The medical examination of concentration camp survivors in the Kraków Psychiatric Clinic

How to cite: Szymusik, A. The medical examination of concentration camp survivors in the Kraków Psychiatric Clinic, 1959–1990. Kapera, M., trans. Medical Review – Auschwitz. July 14, 2020. Originally published as “Badania byłych więźniów obozów koncentracyjnych w krakowskiej Klinice Psychiatrycznej w latach 1959–1990.” . 1991: 22–28.


Adam Szymusik, MD, PhD, 1931–2000, Professor of Psychiatry, Head of Chair of Psychiatry, Head of the Department of Adult Psychiatry, Collegium Medicum, Jagiellonian University, Kraków. Former President of the Polish Psychiatric Association.

In the wake of World War II, Poland found itself in a really tragic situation. Over six million Polish citizens, including three million of Jewish origin, had lost their lives. About a million survivors, famished and wasted, had returned from totalitarian jails and concentration camps. Several million Poles remained dispersed abroad, both in the East and West. More than half of the nation’s material assets had been destroyed. Most of the Polish educated class had been annihilated, and that particular loss could not be made up for in a few years. The medical profession had been especially affected. For instance, of the country’s 300 psychiatrists, only ninety survived the war, and just sixty were fit for work.

A large part of the population had TB, there was a spate of cases of sexually transmitted diseases and skin conditions, and many people had to suffer the consequences of prolonged starvation and the trauma of war. The health of the nation had been seriously damaged. Both medicines and equipment were in short supply, and the majority of hospitals had either been demolished or adapted for non-medical purposes. Huge groups of repatriates returning home from all parts of the world were moving across the country. When Churchill, Roosevelt and Stalin decided that vast stretches of Poland’s eastern territories should become incorporated in the Soviet Union, millions of Polish people were relocated to territories which had belonged to Germany and as a result were now within the borders of People’s Poland.1 Thousands of Polish citizens wanted to repatriate from Great Britain, France, Yugoslavia, or other states where they had been stranded at the end of the war.

In the first years following the War, it was difficult to provide proper care for those who had suffered the most and at the same time proved hard to reach, namely survivors of concentration camps. Many of them died within a few months of liberation, never to enjoy the European peace, because they were utterly exhausted and afflicted with infectious diseases, especially tuberculosis. Some had to undergo long treatment in sanatoria. However, most of them just came back home, were not admitted to any hospital and got no regular medical check-ups, either. Even if they saw a doctor, usually they were dealt with just like other patients and had to cope with the same difficulties and problems. After a sick leave lasting from six months to four years, the majority of them did not seem to show any special symptoms of serious disorders.

That was the general approach to them, especially as many survivors were important public figures, for instance, outstanding academics, artists, business people, members of the military and the Cabinet. Even Prime Minister Józef Cyrankiewicz was a survivor. Survivors in general tended to undertake tasks that were far beyond their physical capabilities. They became deeply engaged in their professional careers as well as in social and political activity, as if trying to make up for the lost time. For a moment, it seemed that both their somatic and mental problems had disappeared. Even those who had lost all their relatives and all their possessions and had no place to return to, wanted to rebuild their lives, so they gradually took up new jobs, started new families, and began acquiring new assets.

So when we were approached in 1959 with a suggestion to examine the mental health of a group of Auschwitz survivors, we were sceptical. We thought it would be difficult to come up with any significant diagnoses. The initiators of the project were Dr Antoni Kępiński (1918–1972), who later headed the Kraków Psychiatric Clinic, and Dr Stanisław Kłodziński (1918–1990). They were brothers-in-law, and both had been incarcerated in concentration camps. Kępiński spent over a year in the Spanish camp Miranda de Ebro. Kłodziński was one of the first to provide relief aid to Auschwitz prisoners,2 but was later imprisoned himself. In the camp, he immediately joined the Kampfgruppe Auschwitz, an underground prisoners’ resistance organization. After the war, Kłodziński was involved in research both on Auschwitz survivors and lung disorders.

By that time, we were familiar with the results of the analogous Danish and French research, as well as with the proceedings of the 1954 and 1957 congresses, held respectively in Copenhagen and Moscow. We also knew Leo Eitinger’s Norwegian studies and the Dutch studies, as some of them were published in Der Nervenarzt alongside articles by Kolle, Levinger, and Strauss, concerning survivors in West Germany, Israel, and the United States.

In 1959–1961 we examined the mental health of 100 Auschwitz survivors, i.e. about 15% of the Kraków population of survivors. The procedures were not connected with any claims for compensation. We wanted to diagnose disorders and see how the prisoners had adjusted to camp life, how they readjusted to the normal circumstances after the war, and how their personalities had changed.

64 patients out of the 100 in the study group were diagnosed with various mental disorders. We had 12 cases of organic syndromes caused by an injury to the central nervous system, including 4 cases of epilepsy. 15 patients were diagnosed with various anxiety disorders, and 6 with depressive disorders. 24 patients showed symptoms of what we called post-camp asthenia, and five of premature ageing. Many of our patients complained of irritability and impulsivity, phobias, dizziness and headaches, apathy, and impaired memory. Less common were sleep disorders, permanent fatigue and weakness, heart conditions, gastric problems, and sexual dysfunctions. We observed alcohol abuse in about 20 patients, though they could not be termed alcoholics. In 48 out of the 64 patients, we saw a clear correlation between their incarceration in the camp and the presenting problems.

Out of the 100 examined patients, 81 had been active, vigorous, healthy, and companionable people before they were imprisoned. 15 had had symptoms of anxiety disorders and 4 of somatic disorders. Health problems were diagnosed especially in those who had been deported to the camp before they turned 19. Mental problems were diagnosed in all the patients who had been legal minors at the time of their incarceration. Psychiatric disorders were the least frequently observed in those who had been confined in the camp at the age of 20–29 (56% of the study group). Symptoms of pathology were manifest more frequently in those who spent more than three years in the camp, as well as in those who had not been part of the resistance movement but were just fortuitous victims of terror. Also, symptoms were twice as frequent in those who had lost their homes and families during the war or who could not accept the Communist system in post-war Poland.

