Post-traumatic stress disorder among victims of great march of return in the Gaza Strip, Palestine: A need for policy intervention.

This study aimed to assess the level of Post-Traumatic Stress Disorder (PSTD) and to examine the relationship between exposure to war stress and posttraumatic symptoms among people who were injured during the Great March of Return (GMR) in the Gaza Strip, Palestine. A sample of 264 adults who were injured during participation in the events of GMR completed the Impact Event Scale-Revised (IES-R). IES-R has three sub-scales; intrusion, avoidance, and hyper-arousal. Only 27.3% of the participants had two or more injuries and 38.4% of participants reported having disability due to their injuries. The results showed that 95.4% of the participants had severe posttraumatic symptoms. Total score of IES-R ranged between 29 and 88 (mean = 61.28). The most frequent symptoms of trauma subscales was "Intrusion" (mean = 2.90), followed by "Avoidance" (mean = 2.73), and then "Hyper-arousal" (mean = 2.70). Level of PTSD was affected by working status, need for hospitalization, need for a referral for treatment outside the Gaza Strip, disability and severity of injury. Such high level of PSTD will have negative consequences on participants' physical and mental status. Therefore, a need for special counseling programs is required to help them to survive with least consequences of PTSD on their wellbeing.

[So-called "difficult children" urgently needed their own medical association: the history of the introduction of the specialist title of "child and youth psychiatry" in Germany in 1968]. / Die "schwer erziehbaren Kinder" benötigten dringend einen Arzt ­ verbandspolitische Vorgeschichte der Einführung des Facharzttitels für Kinder- und Jugendpsychiatrie in Deutschland 1968.

So-called "difficult children" urgently needed their own medical association: the history of the introduction of the specialist title of "child and youth psychiatry" in Germany in 1968 Abstract. In post-war Germany, child psychiatry (CP) was not an independent discipline but part of adult psychiatry/neurology. The primary goal of adult psychiatrists of the day was to maintain power in all areas dealing with nervous diseases and their treatment. Interest in smaller specialties such as CP remained secondary, leaving only the option of an additional qualification. Switzerland, on the other hand, had already early on introduced a separate CP specialization. In many other industrialized nations, CP was expanding to deal better with the difficulties posed by "difficult children" and their sequelae. Because of "cleansing" and the enforced synchronization of social and health care systems during the Nazi regime as well as the effects of the war, the development of CP in West Germany was subject to exceptional conditions. Specialists for this important "social task" were missing. Only after adult psychiatrists had accepted the separation of the disciplines of neurology and psychiatry did the specialist in "Child and Youth Psychiatry" emerge and receive the approval of the Medical Assembly in 1968.

[A staunch National Socialist? Paul Vogel (1900-1979)]. / " voll und ganz auf dem Boden des Nationalsozialismus"? Paul Vogel (1900­1979).

Paul Vogel belonged to a group of neurologists born around 1900 who felt particularly attracted by the promises of National Socialism. Shortly after having completed his Habilitation in 1934 he became head of the leading neurology department in Berlin located at the Hansaplatz. Doctors working there reported patients for sterilization according to the Law for the Prevention of Genetically Diseased Offspring. They also acted as experts for Hereditary Health Courts (Erbgesundheitsgerichte). In 1933, Vogel chose to join the NS Medical Association and in 1937 became member of the National Socialist German Workers' Party (NSDAP). Influential medical officials confirmed his "political reliability" and this status made him eligible to succeed Viktor von Weizsäcker, his teacher, at Heidelberg University in 1941. A denazification tribunal classified him in 1946 as a follower (Mitläufer) partly because he was said to have taken a stance against the NS film drama "I accuse" in front of medical students. After WWII Vogel developed the neurological wards in Heidelberg into a fully-fledged neurological department. In 1955 and 1956 he acted as president of the German Neurological Society. In 1978 he became an honorary member.

Historicising the "Crisis" in Undergraduate Mental Health: British Universities and Student Mental Illness, 1944-1968.

This article explores how and why student mental health became an issue of concern in British universities between 1944 and 1968. It argues that two factors drew student mental health to the attention of medical professionals across this period: first, it argues that the post-war interest in mental illness drew attention to students, who were seen to be the luminaries of the future, investing their wellbeing with particular social importance. Second, it argues that the development of university health services made students increasingly visible, endorsing the view that higher education posed distinctive yet shared mental challenges to young people. The article charts the expansion of services and maps the implications of the visibility of student mental distress for post-war British universities. It suggests that claims that British higher education is currently in the midst of an unprecedented mental health "crisis" should be seen within this broader historical context, for while the contours of the debates around student mental health have shifted substantially, evidence that there was anxiety around student mental wellbeing in the immediate post-war years undermines accusations that contemporary students constitute a unique "snowflake generation."

