Skip to main content
    • Aa
    • Aa

Psychological effects of chemical weapons: a follow-up study of First World War veterans

  • E. Jones (a1), B. Everitt (a1), S. Ironside (a1), I. Palmer (a1) and S. Wessely (a1)...

Chemical weapons exercise an enduring and often powerful psychological effect. This had been recognized during the First World War when it was shown that the symptoms of stress mimicked those of mild exposure to gas. Debate about long-term effects followed the suggestion that gassing triggered latent tuberculosis.


A random sample of 103 First World War servicemen awarded a war pension for the effects of gas, but without evidence of chronic respiratory pathology, were subjected to cluster analysis using 25 common symptoms. The consistency of symptom reporting was also investigated across repeated follow-ups.


Cluster analysis identified four groups: one (n=56) with a range of somatic symptoms, a second (n=30) with a focus on the respiratory system, a third (n=12) with a predominance of neuropsychiatric symptoms, and a fourth (n=5) with a narrow band of symptoms related to the throat and breathing difficulties. Veterans from the neuropsychiatric cluster had multiple diagnoses including neurasthenia and disordered action of the heart, and reported many more symptoms than those in the three somatic clusters.


Mild or intermittent respiratory disorders in the post-war period supported beliefs about the damaging effects of gas in the three somatic clusters. By contrast, the neuropsychiatric group did not report new respiratory illnesses. For this cluster, the experience of gassing in a context of extreme danger may have been responsible for the intensity of their symptoms, which showed no sign of diminution over the 12-year follow-up.

Corresponding author
*Address for correspondence: Professor E. Jones, Institute of Psychiatry and King's Centre for Military Health Research, Weston Education Centre, 10 Cutcombe Road, London SE5 9RJ, UK. (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

DA Alexander , S Klein (2003). Biochemical terrorism: too awful to contemplate, too serious to ignore. British Journal of Psychiatry 183, 495496.

JD Banfield , AE Raftery (1993). Model-based Gaussian and non-Gaussian clustering. Biometrics 49, 803821.

AJ Barsky , JD Goodson , RS Lane , PD Cleary (1988). The amplification of somatic symptoms. Psychosomatic Medicine 50, 510519.

NT Brewer , SE Lillie , WK Hallman (2006). Why people believe they were exposed to biological or chemical warfare: a survey of Gulf War veterans. Risk Analysis 26, 337345.

M Brown (2006). Toxicological assessments of Gulf War veterans. Philosophical Transactions of the Royal Society. Series B, Biological Sciences 361, 649680.

B Durodié (2003). The true cost of precautionary chemicals regulation. Risk Analysis 23, 389398.

G Fraley , AE Raftery (1999). MCLUST: software for model-based cluster analysis. Journal of Classification 16, 297306.

G Fraley , AE Raftery (2002). Model-based clustering, discriminant analysis and density estimation. Journal of the American Statistical Association 97, 611631.

RW Haley , TL Kurt (1997). Self-reported exposure to neurotoxic chemical combinations in the Gulf War. A cross-sectional epidemiological study. Journal of the American Medical Association 277, 231237.

A Hay , G Roberts (1990). The use of poison gas against the Iraqi Kurds: analysis of bomb fragments, soil and wool. Journal of the American Medical Association 263, 10651066.

E Jones , I Palmer , S Wessely (2007). Enduring beliefs about the effects of gassing in war: qualitative study. British Medical Journal 335, 13131315.

RS Lane , AJ Barsky , JD Goodson (1988). Discomfort and disability in upper respiratory tract infection. Journal of General Internal Medicine 3, 540–346.

F Mott (1919). War Neuroses and Shell Shock. Henry Froude and Hodder & Stoughton: London.

I Palmer (2004). The psychological dimension of chemical, biological, radiological and nuclear (CBRN) terrorism. Journal of the Royal Army Medical Corps 150, 39.

JA Stuart , RJ Ursano , CS Fullerton , AE Norwood , K Murray (2003). Belief in exposure to terrorist agents: reported exposure to nerve or mustard gas by Gulf War veterans. Journal of Nervous and Mental Disease 191, 431436.

S Wessely , C Unwin , M Hotopf , L Hull , K Ismail , V Nicolaou , A David (2003). Stability of recall of military hazards over time. Evidence from the Persian Gulf War of 1991. British Journal of Psychiatry 183, 314322.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 20
Total number of PDF views: 68 *
Loading metrics...

Abstract views

Total abstract views: 288 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 20th September 2017. This data will be updated every 24 hours.