Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-02T23:54:38.685Z Has data issue: false hasContentIssue false
  • English
  • Français

The impact of forced displacement in World War II on mental health disorders and health-related quality of life in late life – a German population-based study

Published online by Cambridge University Press:  24 September 2012

Simone Freitag ,
Elmar Braehler ,
Silke Schmidt  and
Heide Glaesmer
Simone Freitag*
Affiliation:
Department Health and Prevention, Ernst-Moritz-Arndt-University Greifswald, 17487 Greifswald, Germany
Elmar Braehler
Affiliation:
Department of Medical Psychology and Medical Sociology, University of Leipzig, 04103 Leipzig, Germany
Silke Schmidt
Affiliation:
Department Health and Prevention, Ernst-Moritz-Arndt-University Greifswald, 17487 Greifswald, Germany
Heide Glaesmer
Affiliation:
Department of Medical Psychology and Medical Sociology, University of Leipzig, 04103 Leipzig, Germany
*
Correspondence should be addressed to: Simone Freitag, Department Health and Prevention, Ernst-Moritz-Arndt-University Greifswald, 17487 Greifswald, Germany. Phone: +49-3834-863805; Fax: +49-3834-863801. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Long-term effects of World War II experiences affect psychological and physical health in aged adults. Forced displacement as a traumatic event is associated with increased psychological burden even after several decades. This study investigates the contribution of forced displacement as a predictor for mental health disorders and adds the aspect of health-related quality of life (QoL).

Method: A sample of 1,659 German older adults aged 60–85 years was drawn from a representative survey. Post-traumatic stress disorder (PTSD), somatoform symptoms, depressive syndromes, and health-related QoL were assessed as outcome variables. Chi-square and t-test statistics examined differences between displaced and non-displaced people. Logistic regression analyses were performed to examine the impact of forced displacement on mental health disorders and QoL.

Results: Displaced people reported higher levels of PTSD, depressive and somatoform symptoms, and lower levels of health-related QoL. Displacement significantly predicted PTSD and somatoform symptoms in late life, but not depressive disorders. Health-related QoL was predicted by forced displacement and socio-demographic variables.

Conclusion: Forced displacement is associated with an elevated risk for PTSD and somatoform symptoms and lowered health-related QoL in aged adults. Its unique impact declines after including socio-demographic variables. Long-term consequences of forced displacement need further investigations and should include positive aspects in terms of resilience and protective coping strategies.