'A disastrous blow': psychiatric risk, social indicators and medical authority in abortion reform in post-war Britain.

The Second World War lent impetus to the creation of new models and explanatory frameworks of risk, encouraging a closer reading of the relationship between individual psychiatric disorder and social disarray. This article interrogates how conceptions of psychiatric risk were animated in debates around abortion reform to forge new connections between social conditions and psychiatric vulnerability in post-war Britain. Drawing upon the arguments that played out between medical practitioners, I suggest that abortion reform, culminating in the 1967 Abortion Act, was both a response to and a stimulus for new ideas about the interaction between social aetiologies and medical pathologies; indeed, it became a site in which the medical and social domains were recognised as mutually constitutive. Positioned in a landscape in which medical professionals were seeking to assert their authority and to defend their areas of practice, abortion reform offered new opportunities for medical professionals to intervene in the social sphere under the guise of risk to women's mental health. The debate in medical journals around the status of issues that were seen to bridge the social and the medical were entangled with increasing anxiety about patient agency and responsibility. These concerns were further underscored as conversations about psychiatric risk extended towards considerations of the potential impact on women's existing families, bringing domestic conditions and the perceived psychosocial importance of family life into relief within medical journals. This article, then, argues that conceptions of psychiatric risk, as refracted through the creation of new synapses connecting the social and the medical domains, were critical to medical debates over abortion reform in post-war Britain.

Maternal health care service utilization in post-war Liberia: analysis of nationally representative cross-sectional household surveys.

BACKGROUND: Post-war Liberia has a fast-growing population and an alarming maternal mortality ratio (MMR). To provide a better understanding about healthcare system recovery in post-war country, we explored the changes in maternal healthcare services utilization between 2007 and 2016. METHODS: We used 2007 and 2013 Liberia Demographic and Health Survey (LDHS) and the 2016 Malaria Indicator Survey (MIS) in this study. The outcomes of interest were: place of delivery and antenatal care visits. Univariate analysis was conducted using percentages and means (standard deviations) and multiple binary multivariable logistic models were used to examine the factors associated with the outcome variables. RESULTS: Between 2007 and 2016, the percentage of adequate ANC visits increased from 71.20 to 79.8%, and that of facility-based delivery increased from 40.90 to 74.60%. The odds of attending at least four ANC visits and formal institutional delivery were low among women residing in rural area, but high among women with higher education, used electronic media, and lived in high wealth index households. Additionally, attending ANC at least four times increased the odds of facility-based delivery by almost threefold. CONCLUSION: The findings suggest that key maternal healthcare utilization indicators have improved substantially, especially facility-based delivery. However, a large proportion of women remain deprived of these life-saving health services in the post-war era. Greater healthcare efforts are needed to improve the quality and coverage of maternal healthcare in order to enhance maternal survival in Liberia.

The introduction of leucotomy in Germany: National Socialism, émigrés, a divided Germany and the development of neurosurgery.

Thinking about the chronology of the introduction of leucotomy in Germany sheds new light on the hypothesis of a special 'radical' approach of German psychiatry to the treatment of the mentally ill during the period of National Socialism. Moreover, it offers new insights into the transnational and interdisciplinary conditions of the introduction of leucotomy in early divided post-war Germany.

[On the road to psychiatric reform : Reconstructing the political preparation of the first Enquete Commission of the German Bundestag]. / Der Weg zur Psychiatrie-Enquete : Rekonstruktion der politischen Vorbereitung der ersten Enquetekommission des Deutschen Bundestags.

BACKGROUND: The purpose of this paper is to analyze the political preparation of the Enquete Commission of the German Bundestag which aimed at assessing and improving the psychiatric and psychotherapeutic/psychosomatic care in the Federal Republic of Germany. METHODS: We performed a selective literature review and a hermeneutic analysis of political, parliamentary and administrative records from public archives which reflect and help reconstruct the run-up process to the so-called Enquete of psychiatry. RESULTS: Literature and documents show how individual actors both in the mental health professions and politics bundled activities in the domains of psychiatry and mental health care as well as health/social politics; they helped to implement political, parliamentary and administrative steps leading up to the Enquete of the German Bundestag (1971-1975). In addition, the records and pertinent literature document the social, cultural and political developments in the Federal Republic of Germany which helped initiate the Enquete project. CONCLUSION: The Enquete was not a straightforward process and was also not tied to any moment. It fits more into the longer-term reform process of psychiatry in the Federal Republic of Germany.

