Somatic hypotheses of war syndromes

Since the end of the American Civil War, unexplained symptoms in military p ersonnel arising after a war or peace mission have frequently been describe d. The pattern of symptoms is highly similar for all of the various war syn dromes although the conditions of each war or peace mission are widely diff erent. Many somatic hypotheses have been formulated to explain these syndro mes; a considerable proportion of them are already outdated. In the last fe w years much attention has been given to Gulf War Syndrome and to unexplain ed symptoms of military personnel who were sent to Cambodia, Rwanda, Burund i, Zaire, or the former Yugoslavia. In this review the symptoms of war synd romes will be considered in more detail and the suggested somatic explanati ons will be discussed. During the last decade the following somatic causes have been suggested as possible explanations for these symptoms: (persisten t) infection, abnormal immune response, administration of multiple vaccinat ions within a short period of time, use of malaria chemoprophylaxis, neurol ogical abnormalities, exposure to toxicological substances and environmenta l factors. The various investigations performed to study these hypotheses a re discussed. The fact that bias regularly occurs in the course of these in vestigations is pointed out. For the future, a reliable investigation of a war syndrome should be a prospective multidisciplinary study and should dis tinguish between causative and sustaining factors.