41 patients observed their first symptoms immediately or within a year of leaving the camp. A further 9 patients fell ill within five years of liberation. 14 patients took from a few years to over a decade to develop symptoms of anxiety disorders, major depression or premature ageing. The onset was typically preceded by a more trivial condition, such as a cold or a bout of flu, or a different kind of problem, e.g. personal or work-related.

Our later research would show that within the next ten years the health of the survivors deteriorated seriously. Out of our group of 100, 18 died, including 4 who took their lives. Now the primary concerns were depression and premature ageing. Either or both of these conditions occurred in almost all the patients who had anxiety disorders or asthenia.

The problem of adjustment to camp life was researched by Aleksander Teutsch (1918–1980). He found that for every prisoner, the first two weeks of incarceration were a period of acute mental trauma, involving despondency, feelings of anxiety, terror, helplessness, perplexity, loneliness, loss of appetite, and insomnia. Sometimes that period was extended up to one, two or three months. The mental symptoms were often accompanied by somatic ones, such as frequent urination, diarrhoea, nausea, and vomiting.

Later on, as the patients reported, they had often had short spells of depression and apathy. In addition, if a prisoner was starved and emaciated, their chances of survival dropped radically. Three levels of adjustment to camp life were distinguished: 37% of the survivors had adapted quite quickly; for 44% of them the initial period was longer than two weeks and later they had nervous breakdowns, were depressed or apathetic; 19 were unable to adjust and experienced protracted breakdowns and depression, had suicidal thoughts, or even attempted suicide. The last group included many women, as well as those prisoners who had found themselves in the camp by chance, had to perform hard labour, sustained a head or brain injury, or contracted an infectious disease. On the other hand, anxiety disorders, compulsive disorders, and phobias, sometimes in an acute form, were fairly frequent in the camp. Some prisoners had transient psychotic symptoms, usually hallucinations, when they were down with an infectious disease.

Roman Leśniak investigated personality changes and observed some enduring ones in as many as 91 out of the 100 survivors. In 46 cases the changes were non-pathological, and pathological in 45 cases. They involved a positive or negative change in the patient’s attitude towards other people and general outlook on life. Also, new traits had emerged, such as irritability and crying proneness, lower self-esteem, or excessive preoccupation with one’s health. Some patients, though, had become more self-reliant, active or brave. Leśniak observed the survivors could be classified in five distinct groups:

  1. The depressed. This group consisted of 33 survivors. Their persistent symptoms were a distinctly lowered mood, pessimism, a feeling that life had no sense, and frequent crying. These symptoms were accompanied by anxiety, restlessness, embitterment, breakdowns, and an inferiority complex. In 16 survivors these changes were abnormal.
  2. The distrustful. This group comprised 19 survivors. Their main symptoms were distrust of other people, little interaction with the people around them, and suspiciousness. Also, these survivors had a generally poor opinion of humans, manifested phobic reactions, were prone to enter into conflicts, and harboured a sense of grievance.
  3. The impulsive. This group numbered 16 survivors. Their main symptoms were irritability, impulsivity, and nervousness. Additionally, hyperbolic emotional reactions, increased self-confidence and self-reliance, and hyperactivity were observed. Some of the survivors had a cynical outlook on life and clearly materialistic interests, which often caused conflicts.
  4. The distrustful and depressed. This group included 23 survivors who displayed symptoms that were manifested both in group (1) and (2).
  5. Nine survivors showed neither subjective nor objective personality changes.

Maria Orwid studied readjustment to normal circumstances following incarceration in a concentration camp. She found that there were two prevalent kinds of response to release from the camp. One response was sthenic: “People felt joy, often uncontrollable joy.” “Many patients stressed that they had been in a frenzy  . . . which lasted for a long time, a few months or even years.” Some survivors did not want to lose even a couple of weeks for a rest, and straightaway started rebuilding their careers, became involved in politics or work for the common good, and socialised. A large number of them worked more intensely than was necessary, often depleting their meagre strength: what they really wanted was to be more active than others now, and more active than they had been before the war. Their hyperactivity often got them into conflicts. These survivors were driven by their need to overcompensate for the lost time, to such an extent that they lived in a world of super-ideals. That made them neglectful of practical considerations, and they could not tolerate even an ordinary difference of opinion. Sometimes a minor clash would bring about a nervous breakdown, depression, suicidal thoughts, or an alcohol problem.

The other response to release from the camp was asthenic. The patients in this group felt no joy on the restoration of their freedom. Instead, they were sad and hesitant, and worried about the future. They were terrified by the prospect of having to procure food, return home, and reestablish personal relationships. It took them a long time to resume everyday routines. Many spent months in hospital or resting, having neither the strength nor the courage to take up a job. They went through frequent spells of apathy, aboulia, depression, and a sense of insecurity. Some of them eventually readjusted to normal life and no longer had any problems with readjustment. Others remained vulnerable and often had anxiety or depressive reactions.

Roman and Elżbieta Leśniak researched the psychological and mental problems of persons who escaped from a concentration camp. They managed to examine 21 escapees, including 2 women. Prior to their confinement, they had been busy, dynamic, outgoing people. Escaping was their dream, but what initially held them back was their concern for the fate of their family and fellow prisoners, as the Germans implemented a policy of collective responsibility. The majority of the escapees used to be extraverts prior to their incarceration, but later they became introverted. As a group, they were characterised by severe asthenic disorders growing more and more intense as time went by. Now their pronounced traits are suspiciousness, distrust, even delusions. They showed signs of anxiety whenever they saw men in uniform or dogs, or heard German being spoken. They were tormented by nightmares about the camp and their escape.