[Leucotomy in the early Federal Republic of Germany]. / Leukotomie in der frühen Bundesrepublik Deutschland.

Leucotomy was introduced in 1936 in Europe as a therapy for mental illness. With the end of World War II leucotomy was also introduced in the early Federal Republic of Germany. Leucotomy was applied in cases of, for example schizophrenia, depression, obsessive-compulsive disorders or even some psychopathic disorders. The operations were carried out in neurosurgical departments outside psychiatric hospitals or patients were also transferred to those which had been established in psychiatric and neurological clinics. Based on published conference reports, retrospective case reports, dissertations as well as representative samples from medical files, the use of leucotomy in West Germany until the early 1950s is presented. It becomes obvious that the introduction of leucotomy in West German post-war psychiatry was encouraged by American psychiatry and neurosurgery.

Melancholic Response to War Destruction and the Emergence of a Group Assumption of Post-Ness.

What psychological response does war and forced displacement evoke in victims? How do survivors of war communicate their experiences to their children? Finally, what culture does the psychological response to loss shape? Using data collected through interviews, psychological consultations, and children's drawings from two sources-the ongoing Syrian civil war and the Bosnian war of 1992-1995, this paper suggests that the experience of the war generation becomes the organizing axis of their identity and that of their children. It seeks to demonstrate that survivor parents communicate their experience of loss through gesture, act, and object rather than through a coherent narrative. Whereas survivor children use metaphoric and metonymic readings of their parents' everyday performance in order to construct meaning and form their identities as descendants of a given family. This paper argues that such an identity is characterized by ambivalence towards the self and towards others, melancholic longing for an idealized pre-war past, and the impossibility of letting it go.

Use of information and communication technology and retention of health workers in rural post-war conflict Northern Uganda: findings from a qualitative study.

BACKGROUND: Information and communication technologies have become a vital infrastructural asset for use in the retention of rural health workers. However, little is known about the potential influence of ICT use, perceptions of health workers on ICT in healthcare delivery, and contribution of ICT to health care providers' retention in rural and remote areas in rural post-war and conflict situations of northern Uganda. METHODS: Data from interviews were transcribed, coded and thematically analysed. RESULTS: Participants generally exhibited low confidence, knowledge and low ICT skills. Majority of participants, however, perceived ICT as beneficial in relation to job performance and health care provider retention in rural areas. Common barriers for the implementation and use of ICT in health centres were inadequate ICT knowledge and skills, poor Internet networks, inadequate computers, inadequate power supply, lack of Internet Modems and expensive access to outside computer centres. CONCLUSIONS: This qualitative study showed low confidence, poor knowledge and skills in ICT usage but positive perceptions about the benefits and contributions of ICT. These findings suggest the need for specific investment in ICT infrastructural development for health care providers in remote rural areas of northern Uganda.

Social relationships and social support among post-war youth in Northern Uganda.

Although social relationships and social support are salient factors for post-war adolescents' psychosocial coping and adjustment, there is only limited information regarding war-affected adolescents' views on social support and the relationships within which social support is provided. This study therefore explored both elements among a clinical sample of 20 adolescents living in post-war Northern Uganda. Following Braun and Clarke's thematic analysis, we found a prominent role of the biological mother and other primary biological family members in the upbringing of our participants. Spiritual and material support were perceived to be the most important type of support, respectively, while the adolescents were growing up and in their current lives. These findings provide support for the perception that caregiving systems are adaptable to particular sociocultural contexts. Further, the importance of particular functions of social support could signify a potentially selective buffering effect of these functions in adverse contexts. Because of the importance of the primary biological family and the salient role of parent-child relationships in the face of adversity, future research needs to focus on this particular kind of social relationship in contexts of prolonged collective violence.

The Post-war Revival of Canadian Planning: Assessing the Impact of the Community Planning Association of Canada.

The Community Planning Association of Canada (CPAC) advocated for the re-establishment of planning in post-war Canada. During this period, the federal government set reconstruction objectives, and both Central (now Canada) Mortgage and Housing Corporation (CMHC) and the CPAC were formed. We believe that 1944-1947 was a critical juncture establishing planned suburban development in Canada as a path-dependent process with tremendous momentum into the 21st-century. Using a historical-institutional approach, the role of CMHC and the influence of the CPAC is examined. Analysis relying on extensive archival material demonstrates that the CPAC gave a tremendous push along the path-dependent process of suburbanization.