Keywords

forced displacementWorld War IIolder adultsPTSDquality of life
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 2 , February 2013 , pp. 310 - 319
Copyright
Copyright © International Psychogeriatric Association 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (APA) (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC: APA.Google Scholar
Beutel, M. E., Decker, O. and Brähler, E. (2007). Welche Auswirkungen haben Flucht und Vertreibung auf Lebensqualitat und Befindlichkeit? Repräsentative Erhebung mit den vor 1946 Geborenen in Deutschland. Zeitschrift für Psychosomatische Medizin und Psychotherapie, 53, 203–215.CrossRefGoogle Scholar
Cheak-Zamora, N. C., Wyrwich, K. W. and McBride, T. D. (2009). Reliability and validity of the SF-12v2 in the medical expenditure panel survey. Quality of Life Research, 18, 727–735.CrossRefGoogle ScholarPubMed
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences. Hillsdale, MI: Lawrence Erlbaum.Google Scholar
Fazel, M., Wheeler, J. and Danesh, J. (2005). Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet, 365, 1309–1314.CrossRefGoogle ScholarPubMed
Fischer, C. J., Struwe, J. and Lemke, M. R. (2006). Langfristige Auswirkungen traumatischer Ereignisse auf somatische und psychische Beschwerden: Am Beispiel von Vertriebenen nach dem 2, Weltkrieg. Der Nervenarzt, 77, 58–63.CrossRefGoogle Scholar
Foa, E. B., Cashman, L., Jaycox, L. and Perry, K. (1997). The validation of a self-report measure of posttraumatic stress disorder: the posttraumatic diagnostic scale. Psychological Assessment, 9, 445–451.CrossRefGoogle Scholar
Glaesmer, H., Gunzelmann, T., Braehler, E., Forstmeier, S. and Maercker, A. (2010). Traumatic experiences and post-traumatic stress disorder among elderly Germans: results of a representative population-based survey. International Psychogeriatrics, 22, 661–670.CrossRefGoogle ScholarPubMed
Glaesmer, H., Braehler, E., Guendel, H. and Riedel-Heller, S. G. (2011). The association of traumatic experiences and posttraumatic stress disorder with physical morbidity in old age: a German population-based study. Psychosomatic Medicine, 73, 401–406.CrossRefGoogle ScholarPubMed
Graefe, K., Zipfel, S., Herzog, W. and Loewe, B. (2004). Screening psychischer störungen mit dem “gesundheitsfragebogen für patienten (PHQ-D).” ergebnisse der deutschen validierungsstudie. Diagnostica, 50, 171–181.CrossRefGoogle Scholar
Griesel, D., Wessa, M. and Flor, H. (2006). Psychometric qualities of the German version of the posttraumatic diagnostic scale (PTDS). Psychological Assessment, 18, 262–268.CrossRefGoogle ScholarPubMed
Kroenke, K., Spitzer, R. L. and Williams, J. B. W. (2001). The PHQ-9 – validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613.CrossRefGoogle ScholarPubMed
Kroenke, K., Spitzer, R. L. and Williams, J. B. W. (2002). The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms. Psychosomatic Medicine, 64, 258–266.CrossRefGoogle ScholarPubMed
Kroenke, K., Spitzer, R. L., Williams, J. B. W. and Loewe, B. (2010). The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review. General Hospital Psychiatry, 32, 345–359.CrossRefGoogle ScholarPubMed
Kuwert, P., Braehler, E., Glaesmer, H., Freyberger, H. J. and Decker, O. (2009). Impact of forced displacement during World War II on the present-day mental health of the elderly: a population-based study. International Psychogeriatrics, 21, 748–753.CrossRefGoogle ScholarPubMed
Kuwert, P., Spitzer, C., Trader, A., Freyberger, H. J. and Ermann, M. (2006). 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., Rosenthal, J. and Freyberger, H. J. (2008). Trauma and post-traumatic stress symptoms in former German child soldiers of World War II. International Psychogeriatrics, 20, 1014–1018.CrossRefGoogle ScholarPubMed
Loewe, B., Kroenke, K., Herzog, W. and Graefe, K. (2004). Measuring depression outcome with a brief self-report instrument: sensitivity to change of the patient health questionnaire (PHQ-9). Journal of Affective Disorders, 81, 61–66.CrossRefGoogle Scholar
Maercker, A. (1998). Posttraumatische Belastungsstörungen: Psychologie der Extrembelastungsfolgen bei Opfern Politischer Gewalt. Lengerich: Pabst.Google Scholar
Muhtz, C.et al. (2011a). Effects of chronic posttraumatic stress disorder on metabolic risk, quality of life, and stress hormones in aging former refugee children. Journal of Nervous and Mental Disease, 199, 646–652.CrossRefGoogle ScholarPubMed
Muhtz, C.et al. (2011b). Long-term consequences of flight and expulsion in former refugee children. Psychotherapie Psychosomatik Medizinische Psychologie, 61, 233–238.CrossRefGoogle ScholarPubMed
Netuveli, G., Wiggins, R. D., Hildon, Z., Montgomery, S. M. and Blane, D. (2006). Quality of life at older ages: evidence from the English longitudinal study of aging (wave 1). Journal of Epidemiology and Community Health, 60, 357–363.CrossRefGoogle ScholarPubMed
Nuebling, M., Stoessel, U., Hasselhorn, H. M., Michaelis, M. and Hofmann, F. (2006). Measuring psychological stress and strain at work – evaluation of the COPSOQ questionnaire in Germany. Psycho-Social-Medicine, 3, Doc05.Google Scholar
Saarela, J. and Finnäs, F. (2009). Forced migration and mortality in the very long term: did perestroika affect death rates also in Finland? Demography, 46, 575–587.CrossRefGoogle ScholarPubMed
Solhaug, H. I., Romuld, E. B., Romild, U. and Stordal, E. (2012). Increased prevalence of depression in cohorts of the elderly: an 11-year follow-up in the general population – the HUNT study. International Psychogeriatrics, 24, 151–158.CrossRefGoogle ScholarPubMed
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. Lancet, 360, 1056–1062.CrossRefGoogle ScholarPubMed
Strauss, K., Dapp, U., Anders, J., von Renteln-Kruse, W. and Schmidt, S. (2011). Range and specificity of war-related trauma to posttraumatic stress; depression and general health perception: displaced former World War II children in late life. Journal of Affective Disorders, 128, 267–276.CrossRefGoogle ScholarPubMed
Streiner, D. L. (2002). Breaking up is hard to do: the heartbreak of dichotomizing continuous data. The Canadian Journal of Psychiatry/La Revue Canadienne de psychiatrie, 47, 262–266.CrossRefGoogle Scholar
Wheaton, B. (2007). The twain meet: distress, disorder and the continuing conundrum of categories (comment on horwitz). Health (London), 11, 303–319; discussion 321–306.CrossRefGoogle ScholarPubMed
Wittchen, H.-U. and Pfister, H. (eds.) (1997). DIA-X-Interviews: Manual für Screening-Verfahren und Interview; Interviewheft Längsschnittuntersuchung (DIA-X-Lifetime); Ergänzungsheft (DIA-X-Lifetime); Interviewheft Querschnittuntersuchung (DIA-X-12 Monate); Ergänzungsheft (DIA-X-12Monate); PC-Programm zur Durchführung des Interviews (Längs- und Querschnittuntersuchung); Auswertungsprogramm. Frankfurt: Swets and Zeitlinger.Google Scholar