The mental health of Auschwitz survivors continued to be one of the main research areas in the Kraków Psychiatric Clinic, and younger colleagues joined the team.

In 1966–68 the team examined 130 patients who had been victims of pseudo-medical experiments in Nazi German concentration camps. All of them suffered from mental disorders, usually comorbid conditions. Psycho-organic syndrome was observed in 77 patients (59%), depressive syndrome in 63 (49%), and personality changes and chronic adaptive deficits in 104 (80%).

Affective and impulse-control disorders were prominent in those with psycho-organic syndrome. These patients reported irritability, impulsive behaviour, emotional lability, dysphoria, memory disorders and attention deficits, which proved burdensome both at school and at work. All of them felt unwell, suffered from vertigo, headaches, tinnitus, balance disorders, impaired sight or hearing, and persistent fatigue. Many patients reported short episodes of delirium, usually lasting for a few seconds. Other symptoms included premature ageing, noticeable especially in those who had been incarcerated at a young age.

The depressive syndrome group comprised patients who either had anxiety disorders or serious chronic depression and anxiety syndrome. Their symptoms were a low mood, a sense of being useless and redundant, insecurity, inability to make plans for the future, and ruminations on life in the camp, which dominated over all their other thoughts. Their most patent personality changes included an enduring depressive mood, distrust of other people, suspiciousness, irritability and impulsivity, problems with personal relations, and sometimes a sense of mission.

Anxiety was a symptom common to all the syndromes. Electroencephalographic examinations conducted by Julian Gątarski, (1922–1982) revealed a pathological condition in 52.8% of the men and 41.1% of the women. His results were strongly correlated with the diagnosis of psycho-organic syndrome.

Wanda Półtawska and her colleagues examined 50 patients who were either born in Auschwitz-Birkenau or deported to the camp before they turned 13. 18 of her subjects were born in the camp. 16 were under 6 when they were deported to Auschwitz, so they could not even give their true personal data. Of the remaining 16 patients, 4 were under 10 when they arrived in the camp. 11 subjects were observed to have pathological changes in the central nervous system, 13 had personality development disorders, and 26 were diagnosed as immature. 61.4% of the subjects had pathological EEGs. Most of the EEG results within the range of normal values tended to be observed in those who had been born in the camp. The researchers explain that this group spent only a short time in the camp, towards the end of the war, when the living conditions were somewhat better. The team could not determine whether the immaturity and abnormal personality development they observed stemmed directly from confinement in the camp. Undoubtedly, such problems could be related to the overprotective attitudes of the mothers, which was frequently observed in this group, as well as the harsh living conditions many of these patients had following their release from the camp (with factors such as the loss of relatives and the family home, life in an orphanage, and financial difficulties), which in turn could be seen as an effect of the war.

In another paper [available here—Website Editor’s note], Półtawska described paroxysmal hypermnesia observed in survivors 30 years after their release from the camp.

Regrettably, the research on the health of survivors’ children has not been finished, although it has reached an advanced stage. Dr Małgorzata Dominik (1941–1979), who had conducted it, died prematurely. Her preliminary results show that this group of children was much more often affected by anxiety and depression than their peers in the general population.

A few papers by Adam Szymusik discussed war disability benefits for the survivors and presented self-report examinations. In 1966, Małgorzata Dominik analysed the general health of 500 Auschwitz survivors. Only 8.2% of them did not report any health problems. The main conditions survivors suffered from were circulatory problems, followed by anxiety and other mental disorders (26%). In 1972 a team of young medical students (now experienced psychiatrists) wanted to find out if their fellow students were interested in the impact of World War II on public health.

Currently3 the Kraków Psychiatric Clinic is still carrying research concerning the dwindling group of Auschwitz survivors, dispensing treatment to them and issuing medical certificates of their wartime disability. Yet our recent publications have taken a different character. Some of them are resumés of our hitherto studies and compilations of the findings. Articles of this kind have been published by Adam Szymusik, Zdzisław Ryn, Andrzej Jakubik, and others. Most of these papers were presented at conferences in Poland and abroad, for example during the international congresses of the FIT (Fédération Internationale des Résistants, Federation of Resistance Fighters) held in Paris, Prague and Warsaw, at the meetings of psychiatrists’ associations in London, Zagreb, Warsaw, Kraków, and at conferences organized e.g. by the Kraków Medical Society (Towarzystwo Lekarskie Krakowskie) in 1984 (the proceedings were published as Wojna i okupacja a medycyna, see References).

A few of our articles appeared in the monographic volume Eksterminacyjna polityka hitlerowska wobec narodu polskiego, published by Główna Komisja Badania Zbrodni Hitlerowskich w Polsce (the Chief Commission for the Prosecution of Nazi Crimes in Poland) in 1978.

To a certain extent, the results of our clinical research have been summed up in the work of Antoni Kępiński, who took a highly individual, unique approach to all Auschwitz-related problems.

In his article Anus mundi” (which was how Auschwitz was termed by an SS doctor Heinz Thilo), Kępiński wrote:

For survivors the memory of that time is not just a nightmare, but also proof that even in the most dreadful conditions they managed to save their humanity, that they survived the ordeal of fire—the question “who am I really?” . . . The biological imperative is extremely strong, and you need tremendous willpower to stop thinking of nothing but bread when you are hungry, and nothing but water when you are thirsty, and nothing but your body when you are stricken with pain. But you needed to make that act of willpower to preserve your inner freedom—the leeway which let you freely think, dream, make plans, take a decision, liberate yourself from the nightmare you were in. If in the anus mundi of life in the concentration camp there was so much self-sacrifice, courage, and love of one’s neighbour—phenomena that might have seemed unimaginable in such conditions—it was only thanks to that inner freedom some prisoners had.

