ABSTRACT
While the diagnostic labels shell shock, disordered action of the heart (DAH), effort syndrome, effects of Agent Orange and Gulf War Syndrome have become familiar, considerable controversy has waged over their nature (Binneveld, 1997; Shephard, 2000). We, among many others, have argued that they should be classified as medically unexplained syndromes (Barsky and Borus, 1999; Bass, Peveler and House, 2001). These are characterised by a range of functional somatic symptoms, common examples being: Fatigue, weakness, sleep difficulties, headache, muscle aches and joint pain, problems with memory, attention and concentration, nausea and other gastrointestinal symptoms, anxiety, depression, irritability, palpitations, shortness of breath, dizziness, sore throat and dry mouth (Barsky, 1988). Despite popular claims to the contrary, no simple biomedical cause has been discovered to account for these disorders, hence the term ‘medically unexplained’ (Wessely, 1999b). Furthermore, they are not easily interpreted using accepted psychiatric classifications (see below). Without demonstrable organic cause, war syndromes have attracted diverse causal explanations, ranging from pressure on the arteries of the chest, constitutional inferiority, toxic exposure, bacterial infection and microscopic cerebral haemorrhage.
