Abstract
Theoretical models suggest a higher vulnerability of chronic schizophrenic patients for critical life events and rapid change of objective living circumstances. On the basis of these models one may hypothesise that the political change in East Germany in 1989/90 was objectively or subjectively distressing to such patients and had a negative impact on their illness. In a retrospective longitudinal study, we investigated patients' assessment of political change, life events that were potentially related to the political changes, impact of the changes on subjective quality of life, and hospitalization rates during five year periods prior to and following the change. 120 patients with chronic schizophrenia in East Berlin and 70 in Chemnitz were examined using quantitative and qualitative methods. Patients reported more individual freedom and better care after 1989. They complained about stress due to loss of employment, financial disadvantages and rising crime rates. Despite the occurrence of potentially change-related life events after 1989, patients stated very little impact of the changes on their illness. Retrospectively, patients in East Berlin reported a significantly better subjective quality of life in 1994 than in 1984. Hospitalization rates did not increase after 1989. The findings are not consistent with the hypothesis and do not suggest that political changes in East Germany in 1989/90 had--subjectively or objectively--a substantial negative effect on the illness of patients with chronic schizophrenia.