title: [Course of trauma sequelae in ex-political prisoners in the GDR: a 15-year follow-up study].
abstract: BACKGROUND
  In a sample of ex-political prisoners in the GDR examined in the middle of the 1990s, a follow-up examination carried out 15 years later investigated alterations in the diagnosis and symptom prevalence of post-traumatic stress syndrome PTSS) as well as other psychiatric disorders. The diagnosis course given by the clinicians was compared with the retrospective subjective estimations by participants.
  
  
  METHODS
  A total of 93 ex-political prisoners participated in the follow-up study (85 %) with an average age of 64 years. Diagnoses and symptoms were collated using structured clinical interviews and questionnaires. The retrospective subjective estimation of progression of the participants was calculated using a PTSS symptom index based on four symptom groups (intrusions, avoidance, numbing and hyperarousal).
  
  
  RESULTS
  At the time of follow-up PTSS was present in 33 % of participants (in 1997 it was 29 %). In 1994 this was present in only approximately 50 % of cases and in the other 50 % it concerned newly incident or remission cases. The next most common diagnoses were major depression episodes (26 %), panic (with or without agoraphobia 24 %) and somatoform disorders (19 %). In the PTSS symptom profile intrusions, flashbacks and alienation feelings decreased with time but in contrast irritability and shock reactions increased. The subjective self-estimation of the course of PTSS symptoms by the participants often gave a resilient (never PTSS) or delayed and rarely a remission course pattern in comparison to the diagnosing clinicians.
  
  
  CONCLUSIONS
  The results indicate a trauma-related long-term morbidity which is, however less stable than previously assumed.
authors.affiliation: Psychologisches Institut der Universität Zürich, Zürich, Schweiz. maercker@psychologie.uzh.ch
authors.forename: A
authors.initials: A
authors.lastname: Maercker
authors.forename: I
authors.initials: I
authors.lastname: Gäbler
authors.forename: M
authors.initials: M
authors.lastname: Schützwohl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003148:Communism; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D005859:Germany, East; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D011329:Prisoners / Q000523:psychology*; D011613:Psychotherapy; D055500:Resilience, Psychological; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D047789:World War II