In an article entitled “The so-called ‘KZ-Syndrome’: An attempt at a synthesis,” which was based on earlier publications by Leśniak, Orwid, Szymusik, and Teutsch, Kępiński wrote,

The initiation into the camp hell was a shock that was stronger than any other trauma of human life.  . . . A prisoner had to adjust to camp life within the first several weeks or months, otherwise they had to die. Two problems were important in the adjustment process. Firstly, prisoners had to become indifferent to everything that was going on around them, had to withdraw into their internal world, and become dull and apathetic but without reaching the Muselmann state, the state of total apathy. This defensive insensitivity was referred to as “camp autism.” On the other hand, however, every prisoner had to find their angel in the camp hell, that is, a person or a group who would treat them in a human way and thus allow them to save the remains of their humanity.  . . . In such an anus mundi, the normal world fell to pieces together with its values, ideals, and important and unimportant matters. The normal world became unreal; it came back in dreams; it appeared to be possible but perhaps on some other planet. When the present world falls to pieces, a person feels lost, seized with fear, is not able to plan his or her future; hence the feeling of hopelessness. In such a situation, a smile offered by another person, a kind word or a little help became heavenly, opened future prospects, and brought back faith in one’s own humanity and the humanity of the others.  . . . It may sound paradoxical, but the feeling of loneliness was less intense in the camp than in the conditions of normal social life.

Ebensee, 6 May 1945. Marian Kołodziej. Photo by Piotr Markowski. Click to enlarge.

On the aetiology of health problems that affected concentration camp survivors, Kępiński observed that

[I]t does not appear reasonable to separate psychological and physical factors.  . . . Starvation, infectious diseases  . . . , head injuries, etc., could always lead to the injury of the central nervous system. Such an injury might be manifested in a chronic neurotic syndrome for many years and only after a long time lead to psycho-organic symptoms. . . . On the other hand, the long-lasting psychological tension that was a permanent element of camp life might result in a premature process of atherosclerosis, or weaken the survivor’s general immunity.4

Putting it briefly, Kępiński said there were three factors that impacted on the health of survivors: the extremity of their camp experiences, their psychosomatic integration, which had been radically tested in the camp, and their “camp autism,” that is their ability to withdraw and find a core of strength in themselves in order to survive the camp.

Kępiński discussed the concentration camp experience in many other writings. For instance, in “Reflections on Auschwitz: The psychopathology of power”, based on survivors’ accounts, he presented an insightful analysis of totalitarian rule. In “Z psychopatologii nadludzi” [On the psychopathology of the Übermensch], co-authored by Maria Orwid, he discussed the personality of the Auschwitz commandant Rudolf Höß. Other articles, such as “Nightmare”, “A psychiatrist’s reflections on Auschwitz”, “Auschwitz reflections: “The Ramp.” The psychopathology of decision” or “Zbrodnie ludobójstwa” [The crimes of genocide] were published both in Przegląd Lekarski – Oświęcim and in Kępiński’s book Rytm życia [Rhythm of life], which so far has had four editions, yet is unavailable in the bookshops.

Of special importance was a series of studies written by Stanisław Kłodziński, Zenon Jagoda (1931–1981), Danuta Wesołowska, Jan Masłowski, and Zdzisław Ryn. They researched aggressive behaviour, camp friendships, prisoners’ self-treatment, their dreams, stereotypical behaviour, attitudes of the victims towards their persecutors, prisoners’ use of stimulants, as well as religion, the black market, laughter, and culture in the camp. These authors investigated heroic attitudes, living and dying, and prisoners’ suicides. Their research was based on self-reports provided by the survivors.

A significant contribution to Auschwitz studies was made in the form of a dictionary of the camp jargon compiled by Kłodziński, Masłowski, and Wesołowska; in fact this collection may serve as yet more evidence of the Nazi German crimes.

Every year Masłowski presented an annual bibliography of Polish publications on the medical aspects of living under German occupation (it appeared in the section “Oceny” [Reviews] in Przegląd Lekarski – Oświęcim), while Ryn prepared several surveys of foreign publications on similar problems for the journal. Zdzisław Ryn and Andrzej Jakubik compiled a bibliography of Polish publications on Nazi German medical and pseudo-medical experiments.

The vast majority of the articles listed above have appeared in Przegląd Lekarski – Oświęcim, edited by Prof. Józef Bogusz, which has been published since 1961. New issues appear every year in January, on the anniversary of the liberation of Auschwitz-Birkenau. 1991 saw the issue of Number 31.5 A selection of articles was printed in the first five volumes of Okupacja i medycyna [Medicine under Nazi occupation]. The sixth volume is due to be published.6 The 1961 issue was re-printed in 1962 in English, French, German, and Russian versions and in 1982 in the Japanese version, in Japan. Some articles reappeared in the FIR bulletins. In 1987 two volumes entitled Die Auschwitz-Hefte came out in West Germany, with articles by the staff of the Kraków Psychiatric Clinic.

It has to be said that we have become fully committed to research on concentration camps. In this work we have come across many issues which have shed light on survivors’ later life, and answers to many other questions in psychiatry, psychology, ethics, and philosophy. We have discovered examples of heroism and dedication as well as unscrupulousness, selfishness, meanness, and even crime. We have come to see the concentration camps as a caricature of the “normal” world, which has given us the chance to understand our patients better and see that their problems acquired new dimensions, swelling or telescoping into one another in the context of their camp experience. We realized that the somatic and mental components of man are interrelated and form a unity, and, above all, we understood how much one person can mean to another person.

In total, between 1961 and 1990 we published about 200 Auschwitz-related papers in seven languages, authored by 20 physicians, psychologists, and linguists working for the Kraków Psychiatric Clinic. Our authors include survivors, such as Dr Półtawska, who was a victim of pseudo-medical experiments in Ravensbrück, and our Jewish contributors, who spent the war in the ghettos or had to use forged “Aryan” documents. Other contributors supported the resistance movement in occupied Poland or fought the Germans on the Western front. We have also had writers who were born during or after the war. Our work with survivors has taught us that even in extreme situations, the friendship and help of another person saves lives, increases the chances of survival, gives people faith in their own strength and resourcefulness. Psychological factors often proved more important than the material ones. To survive, you had to believe in survival, to hold on to some idea. Sometimes those who broke down were the healthy and strong inmates.

