Chronic morbidity of former prisoners of war and other Australian veterans

Objective: This report is the first summary article from a review of studies on long-term morbidity associated with war service or internment, commissioned by the Sir Edward Dunlop Medical Research Foundation.

Data Sources: The Medlars database, from 1966 to the present, under the terms military personnel, veterans, veterans' disability claims, combat disorders and prisoners (matched against war); databases of the Department of Veterans' Affairs (Victoria) and the Central Library, Commonwealth Department of Defence, using the term "prisoner of war"; and the microfiche listings of the Department of Veterans' Affairs, under "prisoner of war" and "repatriation". Only studies in English or French were reviewed, reaching a total of 172.

Study Selection: Forty-eight studies are considered in the present summary, presenting the most significant evidence about long-term morbidity attributable to war-time experiences. Studies concerning Australian veterans are emphasised.

Data Extraction: Studies considered valid were summarised for an annotated bibliography, but only reports of major public health significance are reviewed here.

Data Synthesis: The review confirms that strongyloidiasis, peptic ulcer, anxiety states, depression and hepatitis B are more prevalent in former prisoners of war than in relevant comparison groups. We have not identified further diagnoses that should be attributed specifically to war-time exposures. Attribution of long-term neurological and musculoskeletal disorders to war-time exposures remains uncertain.

Conclusions: Former prisoners of war and veterans constitute a population of survivors highly selected by the rigours of war and imprisonment. Occurrence of the five conditions listed above may be reasonably attributed to war-time exposure. We recommend further research on ageing (including neurological, visual, hearing and musculoskeletal disability), family disruption and rehabilitation strategies in these groups.