Central European Psychiatry: World War I and the Interwar Period

During World War I, soldiers from all warring countries suffered from mental disorders caused by the strains and shocks of modern warfare. Military psychiatrists in Germany and the Austro-Hungarian Empire were initially overwhelmed by the unexpected numbers of psychiatric patients, and they soon engaged in fierce debates about the etiology and therapy of “war neuroses.” After early therapeutic approaches relying on rest and occupational therapy had failed to yield the necessary results, psychiatry faced increasing pressure by the state and the military. After 1916, the etiological debate coalesced around the diagnosis of “war hysteria,” and psychiatric treatment of war neurotics became dominated by so-called active therapies, which promised to return patients to the frontline or the war industry as quickly and efficiently as possible. War psychiatry became characterized by an unprecedented rationalization of medical treatment, which subordinated the goals of medicine to the needs of the military and the wartime economy. Brutal treatment methods and struggles over pensions led to conflicts between patients and doctors that continued after the war ended.