The Cold War in pharmacology: a bibliometric analysis of Berlin's contributions to Naunyn­Schmiedeberg's Archives of Pharmacology (1947-1974).

After World War II, Berlin was divided into the West, controlled by The United States, the UK, and France, and the East, controlled by the Soviet Union, resulting in a Cold War for decades. This bibliometric study analyzes the influence of the Cold War on pharmacological research in Berlin by evaluating publication patterns in Naunyn-Schmiedeberg's Archives of Pharmacology from 1947 to 1974 (n = 383). The publications highlight the political disparities in scientific output, exacerbated by the founding of the Free University of Berlin (FUB) as a countermeasure to Soviet repression, promoting academic freedom in West-Berlin. Researchers in West-Berlin published many more papers in Naunyn-Schmiedeberg's Archives of Pharmacology than researchers in East-Berlin and received much more citations. West-Berlin adopted English as a scientific language much more rapidly than East-Berlin. West-Berlin and East-Berlin focused on totally different research topics. This paper demonstrates how political freedom, financial support, and internationalization boosted research productivity in West-Berlin. In contrast, political suppression, financial scarcity, and restricted international ties hindered scientific development in East-Berlin.

Reintegration of cyber veterans: challenges and strategies for post-war transition.

Battles in the cyber domain often lack visibility compared to the physical domain, which can lead to insufficient appreciation of its actors' achievements by the general public and society. Nonetheless, it has become a crucial area of modern warfare in which cyber professionals defend the nation's critical infrastructure, support other military operations and achieve military objectives that could not be attained in other domains. Although cyber combatants might not have as high a risk of injury or death as those on the front lines, they still can face traumatic events and suffer from the same types of issues after the war as any other veteran. Earlier studies on war veterans have shown they have elevated risks of mental health issues, substance use, social problems and financial difficulties which might push some individuals towards a path of crime. The cyber domain is also not limited by time or place, which has given rise to cyber volunteerism in which skilled individuals around the globe decide to assist their own country or friendly nations. This publication aims to identify the challenges cyber veterans might face when transitioning back to civilian life and develop appropriate strategies to facilitate their reintegration. It also raises the awareness of the hundreds of thousands of volunteers who can develop similar problems after the war. Without proper awareness, support and dialogue, some of these individuals can also drift towards harmful social implications such as cybercrime.

The Rwandan Healthcare System: Can a Shifting Burden of Disease Threaten a Post-war Success Story?

Rwanda is located in Central Africa, bordered by the Democratic Republic of Congo (DRC), Burundi, Tanzania, and Uganda. In 1994, Rwanda was immersed in a brutal war and genocide. Rwanda's subsequent remarkable post-war recovery has been well documented. What this paper aims to do is to explore Rwanda's successes and the vulnerability it faces with the shifting burdens of diseases. This paper seeks to contribute to the global discourse on effective healthcare models in resource-limited, post-conflict settings, even as such countries achieve improved socio-economic conditions and experience associated changes in population disease patterns.

Post-war status of water supply, sanitation, hygiene and related reported diseases in Tigray, Ethiopia: A community-based cross-sectional study.

Water, sanitation and hygiene (WASH) associated diseases remain a global public health issue and linked with Sustainable Development Goal 6. In November 2020, a war broke out in Tigray, Ethiopia, resulting in a negative health consequence. The post war status of WASH and its associated diseases are not documented. The aim of this study was to assess the status of drinking water, sanitation and hygiene practices and the prevalence of WASH-associated diseases in Tigray, Ethiopia following the war. A community-based cross-sectional study was conducted in 24 randomly selected accessible districts of Tigray, Ethiopia. A standardized questionnaire was used to collect data from households in the study. Data was collected from 2338 households. Descriptive statistics and binary logistic regression were used to analyze the data. The average age of respondents was 28.7 years (SD = 6.2). The majority of respondents 2030 (86.8%) were married and 1698 (72.6%) were rural residents. Nearly one third of the respondents were uneducated and around 40% have either radio or TV as means of communication. More than half (55.2%) of the respondents had a family size of over 5. A quarter (25%, 95% CI: 23.3, 26.8) of study participants had access to a basic water supply. Less than a tenth (7.7%, 95% CI: 6.6, 8.8) of households had access to basic sanitation. Basic hand washing was available in 2% of households. Malaria, diarrhoea, skin infection and eye infection were the common reported disease in the community. Marital status, family size, place of residence and liquid waste management were the most important predictors of reported diseases. Access to basic water, sanitation and hygiene services was low, and the prevalence of malaria, diarrhoea and skin infections was higher. There were differences in WASH services and reported diseases according to zone and place of residence (urban-rural). Post war, improved access to basic water, sanitation and hygiene services is recommended to prevent WASH-associated diseases in Tigray, Ethiopia. Furthermore, the prevention oriented policy of the country needs better implementation to reduce preventable diseases and ensure better health status in the community.