Now we realize that such extreme experiences cannot just vanish without a trace, instead, they leave their stigma on the person’s entire future life. Also, we have improved our understanding of the people who found themselves in such difficult conditions, deprived of their freedom, and living in fear under a reign of terror. In Poland this group of victims is much larger than just the survivors of Nazi German concentration camps. In my opinion, the expertise we have acquired from the study of war-related problems has radically modified our views on psychiatric treatment. It is no accident that the majority of the staff of the Kraków Psychiatric Clinic are psychotherapists: we consider psychotherapy the treatment-provider’s most powerful tool. We have also come to appreciate the value of the community. In the camp, your survival often depended on the community you belonged to. At the same time, we understand the impact and consequences of somatic illness, injury, prolonged starvation, and infectious diseases.

Our research has shown a strong correlation between what is physical and what is mental; but it has also shown that no conditions, however harmful, can bring about an illness without other triggering factors coming into play. After all, the lives of our patients ran their different courses, depending on whether they could return to their family homes and their nearest and dearest or, contrariwise, could not be reunited with their relatives, who had been dispersed all over the world or had died. It made a difference if a patient approved of the new political system in Poland, with its purported values and worldview. Such factors could turn out to be as weighty as the camp experience itself.

Finally, our research has demonstrated that every totalitarian system eventually leads to crime, racism, and the extermination of entire social groups or nations. Unfortunately, many countries still experience outbreaks of nationalism, hatred, discrimination against political opponents, ethnic minorities or followers of other religions. Not even Europe is free of such incidents. For a long time, we regarded our papers as historical documents whose value resided only in witnessing to the truth about the past, but it seems they are still relevant and the results they present could be applied to many other persecuted and oppressed groups. Moreover, the consequences of extreme stress may be felt even after many years, and may have a detrimental effect on the health and personalities of the younger generations.

The Kraków Psychiatric Clinic is continuing its research in the areas briefly described above and providing treatment to the victims of totalitarian regimes, not only Nazism, but also Stalinism. Our patients are under the care of Prof. Ryn and his team.

A few representatives of the Clinic’s staff (Adam Szymusik and Maria Orwid) took part in a conference in Hanover held in October 1989, as well as in a Kraków conference in 1990 which was organized by the Polish Psychiatric Association and the German Association of Psychiatry and Neurology. The latter event was attended by many psychiatrists from West Germany. The paper I delivered on that occasion was entitled “Psychiczne następstwa pobytu w obozach koncentracyjnych – KZ-syndrom” [Psychological aftereffects of concentration camp confinement: the KZ-Syndrome].

In October 1990 over ten psychiatrists, psychologists, and nurses from the Clinic spent eight days in North-Rhine-Westphalia, visiting the mental hospitals in that state. The crowning event was the signing of five agreements between Polish and German mental health institutions and the establishment of the Polish-German Association for Mental Health. The president of the Landtag of North-Rhine-Westphalia, who hosted the visit of the Polish delegation, stressed that our cooperation started already in 1985, when the Kraków Medical Society (chaired by Prof. Bogusz) and the Kraków Medical Academy organized a conference entitled “Wojna i okupacja a medycyna” [Medicine during the war and under wartime occupation].

Our German friends, members of the Society of Social Psychiatry and of the Lutheran Church, take a keen interest in the problems related to the concentration camps and the medical, psychological, and sociological ramifications of the persecution of the Poles under German occupation. They are doing all they can to make the cooperation and friendship between the Polish and the German nation as close as possible.

Welcoming our German guests at the 1985 conference, I said this cooperation had its roots in their attention to our Auschwitz research, in the ethical issues that the war brought, and ultimately, in social psychiatry.


  1. This migration was the result of the decision of the Big Three (Stalin, Churchill, and Roosevelt) to effect a shift of the borders of East and Central European countries hundreds of miles west. Millions suddenly found that they were no longer in “their own” country and many decided to move or were forcibly “repatriated” (evicted).a
  2. During the early phase of the War Dr Kłodziński worked for Rada Główna Opiekuńcza, a Polish charity which operated legally in German-occupied Poland.a
  3. The article was originally published in 1991.b
  4. Szymusik’s article does not give a reference for this passage.a
  5. Number 31 (1991) was the last annual edition of the original series of the periodical Przegląd Lekarski – Oświęcim.a
  6. In fact, only five volumes appeared in this series.a

  7. a—notes by Teresa Bałuk-Ulewiczowa, Head Translator of the Medical Review Auschwitz project; b—note by Marta Kapera, the translator of the article.


