Civilians in World War II and DSM-IV mental disorders: results from the World Mental Health Survey Initiative

Rochelle Frounfelker, Stephen E. Gilman, Theresa S. Betancourt, Sergio Aguilar-Gaxiola, Jordi Alonso, Evelyn J. Bromet, Ronny Bruffaerts, Giovanni de Girolamo, Semyon Gluzman, Oye Gureje, Elie G. Karam, Sing Lee, Jean Pierre Lépine, Yutaka Ono, Beth Ellen Pennell, Daniela G. Popovici, Margreet Ten Have, Ronald C. Kessler, Sergio Aguilar-Gaxiola, Ali Al-HamzawiMohammed Salih Al-Kaisy, Jordi Alonso, Laura Helena Andrade, Corina Benjet, Guilherme Borges, Evelyn J. Bromet, Ronny Bruffaerts, Brendan Bunting, Jose Miguel Caldas de Almeida, Graca Cardoso, Alfredo H. Cia, Somnath Chatterji, Louisa Degenhardt, Peter de Jonge, Koen Demyttenaere, John Fayyad, Silvia Florescu, Oye Gureje, Josep Maria Haro, Yanling He, Hristo Hinkov, Chi yi Hu, Yueqin Huang, Aimee Nasser Karam, Elie G. Karam, Norito Kawakami, Ronald C. Kessler, Andrzej Kiejna, Viviane Kovess-Masfety, Sing Lee, On Behalf Of The Who World Mental Health Survey Collaborators

Research output: Contribution to journalArticlepeer-review


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
Pages (from-to)1-13
Number of pages13
JournalSocial Psychiatry and Psychiatric Epidemiology
Publication statusE-pub ahead of print - 2017


  • 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


Dive into the research topics of 'Civilians in World War II and DSM-IV mental disorders: results from the World Mental Health Survey Initiative'. Together they form a unique fingerprint.

Cite this