[The Gulf War Syndrome twenty years on]. / Le syndrome de la guerre du Golfe vingt ans après.

INTRODUCTION: After Operation Desert Storm which took place in Iraq from August 1990 to July 1991 involving a coalition of 35 countries and a 700,000 strong contingent of mainly American men, some associations of war veterans, the media and researchers described a new diagnostic entity: the Gulf War Syndrome (GWS). LITERATURE FINDINGS: GWS seems to be a new disorder which associates a litany of functional symptoms integrating the musculoskeletal, digestive, tegumentary and neurosensory systems. The symptoms presented do not allow a syndrome already known to be considered and the aetiology of the clinical picture remains unexplained, an increasing cause for concern resulting from the extent of the phenomenon and its media coverage. It quickly appears that there is no consensus amongst the scientific community concerning a nosographic description of GWS: where can all these functional complaints arise from? Different aetiopathogenic hypotheses have been studied by the American administration who is attempting to incriminate exposure to multiple risks such as vaccines and their adjuvants, organophosphorous compounds, pyridostigmine (given to the troops for the preventive treatment of the former), impoverished uranium, and the toxic emanations from oil well fires. But despite extremely in-depth scientific investigations, 10 years after the end of the war, no objective marker of physical suffering has been retained to account for the disorders presented. It would appear that the former soldiers are in even better objective health than the civil population whereas their subjective level of health remains low. Within this symptomatic population, some authors have begun to notice that the psychological disorders appear and persist associating: asthenia, fatigability, mood decline, sleep disorders, cognitive disorders and post-traumatic stress disorder (PTSD). Within the nosological framework, does GWS cause functional disorders or somatisation? Finally, 20 years after the end of the fighting, only PTSD has been causally attributed to military deployment. CLINICAL FINDINGS: Certain functional symptoms of GWS occur during the latent phase of a future reexperiencing syndrome, latent phase which is the locus of nonspecific symptoms. The psychotraumatised subject does not express himself spontaneously and waits to be invited to do so: if the social context does not allow this expression, the suffering can remain lodged in a few parts of the body. How can the inexpressible part of the trauma be recounted, particularly if the social context does not allow it? For civil society, calling into question "the somatic word" of veterans is difficult: why were they sent to face these hardships? What could we learn from these soldiers we do not wish to listen to: the horror of the war, the aggressive impulse of men, and the confrontation with death? Another obstacle to this reflection is the reference to stress as a prevalent aetiopathogenic model of the psychological trauma. A model like this, considering that PTSD is a normal reaction to an abnormal situation, finally discredits the subject and society and disempowers them by freezing them in a passive status of victim. DISCUSSION: However, as GWS affects approximately a quarter of subjects deployed, it is not very likely that all these symptoms are caused by a psychotraumatic reaction. Many veterans suffering from GWS have themselves rejected the diagnosis of PTSD, arguing that they do not suffer repetition nightmares. What the veterans rightly tell us here is that the notions of stress and trauma cannot strictly be superimposed. A subject may have been intensely stressed without ever establishing traumatic flashbacks and likewise; a psychological trauma can be experienced without stress and without fear but in a moment of terror. This clarification is in line with the first criterion of the DSM-IV-TR which necessarily integrates the objective and subjective dimensions as determinants of PTSD. Yet, scientific studies relating to GWS are struggling to establish opposition or continuity links between the objective external exposure (smoke from petrol wells, impoverished uranium, biological agents, chemicals) and the share of inner emotion albeit reactive and characterised by a subjective stress. There were no lack of stress factors for the troops deployed: repeated alerts of chemical attacks, hostility of the environment with its sandstorms and venomous animals, climatic conditions making long hours of backup and static observation difficult, collecting bodies, lack of knowledge of the precise geography of their movements and uncertainty of the duration of the conflict. The military anti-nuclear-bacteriological-chemical uniform admittedly provided protective confinement, shutting out the hostile world from which the threat would come but, at the same time, this isolation increases the fear of a hypothetical risk whilst the internal perceptions are increased and can open the way to future somatisations. In a context like this, the somatic manifestations of anxiety (palpitations, sweating, paresthesia…) are willingly associated with somatised functional disorders to which can also be assigned over-interpretations of bodily feelings according to a hypochondriacal mechanism. The selective attention to somatic perceptions in the absence of mentalisations, the request for reassurance reiterated and the excessive use of the treatment system will be diagnostic indices of these symptoms caused by the stress. Rather than toxic exposure to such and such a substance, the non-specific syndrome called "Gulf War Syndrome" is the result of exposure to the eponymous operational theatre. But if the psychological and psychosomatic suffering occurring in veterans is immutable throughout history, the expression of these difficulties has specificities according to the past cultural, political and scientific context. In the example of GWS, the diffusion of the fear of a pathology resulting from chemical weapons has promoted this phenomenon. In the end, biochemical and biological weapons have not been used on a large scale but the mediatisation of this possibility has led to a deleterious… To spare the bother of a group psychological reflection, the scientific and political authorities chose to investigate the implication of environmental factors in the genesis of the disorder. At individual as well as social level, rather than accept a psychogenic origin, a common defence mechanism is to assign the suffering to an external cause. With the perspective of preventing the risk of diffusion of other unexplained syndromes, which could occur following future armed conflicts, new epidemiological diagnostic models must be defined. The media also has considerable responsibility for the diffusion of epidemic psychological reactions but at the same time, they can inform the population about certain individual or group psychopathological mechanisms. CONCLUSION: The GWS exists: it is not an "imaginary illness" but a serious public health issue which has led to tens of thousands of complaints and swallowed up millions of dollars. To reply to human suffering, a new nosographic entity can spread through society taking the epidemic expression of a somatised disorder via identification, imitation and suggestion mechanisms. This possibility questions not only mental health but also the sociology and politics. It is necessary to inform the leaders and the general population of the possibility of this type of mass reaction, which can take the shape of a highly contagious complex functional syndrome.

