BACKGROUND: 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. METHODS: In 1992, a community survey was held. In 2002, vital status was checked. RESULTS: 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. LIMITATIONS: 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. CONCLUSIONS: 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.
BACKGROUND: 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. METHODS: In 1992, a community survey was held. In 2002, vital status was checked. RESULTS: 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. LIMITATIONS: 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. CONCLUSIONS: 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.
Authors: Ranak B Trivedi; Edward P Post; Haili Sun; Andrew Pomerantz; Andrew J Saxon; John D Piette; Charles Maynard; Bruce Arnow; Idamay Curtis; Stephan D Fihn; Karin Nelson Journal: Am J Public Health Date: 2015-10-16 Impact factor: 9.308
Authors: James B Lohr; Barton W Palmer; Carolyn A Eidt; Smitha Aailaboyina; Brent T Mausbach; Owen M Wolkowitz; Steven R Thorp; Dilip V Jeste Journal: Am J Geriatr Psychiatry Date: 2015-05-07 Impact factor: 4.105
Authors: Alexander N Bennett; Daniel Mark Dyball; Christopher J Boos; Nicola T Fear; Susie Schofield; Anthony M J Bull; Paul Cullinan Journal: BMJ Open Date: 2020-10-30 Impact factor: 2.692