  1. Abstracta des travaux prévus, Vienna 1976, FIR (translated abstracts of papers delivered at FIR congresses, here at the 6th congress; The papers from the 5th congress and some previous ones were discussed in Przegląd Lekarski – Oświęcim. 1972: 211-15.
  2. Banach, Grażyna, and Dominik, Małgorzata. “Mental health effects of concentration camp imprisonment in survivors’ children.” Kapera, M., trans. Medical Review – Auschwitz. August 2, 2018. Originally published as “Psychiatryczne następstwa obozów hitlerowskich w drugim pokoleniu byłych więźniów.” Przegląd Lekarski – Oświęcim. 1985: 29–34.
  3. Die Auschwitz-Hefte. Band 2: Texte der polnischen Zeitschrift “Przegląd Lekarski” über historische, psychische und medizinische Aspekte des Lebens und Sterbens in Auschwitz. 1987. Translated from Polish into German and edited by Jochen August. Hamburger Institut für Sozialforschung. Basel and Weinheim: Beltz Verlag (see Vol. 2, 7–13 for Antoni Kępiński, “Das sogenannte KZ-Syndrom. Versuch einer Synthese.” The bibliography for this article includes a selection of papers authored by the staff of the Kraków Psychiatric Clinic). At the back of Volume 2 there are notes about the authors, an index of persons, and a list of articles by the staff of the Clinic, published by Przegląd Lekarski – Oświęcim, 1961–1987.
  4. Dominik, Małgorzata. “Offspring in some families of former prisoners of Nazi concentration camps.” Medical Review – Auschwitz. Also available in hard copy on pp. 235–263 of Auschwitz Survivors: Clinical-Psychiatric Studies. 2013 (2nd edition). Zdzisław J. Ryn and Władysław Sułowicz (eds.). Kraków: Wydawnictwo Przegląd Lekarski. Translated from Polish into English by Elżbieta Jarosz and Piotr Mizia. Originally published as “Potomstwo w niektórych rodzinach byłych więźniów hitlerowskich obozów koncentracyjnych.” Przegląd Lekarski – Oświęcim. 1979: 25–38.
  5. Dominik, Małgorzata, and Aleksander Teutsch. “Neurosis in the offspring of concentration camp survivors.” Dawidowicz, A., trans. Medical Review – Auschwitz. 2018. Originally published as “Nerwice u potomstwa byłych więźniów obozów koncentracyjnych.” Przegląd Lekarski – Oświęcim. 1978: 16–20.
  6. Gątarski, Julian, Maria Orwid, and Małgorzata Dominik. “The results of psychiatric and electroencephalographic examinations of 130 former prisoners of the Auschwitz-Birkenau concentration camp.” Medical Review – Auschwitz. Also available in hard copy on pp. 181–188 of Auschwitz Survivors: Clinical-Psychiatric Studies. 2013 (2nd edition). Zdzisław J. Ryn and Władysław Sułowicz (eds.). Kraków: Wydawnictwo Przegląd Lekarski. Translated from Polish into English by Elżbieta Jarosz and Piotr Mizia. Originally published as “Wyniki badania psychiatrycznego i elektroencefalograficznego 130 byłych więźniów Oświęcimia-Brzezinki.” Przegląd Lekarski – Oświęcim. 1969: 25–28.
  7. Jagoda, Zenon, Stanisław Kłodziński, and Jan Masłowski. A series of articles in Przegląd Lekarski – Oświęcim. 1973: 84–89; 1974: 19–39; 1975: 40–67; 1976: 46–71; 1977: 28–66 and 77–108; 1978: 32–77; 1980: 43–75; 1981: 37–62; 1982: 25–56.
  8. Jagoda, Zenon, Stanisław Kłodziński, Jan Masłowski, and Danuta Wesołowska. “Słownik oświęcimski” (more bibliographical data in Przegląd Lekarski – Oświęcim. 1991, in the introduction for entries starting with M).
  9. Jakubik, Andrzej, and Zdzisław J. Ryn. “Pseudo-medical experiments in Hitler’s concentration camps.” Medical Review – Auschwitz. Also available in hard copy on pp. 129–148 of Auschwitz Survivors: Clinical-Psychiatric Studies. 2013 (2nd edition). Zdzisław J. Ryn and Władysław Sułowicz (eds.). Kraków: Wydawnictwo Przegląd Lekarski. Translated from Polish into English by Teresa Bałuk-Ulewiczowa. Originally published as “Eksperymenty pseudomedyczne w hitlerowskich obozach koncentracyjnych.” Przegląd Lekarski – Oświęcim. 1973: 64–277 and 72–75; includes a bibiography.
  10. Kępiński, Antoni. “Anus mundi.”. Medical Review – Auschwitz. Translated from Polish into English by Teresa Bałuk-Ulewiczowa. Originally published in Przegląd Lekarski – Oświęcim; 1965: 150–152.
  11. Kępiński, Antoni. “A psychiatrist’s reflections on Auschwitz.” Medicla Review – Auschwitz. Translated from Polish into English by Teresa Bałuk-Ulewiczowa. Originally published as “Oświęcimskie refleksje psychiatry.” Przegląd Lekarski – Oświęcim 1964: 7–9.
  12. Kępiński, Antoni. “Auschwitz reflections: ‘The Ramp.’ The psychopathology of decision.”. Medical Review – Auschwitz. Also available in hard copy on pp. 81–98 of Auschwitz Survivors: Clinical-Psychiatric Studies. 2013 (2nd edition). Zdzisław J. Ryn and Władysław Sułowicz (eds.). Kraków: Wydawnictwo Przegląd Lekarski. Translated from Polish into English by Elżbieta Jarosz and Piotr Mizia. Originally published as “Refleksje oświęcimskie: rampa - psychopatologia decyzji.” Przegląd Lekarski – Oświęcim 1968: 25–36.
  13. Kępiński, Antoni. “Niektóre zagadnienia psychosocjologiczne masowych zbrodni hitlerowskich II wojny światowej.” Przegląd Lekarski – Oświęcim. 1962: 81–83.
