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Am J Psychiatry 1992; 149:337-340
Copyright © 1992 by American Psychiatric Association
Symptoms of PTSD in 124 survivors of the Holocaust
K Kuch and BJ Cox
Anxiety Disorders Clinic, Clarke Institute of Psychiatry, University of Toronto, Ont., Canada.
OBJECTIVE: Survivors of the Holocaust are expected to be at risk for
posttraumatic stress disorder (PTSD), but few empirical data are available.
This study investigated PTSD symptoms in Holocaust survivors with
well-documented exposure to trauma. METHOD: The German files of 124 Jewish
Holocaust survivors who were judged to be free from bipolar affective
disorder, obsessive-compulsive disorder, and organic brain syndrome were
selected from those of 145 applicants to West German compensation boards.
The psychiatric assessments were reexamined for explicit descriptions of
current PTSD symptoms according to the DSM-III- R diagnostic criteria. A
subgroup of 20 Auschwitz survivors with tattooed identification numbers
were also compared with the 45 survivors who had not been in concentration
camps. RESULTS: Sixty-three percent of the total sample had been detained
in concentration camps, and an average of 78% of their first-degree
relatives were reported killed in the Holocaust. Forty-six percent of the
total sample met the DSM-III-R criteria for PTSD. The most common symptoms
were sleep disturbance, recurrent nightmares, and intense distress over
reminders. The tattooed Auschwitz survivors had significantly more symptoms
and were three times more likely to meet diagnostic criteria for PTSD than
the survivors who had not been in concentration camps. CONCLUSIONS: The
results suggest a greater risk of chronic PTSD in survivors who were
exposed to atrocities. Most survivors had not received adequate psychiatric
care.
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