King's College London

Research portal

Soldier’s heart: the forgotten circulatory neurasthenia–a systematic review

Research output: Contribution to journalReview article

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

Original languageEnglish
Pages (from-to)510-519
Number of pages10
JournalInternational Review of Psychiatry
Issue number5-6
Publication statusPublished - 17 Aug 2020

King's Authors


Soldier’s Heart (SH) is a former medical diagnosis, rarely mentioned nowadays, presented under several other names. Considering the controversy regarding the removal of Soldier’s Heart diagnosis from DSM-5, this study aimed to conduct a systematic review to evaluate its usage in the clinical practice. Information on diagnosis, military stress, heart rate variability, treatment, and prognosis were collected from 19 studies included after a systematic literature search. Considering the lack of adequate use of Soldier’s Heart diagnosis and the diagnostic overlapping with other conditions, the present systematic review supports the inclusion of Soldier’s Heart under the umbrella of posttraumatic stress disorders (PTSDs). This proposal is also in line with the conception that physical symptoms are relevant features often associated with generalized anxiety disorder and PTSD. Also, it will be described the higher prevalence of cardiological comorbidities in SH and possible cardiological consequences. Pharmacotherapy based on benzodiazepines and beta-blockers, as well as biofeedback and mindfulness techniques are considered to be useful treatment options. Further studies are needed to better define psychopathological domains of this syndrome and possible novel treatment targets.

View graph of relations

© 2018 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454