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Impact of forced displacement during World War II on the present-day mental health of the elderly: a population-based study

Published online by Cambridge University Press:  01 August 2009

Philipp Kuwert ,
Elmar Brähler ,
Heide Glaesmer ,
Harald Jürgen Freyberger  and
Oliver Decker
Philipp Kuwert*
Affiliation:
Department of Psychiatry and Psychotherapy, Ernst-Moritz-Arndt University Greifswald, Stralsund, Germany
Elmar Brähler
Affiliation:
Department of Medical Psychology and Sociology, University of Leipzig, Leipzig, Germany
Heide Glaesmer
Affiliation:
Department of Medical Psychology and Sociology, University of Leipzig, Leipzig, Germany
Harald Jürgen Freyberger
Affiliation:
Department of Psychiatry and Psychotherapy, Ernst-Moritz-Arndt University Greifswald, Stralsund, Germany
Oliver Decker
Affiliation:
Department of Medical Psychology and Sociology, University of Leipzig, Leipzig, Germany
*
Correspondence should be addressed to: Philipp Kuwert, MD, Department of Psychiatry and Psychotherapy, Ernst-Moritz-Arndt University Greifswald, Rostocker Chaussee 70, D-18437 Stralsund, Germany. Phone: +49 (0)3831 452158; Fax: +49 (0)3831 452185. Email: kuwert@uni-greifswald.de.
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Abstract

Background: The effects of traumatization among the elderly is a neglected topic in research and clinical settings. Forced displacement of civilians is one of the main traumatic features of modern armed conflict. Roughly 12 million German people were displaced in World War II (WWII) and to our knowledge there has been no representative study investigating the mental health outcomes of such trauma in the elderly population. The survey assessed whether current depression, anxiety, resilience and life satisfaction were significantly associated with forced displacement in WWII.

Methods: A nationwide representative face-to-face household survey was conducted in Germany. A representative sample of the German population aged 61 years or older (N = 1513 participants, N = 239 displaced in WWII) was approached using 258 sample points. Measurements included depressive symptoms (PHQ-2), anxiety (GAD-7), resilience (RS-11), general and domain-specific life satisfaction (FLZM) and sociodemographic variables.

Results: Forced displacement in WWII is significantly associated with higher levels of anxiety and lower levels of resilience and life satisfaction 60 years later. In regression analyses, forced displacement in WWII significantly predicted current anxiety (β 0.07; p < 0.01), life satisfaction (β −0.06; p < 0.05) and resilience (β −0.07; p < 0.01).

Conclusion: To our knowledge this is the first nationwide representative survey to examine the late-life effects of forced displacement, particularly of persons displaced during WWII in Germany. Further research is needed to identify mediating variables and to evaluate psychotherapeutic interventions in elderly trauma survivors.

Keywords

displaced peoplewartraumalife satisfactionanxietyresiliencedepression
Type
Research Article
Information
International Psychogeriatrics , Volume 21 , Issue 4 , August 2009 , pp. 748 - 753
Copyright
Copyright © International Psychogeriatric Association 2009

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References

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Press.Google Scholar
Benz, W. (1985). Die Vertreibung der Deutschen aus dem Osten. Ursachen, Ereignisse, Folgen. Frankfurt/Main: Fischer Verlag.Google Scholar
Henrich, G. and Herschbach, P. (2000). Questions on life satisfaction: a short measure for assessing quality of life. European Journal of Psychological Assessment, 16, 159.CrossRefGoogle Scholar
Hollifield, M. (2005). Taking measure of war trauma. The Lancet, 365, 1283–1284.Google Scholar
Kroenke, K., Spitzer, R. L. and Williams, J. B. (2003). The Patient Health Questionnaire-2: validity of a two-item depression screener. Medical Care, 41, 1284–1292.CrossRefGoogle ScholarPubMed
Kroenke, K., Spitzer, R. L., Williams, J. B., Monahan, P. O. and Loewe, B. (2007). Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Annals of Internal Medicine, 146, 317–325.Google Scholar
Kuwert, P., Spitzer, C., Traeder, A., Freyberger, H. J. and Ermann, M. (2007). Sixty years later: post-traumatic stress symptoms and current psychopathology in former German children of World War II. International Psychogeriatrics, 19, 955–961.CrossRefGoogle ScholarPubMed
Kuwert, P., Spitzer, C., Dudeck, M., Vogel, M., Freyberger, H. J. and Ermann, M. (2008a). Psychological complaints, interpersonal problems, quality of life and sense of coherence in former german warchildren. Psychotherapie, Psychosomatik und Medizinische Psychologie, 58, 257–263.CrossRefGoogle ScholarPubMed
Kuwert, P., Spitzer, C., Rosenthal, J. and Freyberger, H. J. (2008b). Trauma and post-traumatic stress symptoms in former German child soldiers of World War II. International Psychogeriatrics, 20, 1014–1018.Google Scholar
Leppert, K., Gunzelmann, T., Schumacher, J., Strauss, B. and Braehler, E. (2005). Resilience as a protective personality characteristic in the elderly. Psychotherapie, Psychosomatik und Medizinische Psychologie, 55, 365–369.CrossRefGoogle ScholarPubMed
Loncar, M., Medved, V., Jovanovic, N. and Hotujac, L. (2006). Psychological consequences of rape on women in 1991–1995 war in Croatia and Bosnia and Herzegovina. Croatian Medical Journal, 47, 67–75.Google ScholarPubMed
Loewe, B., Kroenke, K. and Graefe, K. (2005). Detecting and monitoring depression with a two-item questionnaire (PHQ-2). Journal of Psychosomatic Research, 58, 163–171.CrossRefGoogle Scholar
Miller, G. A., Elbert, T., and Rockstroh, B. (2005). Judging psychiatric disorders in refugees. The Lancet, 366, 1604–1605.CrossRefGoogle ScholarPubMed
Mollica, R. F., Cardozo, B. L., Osofsky, H. J., Raphael, B., Ager, A. and Salama, P. (2004). Mental health in complex emergencies. The Lancet, 364, 2058–2067.Google Scholar
Roberts, B., Ocaka, K. F., Browne, J., Oyok, T. and Sondorp, E. (2008). Factors associated with post-traumatic stress disorder and depression amongst internally displaced persons in northern Uganda. BMC Psychiatry, 8, 38.Google Scholar
Schoevers, R. A., Geerlings, M. I., Deeg, D. J., Holwerda, T. J., Jonker, C. and Beekman, A. T. (2009). Depression and excess mortality: evidence for a dose response relation in community living elderly. International Journal of Geriatric Psychiatry, 24, 169–176.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Kroenke, K., Williams, J. B and Loewe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine, 166, 1092–1097.Google Scholar
Spitzer, C., Barnow, S., Voelzke, H.John, U., Freyberger, H-J. and Grabe, H. J. (2008). Trauma and post-traumatic stress disorder in the elderly: findings from a German community study. Journal of Clinical Psychiatry, 69, 693–700.Google Scholar
Statistisches Bundesamt (2005). Mikrozensus. Wiesbaden: Bundesdruckerei.Google Scholar
Steel, Z., Silove, D., Phan, T. and Bauman, A. (2002). Long-term effect of psychological trauma on the mental health of Vietnamese refugees resettled in Australia: a population-based study. The Lancet, 360, 1056–1062.Google Scholar
United States Committee on Refugees (USCR) (2002). World Refugee Survey 2002. Washington, DC: United States Press.Google Scholar
Wagnild, G. M. and Young, H. M. (1993). Development and psychometric evaluation of the Resilience Scale. Journal of Nursing Measurement, 1, 165–178.Google Scholar