  14. Kępiński, Antoni. “Nightmare.” Translated from Polish into English by Teresa Bałuk-Ulewiczowa. Originally published as “Koszmar.” Przegląd Lekarski – Oświęcim 1971: 54–58.
  15. Kępiński, Antoni. “Reflections on Auschwitz: The psychopathology of power.” Medical Review – Auschwitz. 2018. Also available in hard copy on pp. 109–128 of Auschwitz Survivors: Clinical-Psychiatric Studies. 2013 (2nd edition). Zdzisław J. Ryn and Władysław Sułowicz (eds.). Kraków: Wydawnictwo Przegląd Lekarski. Translated from Polish into English by Teresa Bałuk-Ulewiczowa. Originally published as “Refleksje oświęcimskie: psychopatologia władzy.” Przegląd Lekarski – Oświęcim 1967: 42–60.
  16. Kępiński, Antoni. 1972 (1st edition). Rytm życia. Kraków: Wydawnictwo Literackie.
  17. Kępiński, Antoni, and Maria Orwid. 1962. “Z psychopatologii nadludzi.” Przegląd Lekarski – Oświęcim: 83–89.
  18. Kłodziński, Stanisław. 1984. “Kilka uwag o KZ-syndromie.” Przegląd Lekarski – Oświęcim: 17–21.
  19. Kłodziński, Stanisław. “The idiosyncratic disorder observed in survivors of the Nazi German concentration camps.” Translated from Polish into English by Teresa Bałuk-Ulewiczowa. Originally published as “Swoisty stan chorobowy po przebyciu obozów hitlerowskich.” Przegląd Lekarski – Oświęcim. 1972: 15–21.
  20. Kłodziński, Stanisław, and Jan Masłowski. Articles in Przegląd Lekarski – Oświęcim. 1983: 73–99; 1984: 37–54; 1989: 22–57; 1990: 50–77.
  21. Kołakowski, Stanisław, Jerzy Zadęcki, and Andrzej Zięba, A. “Czy studenci medycyny interesują się okupacją.” Przegląd Lekarski – Oświęcim. 1972: 77–79.
  22. Leśniak, Roman. “Post-camp personality alterations in former prisoners of the Auschwitz-Birkenau concentration camp.” Also available in hard copy on pp. 37–54 of Auschwitz Survivors: Clinical-Psychiatric Studies. 2013 (2nd edition). Zdzisław J. Ryn and Władysław Sułowicz (eds.). Kraków: Wydawnictwo Przegląd Lekarski. Translated from Polish into English by Elżbieta Jarosz and Piotr Mizia. Originally published as “Poobozowe zmiany osobowości byłych więźniów obozu koncentracyjnego Oświęcim-Brzezinka.” Przegląd Lekarski – Oświęcim. 1965: 13–20.
  23. Leśniak, Elżbieta, and Roman Leśniak. “Escapes from concentration camps: a psychiatric-psychological analysis.” Also available in hard copy on p. 289–309 ofAuschwitz Survivors: Clinical-Psychiatric Studies. 2013 (2nd edition). Zdzisław J. Ryn and Władysław Sułowicz (eds.). Kraków: Wydawnictwo Przegląd Lekarski. Translated from Polish into English by Elżbieta Jarosz and Piotr Mizia. Originally published as “Ucieczki z obozów koncentracyjnych. Analiza psychiatryczno-psychologiczna.” Przegląd Lekarski – Oświęcim 1976: 17–24.
  24. Leśniak, Elżbieta, Roman Leśniak, and Zdzisław J. Ryn. “Nurt oświęcimski w twórczości Antoniego Kępińskiego.” Refleksje oświęcimskie. 2005. Zdzisław J. Ryn (ed.). Kraków: Wydawnictwo Literackie, 305–319.
  25. Leśniak, Roman, and Jan Masłowski. 1974. “Psychiatryczna problematyka obozów hitlerowskich w pracach Antoniego Kępińskiego.” Przegląd Lekarski – Oświęcim: 13–18.
  26. Masłowski, Jan. 1990. “Treść poprzednich zeszytów Przeglądu Lekarskiego poświęconych zagadnieniom lekarskim okresu okupacji hitlerowskiej.” Przegląd Lekarski – Oświęcim: 233–261 (contains an index of names as well as bibliographical data for articles by M. Dominik, J. Gątarski, Z. Jagoda, A. Jakubik, A. Kępiński, S. Kłodziński, E. Leśniak, R. Leśniak, J. Masłowski, J. Mitarski, M. Orwid, W. Półtawska, Z. Ryn, M. Susułowska, A. Szymusik, A. Teutsch, D. Wesołowska, J. Zadęcki, A. Zięba). Medizinische Untersuchungen der Spätfolgen des Krieges und des NS-Regimes bei Jugendlichen und Kindern von ehemaligen KZ-Häftlingen und Verfolgten. Vienna 1978, FIR (with papers by M. Dominik and A. Teutsch and W. Półtawska).
  27. Mitteilungen der Internationale Föderation der Widerstandskämper (FIR) zu medizinischen, sozialen und Rechtsfragen, Vienna (includes some translated papers by the staff of the Kraków Psychiatric Clinic, e.g. Dominik, M. “Die Nachkommenschaft in manchen Familien ehemaliger Häftlinge der Nazi-Konzentrationslager.” Ibidem, 1979(16): 28–44.
  28. Okupacja i medycyna (selected papers from Przegląd Lekarski – Oświęcim). Vols. 1–5, Warsaw 1971, 1975, 1977, 1979, 1984 (includes abridged versions of articles by M. Dominik, Z. Jagoda, A. Jakubik, A. Kępiński, S. Kłodziński, J. Masłowski, R. Leśniak, W. Półtawska, Z. Ryn, and A. Teutsch).
  29. Orwid, Maria. “Socio-psychiatric after-effects of imprisonment in the Auschwitz-Birkenau concentration camp.” Also available in hard copy on pp. 55–66 of Auschwitz Survivors: Clinical-Psychiatric Studies. 2013 (2nd edition). Zdzisław J. Ryn and Władysław Sułowicz (eds.). Kraków: Wydawnictwo Przegląd Lekarski. Translated from Polish into English by Elżbieta Jarosz and Piotr Mizia. Originally published as “Socjopsychiatryczne następstwa pobytu w obozie koncentracyjnym Oświęcim-Brzezinka.” Przegląd Lekarski – Oświęcim 1964: 17–23.