Post-War Assessment of the Prevalence and Determinants of Unplanned Pregnancy Among Pregnant Women Attending Public Hospitals in Conflict-Zones of South Wollo, Northeast Ethiopia, 2022, Multi-Center Study.

Background: Worldwide, although unplanned pregnancy seems decreasing, 38% of pregnancies are unintended. In sub-Saharan Africa, unintended pregnancy accounts for more than a quarter of the 40 million pregnancies that occur annually. Objective: The study aimed to assess the prevalence and determinants of unplanned pregnancy among pregnant women attending public hospitals in conflict-zones of South Wollo zone, Northeast Ethiopia, 2022. Methods: A multi-center facility-based cross-sectional study was conducted from December 20, 2021 to February 30, 2022 among the hospitals of South Wollo zone that that were destructed by the armed conflict. Results: The prevalence of unplanned pregnancy in our study was 44.72% (CI=39.40-48.08%). Conclusion: In this study nearly half of the pregnancies were unplanned, which is shocking to the health care system in the 21st century.

Double suicide in Japan in the post-war reconstruction period, with reference to contemporary Japan.

After Japan's post-war reconstruction, in the early 1950s, cases of double suicide, in which two people (particularly young lovers) leave a suicide note and die together, were a relatively frequent occurrence. During the three-year period between 1954 and 1956, 5466 suicides were recorded in the special wards of Tokyo, including 79 cases of double suicides, accounting for 158 deaths. In these double suicide cases (2.89% of all deaths by suicide), the evidence revealed that 65.8% involved lovers and 29.1% involved married couples. By contrast, contemporary data indicate a large drop in suicide pacts between lovers to 15.9% and an increase between spouses to 48.8%. Conceivably, the relatively high double-suicide rate after post-war reconstruction reflected difficulties for the younger generation in reconciling 'marriage based primarily on love' and the traditional family system, specifically marriage problems and stress caused by rapidly changing post-war values. One notable difference between victims of double suicide in 1954-1956 and the contemporary period is the younger average age of the former. Another important shift was found in the most common causes of death among victims of double suicide: in 1954-1956 these were poisoning by cyanide or hypnotic drugs, compared to carbon monoxide poisoning and hanging in modern times. We discuss similarities and differences concerning double suicides in relation to social and economic conditions in Japan in the 1950s and today.