title: 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.
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).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department Health and Prevention, Ernst-Moritz-Arndt-University Greifswald, 17487 Greifswald, Germany. freitag@uni-greifswald.de
authors.forename: Simone
authors.initials: S
authors.lastname: Freitag
authors.forename: Elmar
authors.initials: E
authors.lastname: Braehler
authors.forename: Silke
authors.initials: S
authors.lastname: Schmidt
authors.forename: Heide
authors.initials: H
authors.lastname: Glaesmer
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008016:Life Change Events; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000209:etiology / Q000523:psychology; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D012917:Social Adjustment; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013995:Time; D047789:World War II