  30. Półtawska, W. “Paroxysmal hypermnesia states observed in former prisoners after 30 years.” Also available in hard copy on pp. 189–198 of Auschwitz Survivors: Clinical-Psychiatric Studies. 2013 (2nd edition). Zdzisław J. Ryn and Władysław Sułowicz (eds.). Kraków: Wydawnictwo Przegląd Lekarski. Translated from Polish into English by Teresa Bałuk-Ulewiczowa. Originally published as “Stany hipermnezji napadowej u byłych więźniów obserwowane po 30 latach.” Przegląd Lekarski – Oświęcim. 1978: 20–24.
  31. Półtawska, Wanda, Andrzej Jakubik, Józef Sarnecki, and Julian Gątarski. “The results of psychiatric examinations of persons born, or imprisoned in their childhood, in Nazi concentration camps.”. Also available in hard copy on pp. 199–234 ofAuschwitz Survivors: Clinical-Psychiatric Studies. 2013 (2nd edition). Zdzisław J. Ryn and Władysław Sułowicz (eds.). Kraków: Wydawnictwo Przegląd Lekarski. Translated from Polish into English by Elżbieta Jarosz and Piotr Mizia. Originally published as “Wyniki badań psychiatrycznych osób urodzonych lub więzionych w dzieciństwie w hitlerowskich obozach koncentracyjnych.” Przegląd Lekarski – Oświęcim. 1966: 21–36.
  32. Ryn, Zdzisław J. “A psychiatrist’s remarks on the concentration camp syndrome.” Translated from Polish into English by Marta Kapera. Originally published as “Uwagi psychiatryczne o tzw. KZ-syndromie.” Przegląd Lekarski – Oświęcim 1981: 26–29.
  33. Ryn, Zdzisław J. “Czy Oświęcim jest nadal rzeczywistością? Refleksje psychiatryczne.” Przegląd Lekarski – Oświęcim 1972: 206–210.
  34. Ryn, Zdzisław J., and Stanisław Kłodziński. “Głód w obozie koncentracyjnym.” Przegląd Lekarski – Oświęcim 1984: 21–37.
  35. Ryn, Zdzisław J., and Stanisław Kłodziński. “Psychopatologia głodu w obozie koncentracyjnym.” Przegląd Lekarski – Oświęcim. 1985: 41–55.
  36. Ryn, Zdzisław J., and Stanisław Kłodziński. “Teetering on the brink between life and death: A study on the concentration camp Muselmann.” Medical Review – Auschwitz Translated from Polish into English by Teresa Bałuk-Ulewiczowa. Originally published as “Na granicy życia i śmierci. Studium obozowego <>.” Przegląd Lekarski – Oświęcim 1983: 27–73.
  37. Susułowska, Maria. “Próba interpretacji snów byłych więźniów obozów hitlerowskich.” Przegląd Lekarski – Oświęcim 1976: 13–17.
  38. Szymusik, Adam. [A report from the conference in Hanover held on 11–14 October 1989, attended by K. Godorowski, A. Szymusik, and M. Orwid]. Przegląd Lekarski – Oświęcim 1990: 217.
  39. Szymusik, Adam. 1976. “Choroby psychiczne i psychonerwice w populacji byłych więźniów hitlerowskich obozów koncentracyjnych. Astenia przewlekła postępująca.” Eksterminacyjna polityka hitlerowska wobec narodu polskiego. Halina Szwarc et al. (eds.). Warsaw: Główna Komisja Badania Zbrodni Hitlerowskich w Polsce, 221–244.
  40. Szymusik, Adam. “Concentration camp survivors and war disability benefits.” Also available in hard copy on pp. 321–326 ofAuschwitz Survivors: Clinical-Psychiatric Studies. 2013 (2nd edition). Zdzisław J. Ryn and Władysław Sułowicz (eds.). Kraków: Wydawnictwo Przegląd Lekarski. Translated from Polish into English by Elżbieta Jarosz and Piotr Mizia. Originally published as “Inwalidztwo wojenne byłych więźniów obozów koncentracyjnych.” Przegląd Lekarski – Oświęcim 1974: 110–112.
  41. Szymusik, Adam. 1989. “KZ-syndrom.” Biuletyn Towarzystwa Opieki nad Oświęcimiem. 3–7.
  42. Szymusik, Adam. “Progressive asthenia in former prisoners of the Auschwitz-Birkenau concentration camp.” Also available in hard copy on pp. 67–79 ofAuschwitz Survivors: Clinical-Psychiatric Studies. 2013 (2nd edition). Zdzisław J. Ryn and Władysław Sułowicz (eds.). Kraków: Wydawnictwo Przegląd Lekarski. Translated from Polish into English by Elżbieta Jarosz and Piotr Mizia. Originally published as “Astenia poobozowa u byłych więźniów obozu koncentracyjnego w Oświęcimiu.” Przegląd Lekarski – Oświęcim 1964: 23–29.
  43. Teutsch, Aleksander. “Psychological reactions to psychosomatic stress in 100 former prisoners of the Auschwitz-Birkenau concentration camp.” Also available in hard copy on pp. 25–36 ofAuschwitz Survivors: Clinical-Psychiatric Studies. 2013 (2nd edition). Zdzisław J. Ryn and Władysław Sułowicz (eds.). Kraków: Wydawnictwo Przegląd Lekarski. Translated from Polish into English by Elżbieta Jarosz and Piotr Mizia. Originally published as “Reakcje psychiczne w czasie działania psychofizycznego stresu u 100 byłych więźniów w obozie koncentracyjnym Oświęcim-Brzezinka.” Przegląd Lekarski – Oświęcim 1964: 12–17.
  44. Wojna i okupacja a medycyna. 1986. [Proceedings of an international conference held in Kraków on 25–26 April 1985, with papers by A. Jakubik, S. Kłodziński, E. Leśniak, R. Leśniak, J. Masłowski, M. Orwid, K. Pietruszewski, Z. Ryn, A. Szymusik, and J. Zadęcki.] Kraków: Akademia Medyczna w Krakowie and Towarzystwo Lekarskie Krakowskie.

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