Psychological distress and psychiatric disorders in primary health care patients in East and West Germany 1 year after the fall of the Berlin Wall

Background: The reunification of Germany confronted citizens in East and We st Germany with many changes in their lives. These changes may be considere d as critical life events. Especially for those in East Germany, life circu mstances drastically changed, and individuals were increasingly required to adopt and develop coping capabilities. In addition to new opportunities an d freedom, there was threatening uncertainty about the future. Theories of life events and stress postulate that threat events have an impact on human wellbeing. It was expected that there would be an increased rate of psychi atric morbidity after unification, especially in the eastern part of German y. Method: An international study by the WHO on psychiatric disorders in gener al health care was carried out in 1990, 1 year after the opening of the Ber lin Wall, in both parts of Berlin and in Mainz, West Germany. This allowed for a comparison of the prevalence rates of psychiatric disorders among gen eral health care patients in the East and West, after the euphoria immediat ely following unification had subsided. Results: The prevalence rates of current ICD-10 diagnoses and of subthresho ld disorders in East Berlin were similar to the rates in West Berlin and Ma inz. The recognition rate of psychiatric disorders by physicians did not di ffer in East Berlin as compared to West Berlin and Mainz. Conclusion: Contrary to the prediction expected from the literature on indi vidual negative life events, major changes in life circumstances and stress ful life events on a societal level within 1 year did not have a major impa ct on psychological function.