Barbed Wire Disease

The Swiss physician Adolf Lukas Vischer (1884–1974) was an observer of the impact of the First World War on the human condition. In 1918 Vischer published an account of the psychological harm done to young men through the modern phenomenon of wartime captivity in POW and internment camps. The name of the book was Die Stacheldrahtkrankheit ('The Barbed-Wire Disease').

Vischer’s observations indicated that those who had been in enemy captivity for extended periods —two years or more— were also suffering from a particular kind of mental illness characterized by disinterest in life beyond the camp, restlessness and an inability to concentrate. He also witnessed similar symptoms among European and Indian POWs in Turkish captivity during an inspection tour with the Red Cross in Asia Minor in 1916–17, and again among German civilian internees on the Isle of Man and prisoners held in military and civilian camps on the British mainland.

This brought Vischer to the conclusion that what was already being dubbed ‘barbed-wire disease’ in some of the camp newspapers was a universal human response to being held behind barbed wire for prolonged stretches of time.

The syndrome was something common to all long-term prisoners. Furthermore, it was not eased or worsened by education, class, ethnicity or religion of any particular group of prisoners; rather, its sole cause was the fact of living behind barbed wire itself. The degree of severity depended primarily on the duration of captivity, not on experiences prior to capture.

At the same time in France, physicians also observed these same effects on captivity, but they invented their own term: cafard, from the Arabic kafir ('unbeliever') but with the currupted meaning of 'depression' or 'melancholy. They saw cafard as a form of spiritual home-sickness to be fought against and overcome, rather than as a medical condition that could only be treated, if at all, by release back into civilian life.

Though not exactly the same, modern researchers use the term 'institutionalization' or 'institutional syndrome' to describe deficits or disabilities in social and life skills, which develop after a person has spent a long period living in prisons or mental hospitals. These individuals may be deprived of independence and of responsibility, to the point that once they return to 'outside life' they are often unable to manage many of its demands.