Psychiatric Aspects of Chemical Weapons: Less Considered Points

Chemical warfare agents are weapons of mass destruction and are usually highly toxic. Although they have been used for centuries, they have not yet been fully and comprehensively described. Today, they are classified as nerve agents, blister agents, blood agents, choking agents, tear gases, psychoto mimetic agents, and toxins. The mass production and consequent widespread deployment of these agents has been documented since the 19th century following the expansion of industrial chemistry. Since then, several large-scale attacks using them have been reported. Chemical weapons can be examined from various aspects, including environmental, legal, ethical, medical, etc. The psychiatric aspect and its considerations have not received sufficient attention.
The psychological aspect of chemical attacks has been neglected, or at least not sufficiently addressed. Indeed, if medical preparedness for chemical attacks is carried out, it is unlikely to include psychiatrists or consider adequate psychological assistance. Meanwhile, mood, cognitive, and behavioral disorders resulting from trauma and chemical agents are common, both in the short and long term. Psychiatrists have significant multifaceted roles and duties in such a crisis, including helping to differentiate somatization and anxiety in patients presenting to the emergency department, treating short-term and long-term psychiatric disorders, providing crisis management intervention to healthcare staff, and providing advice and guidance to decision-makers.
Multiple effects of chemical substances on the mental health of individuals exposed to them in war or research have been reported, including intellectual disorders, concentration problems, anxiety disorders, sleep disorders, psychomotor retardation, depression, social withdrawal, antisocial thoughts, fatigue, amnesia, restlessness, and irritability. Psychiatric disorders caused by chemical weapons can affect individuals long after the attack, with one study showing that psychiatric and psychological findings, including somatization, obsessive-compulsive disorder, depression, anxiety, and hostility, were more prevalent in a population exposed to sulfur mustard, panic and fear, even up to 20 years after exposure.
Sulfur mustard is a blister agent for which there is still no effective antidote. The city of Sardasht in West Azerbaijan was the victim of a chemical attack on June 7, 1987, during the Iran-Iraq war. On that evening, many people were massacred, and since then, many people have suffered from the consequences, of which the psychiatric aspect is only a small part.