Civilians in World War II and DSM-IV mental disorders

results from the World Mental Health Survey Initiative

on behalf of the WHO World Mental Health Survey Collaborators

Research output: Contribution to journalArticle

Abstract

Purpose: Understanding the effects of war on mental disorders is important for developing effective post-conflict recovery policies and programs. The current study uses cross-sectional, retrospectively reported data collected as part of the World Mental Health (WMH) Survey Initiative to examine the associations of being a civilian in a war zone/region of terror in World War II with a range of DSM-IV mental disorders. Methods: Adults (n = 3370) who lived in countries directly involved in World War II in Europe and Japan were administered structured diagnostic interviews of lifetime DSM-IV mental disorders. The associations of war-related traumas with subsequent disorder onset-persistence were assessed with discrete-time survival analysis (lifetime prevalence) and conditional logistic regression (12-month prevalence). Results: Respondents who were civilians in a war zone/region of terror had higher lifetime risks than other respondents of major depressive disorder (MDD; OR 1.5, 95% CI 1.1, 1.9) and anxiety disorder (OR 1.5, 95% CI 1.1, 2.0). The association of war exposure with MDD was strongest in the early years after the war, whereas the association with anxiety disorders increased over time. Among lifetime cases, war exposure was associated with lower past year risk of anxiety disorders (OR 0.4, 95% CI 0.2, 0.7). Conclusions: Exposure to war in World War II was associated with higher lifetime risk of some mental disorders. Whether comparable patterns will be found among civilians living through more recent wars remains to be seen, but should be recognized as a possibility by those projecting future needs for treatment of mental disorders.

Original languageEnglish (US)
Pages (from-to)1-13
Number of pages13
JournalSocial Psychiatry and Psychiatric Epidemiology
DOIs
StateAccepted/In press - Nov 8 2017

Fingerprint

World War II
mental disorder
Health Surveys
Mental Disorders
Diagnostic and Statistical Manual of Mental Disorders
Mental Health
mental health
Anxiety Disorders
anxiety
Major Depressive Disorder
Survival Analysis
terrorism
Japan
Cross-Sectional Studies
Logistic Models
Warfare
Global Health
Interviews
persistence
trauma

Keywords

  • Anxiety disorders
  • Civilians in war
  • Major depressive disorder
  • World War II

ASJC Scopus subject areas

  • Epidemiology
  • Health(social science)
  • Social Psychology
  • Psychiatry and Mental health

Cite this

Civilians in World War II and DSM-IV mental disorders : results from the World Mental Health Survey Initiative. / on behalf of the WHO World Mental Health Survey Collaborators.

In: Social Psychiatry and Psychiatric Epidemiology, 08.11.2017, p. 1-13.

Research output: Contribution to journalArticle

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abstract = "Purpose: Understanding the effects of war on mental disorders is important for developing effective post-conflict recovery policies and programs. The current study uses cross-sectional, retrospectively reported data collected as part of the World Mental Health (WMH) Survey Initiative to examine the associations of being a civilian in a war zone/region of terror in World War II with a range of DSM-IV mental disorders. Methods: Adults (n = 3370) who lived in countries directly involved in World War II in Europe and Japan were administered structured diagnostic interviews of lifetime DSM-IV mental disorders. The associations of war-related traumas with subsequent disorder onset-persistence were assessed with discrete-time survival analysis (lifetime prevalence) and conditional logistic regression (12-month prevalence). Results: Respondents who were civilians in a war zone/region of terror had higher lifetime risks than other respondents of major depressive disorder (MDD; OR 1.5, 95{\%} CI 1.1, 1.9) and anxiety disorder (OR 1.5, 95{\%} CI 1.1, 2.0). The association of war exposure with MDD was strongest in the early years after the war, whereas the association with anxiety disorders increased over time. Among lifetime cases, war exposure was associated with lower past year risk of anxiety disorders (OR 0.4, 95{\%} CI 0.2, 0.7). Conclusions: Exposure to war in World War II was associated with higher lifetime risk of some mental disorders. Whether comparable patterns will be found among civilians living through more recent wars remains to be seen, but should be recognized as a possibility by those projecting future needs for treatment of mental disorders.",
keywords = "Anxiety disorders, Civilians in war, Major depressive disorder, World War II",
author = "{on behalf of the WHO World Mental Health Survey Collaborators} and Rochelle Frounfelker and Gilman, {Stephen E.} and Betancourt, {Theresa S.} and Sergio Aguilar-Gaxiola and Jordi Alonso and Bromet, {Evelyn J.} and Ronny Bruffaerts and {de Girolamo}, Giovanni and Semyon Gluzman and Oye Gureje and Karam, {Elie G.} and Sing Lee and L{\'e}pine, {Jean Pierre} and Yutaka Ono and Pennell, {Beth Ellen} and Popovici, {Daniela G.} and {Ten Have}, Margreet and Kessler, {Ronald C.} and Sergio Aguilar-Gaxiola and Ali Al-Hamzawi and Al-Kaisy, {Mohammed Salih} and Jordi Alonso and Andrade, {Laura Helena} and Corina Benjet and Guilherme Borges and Bromet, {Evelyn J.} and Ronny Bruffaerts and Brendan Bunting and {de Almeida}, {Jose Miguel Caldas} and Graca Cardoso and Cia, {Alfredo H.} and Somnath Chatterji and Louisa Degenhardt and {de Girolamo}, Giovanni and {de Jonge}, Peter and Koen Demyttenaere and John Fayyad and Silvia Florescu and Oye Gureje and Haro, {Josep Maria} and Yanling He and Hristo Hinkov and Hu, {Chi yi} and Yueqin Huang and Karam, {Aimee Nasser} and Karam, {Elie G.} and Norito Kawakami and Kessler, {Ronald C.} and Andrzej Kiejna and Viviane Kovess-Masfety",
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T1 - Civilians in World War II and DSM-IV mental disorders

T2 - results from the World Mental Health Survey Initiative

AU - on behalf of the WHO World Mental Health Survey Collaborators

AU - Frounfelker, Rochelle

AU - Gilman, Stephen E.

