Barbaros ÖZDEMİR, Cemil ÇELİK, KAMİL NAHİT ÖZMENLER, Aytekin ÖZŞAHİN

Savaş stres reaksiyonlarının tarihsel gelişim süreci

Bu güne kadar savaşların psikolojik ve psikiyatrik etkileri dikkat çekici olmuştur. Savaş stresi ile ilişkili psikiyatrik tablolar tarihsel gelişim süreci içinde öne çıkan belirtilerin farklılığı nedeniyle nostalji, savaş şoku (shell shock), asker kalbi, Da Costa Sendromu, agent orange etkisi, travma sonrası stres bozukluğu (TSSB), gibi farklı isimlerde anılmışlardır. Buna karşın belirti ve bulgular bağlamında (çarpıntı, mide şikâyetleri, romatizmal ağrılar, nörolojik ve psikiyatrik belirtiler vs.) benzerlikler göstermektedirler. Tarihsel süreçte yöntemlerin değişmesi savaş stres reaksiyonlarının göze çarpan klinik özelliklerini etkilemiştir. Körfez savaşlarında ortaya çıkan belirtiler önceki savaş stres reaksiyonları ile benzeşmeyen ve açıklanamayan özellikler göstermiştir. Bu nedenle sınıflandırma sistemleri içinde nereye dâhil edileceği açıklık kazanmamıştır. Savaş stres reaksiyonlarında tatmin edici bir organik patolojinin bulunamaması değişmeyen özellik olarak kalmıştır. Savaşlarda ortaya çıkan mortalite ve morbiditenin artmasında önemli bir etken olmakla birlikte etkilenen hastaların savaş sonrasında da iyileşmeye direnç göstermeleri gerek hükümetleri, gerek askeri otoriteleri gerekse tıp doktorlarını düşündüren önemli bir sorun olmaya devam etmektedir.

Historical development of war stress reaction syndromes

The battles that have come to this day had spectacular psychologic and psychiatric effects. Battle stres reactions in historical development phase has been mentioned with such different names as nostalgia, shell shock, soldier’s heart, Da Costra Syndrome, old sergeant syndrome, agent orange effect and post traumatic stress disorder (PTSD) due to the symptoms coming into prominence. On the othere hand they do tend to show similarities (palpilation, stomach complaints, rhomatizmal aches, neurological and psychiatric symptoms, etc.) in the context of symptoms and findigs. During the historical phase, the transition of methods have also infliuenced the prominent clinical characteristics of the war stress syndromes. The symptoms that arose during the gulf War have exhibited neither similarities nor explainable characteristics with previous war stress reactions of the past. Therefore, in the context of diagnostics systems, there is no clarity about where it should be incorporated. The inability to find any satisfactory organic pathology in war stress reactions have been the unchanging characteristic of the illness. In collaboration with the increasing mortality and morbidity that arise in wars it is not only an important factor but the resistance of patients, who had been effected, to amelioration is continuing to be an important concern which preoccupies governments, military authorities and doctors.

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