Skip to main content
    • Aa
    • Aa

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

  • Simone Freitag (a1), Elmar Braehler (a2), Silke Schmidt (a1) and Heide Glaesmer (a2)

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.

Corresponding author
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:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

M. E. Beutel , O. Decker and E. Brähler (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, 203215.

N. C. Cheak-Zamora , K. W. Wyrwich and T. D. McBride (2009). Reliability and validity of the SF-12v2 in the medical expenditure panel survey. Quality of Life Research, 18, 727735.

J. Cohen (1988). Statistical Power Analysis for the Behavioral Sciences. Hillsdale, MI: Lawrence Erlbaum.

M. Fazel , J. Wheeler and J. Danesh (2005). Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet, 365, 13091314.

C. J. Fischer , J. Struwe and M. R. Lemke (2006). Langfristige Auswirkungen traumatischer Ereignisse auf somatische und psychische Beschwerden: Am Beispiel von Vertriebenen nach dem 2, Weltkrieg. Der Nervenarzt, 77, 5863.

E. B. Foa , L. Cashman , L. Jaycox and K. Perry (1997). The validation of a self-report measure of posttraumatic stress disorder: the posttraumatic diagnostic scale. Psychological Assessment, 9, 445451.

H. Glaesmer , E. Braehler , H. Guendel and S. G. Riedel-Heller (2011). The association of traumatic experiences and posttraumatic stress disorder with physical morbidity in old age: a German population-based study. Psychosomatic Medicine, 73, 401406.

K. Graefe , S. Zipfel , W. Herzog and B. Loewe (2004). Screening psychischer störungen mit dem “gesundheitsfragebogen für patienten (PHQ-D).” ergebnisse der deutschen validierungsstudie. Diagnostica, 50, 171181.

D. Griesel , M. Wessa and H. Flor (2006). Psychometric qualities of the German version of the posttraumatic diagnostic scale (PTDS). Psychological Assessment, 18, 262268.

K. Kroenke , R. L. Spitzer and J. B. W. Williams (2001). The PHQ-9 – validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606613.

K. Kroenke , R. L. Spitzer and J. B. W. Williams (2002). The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms. Psychosomatic Medicine, 64, 258266.

K. Kroenke , R. L. Spitzer , J. B. W. Williams and B. Loewe (2010). The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review. General Hospital Psychiatry, 32, 345359.

P. Kuwert , C. Spitzer , A. Trader , H. J. Freyberger and M. Ermann (2006). Sixty years later: post-traumatic stress symptoms and current psychopathology in former German children of World War II. International Psychogeriatrics, 19, 955961.

P. Kuwert , C. Spitzer , J. Rosenthal and H. J. Freyberger (2008). Trauma and post-traumatic stress symptoms in former German child soldiers of World War II. International Psychogeriatrics, 20, 10141018.

B. Loewe , K. Kroenke , W. Herzog and K. Graefe (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, 6166.

C. Muhtz 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, 646652.

C. Muhtz et al. (2011b). Long-term consequences of flight and expulsion in former refugee children. Psychotherapie Psychosomatik Medizinische Psychologie, 61, 233238.

G. Netuveli , R. D. Wiggins , Z. Hildon , S. M. Montgomery and D. Blane (2006). Quality of life at older ages: evidence from the English longitudinal study of aging (wave 1). Journal of Epidemiology and Community Health, 60, 357363.

J. Saarela and F. Finnäs (2009). Forced migration and mortality in the very long term: did perestroika affect death rates also in Finland? Demography, 46, 575587.

Z. Steel , D. Silove , T. Phan and A. Bauman (2002). Long-term effect of psychological trauma on the mental health of Vietnamese refugees resettled in Australia: a population-based study. Lancet, 360, 10561062.

K. Strauss , U. Dapp , J. Anders , W. von Renteln-Kruse and S. Schmidt (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, 267276.

B. Wheaton (2007). The twain meet: distress, disorder and the continuing conundrum of categories (comment on horwitz). Health (London), 11, 303319; discussion 321–306.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

International Psychogeriatrics
  • ISSN: 1041-6102
  • EISSN: 1741-203X
  • URL: /core/journals/international-psychogeriatrics
Please enter your name
Please enter a valid email address
Who would you like to send this to? *