AU - Betancourt, Theresa S.

AU - Aguilar-Gaxiola, Sergio

AU - Alonso, Jordi

AU - Bromet, Evelyn J.

AU - Bruffaerts, Ronny

AU - de Girolamo, Giovanni

AU - Gluzman, Semyon

AU - Gureje, Oye

AU - Karam, Elie G.

AU - Lee, Sing

AU - Lépine, Jean Pierre

AU - Ono, Yutaka

AU - Pennell, Beth Ellen

AU - Popovici, Daniela G.

AU - Ten Have, Margreet

AU - Kessler, Ronald C.

AU - Aguilar-Gaxiola, Sergio

AU - Al-Hamzawi, Ali

AU - Al-Kaisy, Mohammed Salih

AU - Alonso, Jordi

AU - Andrade, Laura Helena

AU - Benjet, Corina

AU - Borges, Guilherme

AU - Bromet, Evelyn J.

AU - Bruffaerts, Ronny

AU - Bunting, Brendan

AU - de Almeida, Jose Miguel Caldas

AU - Cardoso, Graca

AU - Cia, Alfredo H.

AU - Chatterji, Somnath

AU - Degenhardt, Louisa

AU - de Girolamo, Giovanni

AU - de Jonge, Peter

AU - Demyttenaere, Koen

AU - Fayyad, John

AU - Florescu, Silvia

AU - Gureje, Oye

AU - Haro, Josep Maria

AU - He, Yanling

AU - Hinkov, Hristo

AU - Hu, Chi yi

AU - Huang, Yueqin

AU - Karam, Aimee Nasser

AU - Karam, Elie G.

AU - Kawakami, Norito

AU - Kessler, Ronald C.

AU - Kiejna, Andrzej

AU - Kovess-Masfety, Viviane

PY - 2017/11/8

Y1 - 2017/11/8

N2 - Purpose: Understanding the effects of war on mental disorders is important for developing effective post-conflict recovery policies and programs. The current study uses cross-sectional, retrospectively reported data collected as part of the World Mental Health (WMH) Survey Initiative to examine the associations of being a civilian in a war zone/region of terror in World War II with a range of DSM-IV mental disorders. Methods: Adults (n = 3370) who lived in countries directly involved in World War II in Europe and Japan were administered structured diagnostic interviews of lifetime DSM-IV mental disorders. The associations of war-related traumas with subsequent disorder onset-persistence were assessed with discrete-time survival analysis (lifetime prevalence) and conditional logistic regression (12-month prevalence). Results: Respondents who were civilians in a war zone/region of terror had higher lifetime risks than other respondents of major depressive disorder (MDD; OR 1.5, 95% CI 1.1, 1.9) and anxiety disorder (OR 1.5, 95% CI 1.1, 2.0). The association of war exposure with MDD was strongest in the early years after the war, whereas the association with anxiety disorders increased over time. Among lifetime cases, war exposure was associated with lower past year risk of anxiety disorders (OR 0.4, 95% CI 0.2, 0.7). Conclusions: Exposure to war in World War II was associated with higher lifetime risk of some mental disorders. Whether comparable patterns will be found among civilians living through more recent wars remains to be seen, but should be recognized as a possibility by those projecting future needs for treatment of mental disorders.

AB - Purpose: Understanding the effects of war on mental disorders is important for developing effective post-conflict recovery policies and programs. The current study uses cross-sectional, retrospectively reported data collected as part of the World Mental Health (WMH) Survey Initiative to examine the associations of being a civilian in a war zone/region of terror in World War II with a range of DSM-IV mental disorders. Methods: Adults (n = 3370) who lived in countries directly involved in World War II in Europe and Japan were administered structured diagnostic interviews of lifetime DSM-IV mental disorders. The associations of war-related traumas with subsequent disorder onset-persistence were assessed with discrete-time survival analysis (lifetime prevalence) and conditional logistic regression (12-month prevalence). Results: Respondents who were civilians in a war zone/region of terror had higher lifetime risks than other respondents of major depressive disorder (MDD; OR 1.5, 95% CI 1.1, 1.9) and anxiety disorder (OR 1.5, 95% CI 1.1, 2.0). The association of war exposure with MDD was strongest in the early years after the war, whereas the association with anxiety disorders increased over time. Among lifetime cases, war exposure was associated with lower past year risk of anxiety disorders (OR 0.4, 95% CI 0.2, 0.7). Conclusions: Exposure to war in World War II was associated with higher lifetime risk of some mental disorders. Whether comparable patterns will be found among civilians living through more recent wars remains to be seen, but should be recognized as a possibility by those projecting future needs for treatment of mental disorders.

KW - Anxiety disorders

KW - Civilians in war

KW - Major depressive disorder

KW - World War II

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