Psychological distress and psychiatric disorders in primary health care patients in East and West Germany 1 year after the fall of the Berlin Wall.
BACKGROUND
The reunification of Germany confronted citizens in East and West Germany with many changes in their lives. These changes may be considered as critical life events. Especially for those in East Germany, life circumstances drastically changed, and individuals were increasingly required to adopt and develop coping capabilities. In addition to new opportunities and freedom, there was threatening uncertainty about the future. Theories of life events and stress postulate that threat events have an impact on human well-being. It was expected that there would be an increased rate of psychiatric morbidity after unification, especially in the eastern part of Germany.


METHODS
An international study by the WHO on psychiatric disorders in general health care was carried out in 1990, 1 year after the opening of the Berlin Wall, in both parts of Berlin and in Mainz, West Germany. This allowed for a comparison of the prevalence rates of psychiatric disorders among general health care patients in the East and West, after the euphoria immediately following unification had subsided.


RESULTS
The prevalence rates of current ICD-10 diagnoses and of subthreshold disorders in East Berlin were similar to the rates in West Berlin and Mainz. The recognition rate of psychiatric disorders by physicians did not differ in East Berlin as compared to West Berlin and Mainz.


CONCLUSIONS
Contrary to the prediction expected from the literature on individual negative life events, major changes in life circumstances and stressful life events on a societal level within 1 year did not have a major impact on psychological function.
Achberger
M
M
Department of Psychiatry, Freie Universität Berlin, Germany.
Linden
M
M
Benkert
O
O
D000328:Adult; D001604:Berlin / Q000453:epidemiology; D005260:Female; D005859:Germany, East / Q000453:epidemiology; D005860:Germany, West / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D011057:Politics; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012494:Sampling Studies; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology*