costs of Traumatic War Experiences Among Civil War Veterans," abstract, Archives of General Psychiatry, February (link)

"Combat Effects on Mental Health: The More Things Change, the More They Remain the Same," extract, Archives of General Psychiatry, February (link)

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