Bramsen Inge, Deeg Dorly J H, van der Ploeg Eleonore, Fransman Sonja
Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands.
J Affect Disord. 2007 Nov;103(1-3):121-9. doi: 10.1016/j.jad.2007.01.014. Epub 2007 Feb 8.
Pathways through which wartime stress leads to excess mortality have not been examined so far. The current study examines wartime stress in relation to late-life mortality among 1448 World War II survivors, and potential mediating effects of mental health symptoms that were assessed in 1992.
In 1992, a community survey was held. In 2002, vital status was checked.
The highest hazard rates of mortality were found among military veterans and war survivors who had been seriously wounded. Posttraumatic stress disorder, suicidal thoughts, and, particularly, depression were associated with a higher hazard rate. Depression, anxiety, and somatic complaints appeared to act as mediators between the wartime stressor 'permanent disability or illness' and survival time.
The results may not be generalizable to all World War II survivors since the sample was restricted to those who survived until 1992. In addition, there was a considerable level of non-response, and the study used self-report data on wartime exposure and psychological symptoms.
Exposure to wartime stress as well as mental health symptoms in the long-term aftermath of war and violence are significant predictors of late-life mortality. Wounded survivors and those with a permanent disability or illness are particularly vulnerable.
迄今为止，战时压力导致过高死亡率的途径尚未得到研究。本研究调查了1448名二战幸存者中战时压力与晚年死亡率的关系，以及1992年评估的心理健康症状的潜在中介作用。
1992年进行了一项社区调查。2002年核查了生命状况。
在军事退伍军人和受过重伤的战争幸存者中发现了最高的死亡风险率。创伤后应激障碍、自杀念头，尤其是抑郁症与较高的风险率相关。抑郁症、焦虑症和躯体不适似乎在战时应激源“永久性残疾或疾病”与生存时间之间起中介作用。
由于样本仅限于那些活到1992年的人，结果可能不适用于所有二战幸存者。此外，无应答水平相当高，且该研究使用了关于战时暴露和心理症状的自我报告数据。
战时压力暴露以及战争和暴力长期后果中的心理健康症状是晚年死亡率的重要预测因素。受伤的幸存者以及有永久性残疾或疾病的人尤其脆弱。
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