The effect of the sociopolitical upheaval in East Germany on psychosocial health is examined in a follow-up study of former psychotherapeutic patients who underwent in-patient psychotherapy before 1989. Special attention is given to the question of whether ideology and other factors generated by the political system of the GDR may have influenced the development of psychosomatic illness before and/or after the political change in East Germany. Using a pair-matching design, 14 former patients who worked within the teaching profession and thereby occupied a special role as "mediators of ideology" were compared with 14 age- and gender-matched patients with non-ideology-bound professions. Information from the patient's charts together with an interview were used to establish psychiatric diagnoses and to assess their attitude towards the political system of the GDR. In addition, psychometric tests (MMPI, BFB-B, Gießen-Test, SCL-90-R) were applied. Psychosocial circumstances of the release situation were assessed in each case, as well as possible psychodynamically relevant invariate conflict patterns as described in the OPD classification system (Operationalisierte Psychodynamische Diagnostik). Results revealed a wide spectrum of attitudes in both groups towards the political system of the GDR, ranging from open opposition to genuine identification. Independent of such attitudes, the majority of patients in both groups showed good long term outcomes and did not experience an increase in psychosomatic symptoms during the time of sociopolitical upheaval. In both groups, system-specific stressors played a relatively subordinate role as release factors in the global psychosocial constellation before and after the political change. With particular regard to the teacher's group, it may be presumed that the increased freedom resulting from the political change in East Germany, which goes along with greater personal and professional opportunities, apears to have had a positive effect on psychosocial health.