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Historical, social and cultural perspectives on NCCP
Published in Elizabeth Marks, Myra Hunter, John Chambers, CBT for Managing Non-cardiac Chest Pain, 2017
Elizabeth Marks, Myra Hunter, John Chambers
Descriptions of NCCP recognizable to a modern physician or psychologist were recorded in 19th century America in civilians and Civil War soldiers (see Box 3.1). Similar descriptions appeared in the First World War (Lewis, 1918; Cohn, 1919). There was depression and concern about heart disease. In Paul Wood’s study of 200 military cases (Wood, 1941), the symptoms were breathlessness (93%), palpitation (89%), fatigue (88%), sweats (80%), nervousness (80%), dizziness (78%) and left chest pain (78%). The condition was variously labelled, as da Costa’s syndrome (Ogelsby, 1987), circulatory neurasthenia, irritable heart, soldier’s heart (McKenzie, 1916) or effort syndrome.
A Conceptual History of Anxiety and Depression
Published in Siegfried Kasper, Johan A. den Boer, J. M. Ad Sitsen, Handbook of Depression and Anxiety, 2003
The debate was settled provisionally by two collaborative studies by a number of specialists from a section of the Maudsley Hospital, which was rehoused at Mill Hill School during World War II. A special unit had been set up at the school for the purpose of studying patients with effort syndrome. One of these studies was an award-winning work by Maxwell Jones, who later achieved fame as a champion of the therapeutic community [143]. In the other study, cardiologist Paul Wood concluded that the symptoms of Da Costa syndrome were also prevalent in peace time and that they closely resembled the symptoms of anxiety neurosis [144]. Although constitution, heavy exertion, and previous infectious diseases could all be precipitating factors, effort syndrome was ultimately explicable in terms of (and maintained by) a neurotic mechanism. It affects those who, in their youth, “clung too long to their mothers’ skirts” [145] and who, either due to parental overconcern or to comments by their physician, learned to interpret various (normal) physiological changes as signs of physical impotence or even of danger.
Soldier’s heart: the forgotten circulatory neurasthenia – a systematic review
Published in International Review of Psychiatry, 2020
Guilherme Passamani Borges, João Henrique Almeida Tonon, Pablo Andres Alves da Silva Zunini, Anderson Sousa Martins da Silva, Marcelo de Freitas Valeiro Garcia, Cintia de Azevedo-Marques Périco, Danielle Ruiz Lima, Julio Torales, Antonio Ventriglio, Dinesh Bhugra, João Mauricio Castaldelli-Maia
During the American civil war, Philadelphia became the site of several military hospitals, and doctor Da Costa served in one of those. He observed and described a ‘cardiac malady common among soldiers’. These symptoms were reported as an overstimulation of soldiers’ heart nervous system. Da Costa wrote a report to the U.S. War Department in 1862 and finally gathered all his observations about the disorder in a 36-pages article published in 1871 in the American Journal of Medical Sciences (Paul, 1987). Da Costa’s syndrome and Soldier’s Heart both include the following symptoms: palpitation; fatigue; breathlessness; nervousness; chest pain; sighing; dizziness; faintness; apprehensiveness; headache; paresthaesia; weakness; trembling; insomnia; and unhappiness (Cohen & White, 1951; Paul, 1987).