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Aim To explore posttraumatic stress symptoms and current psychopathology in a binational sample of Croatian and German participants with severe mental illness. Methods We studied 178 inpatients from the Greifswald University (German patients, n = 89) and University Hospital Zagreb and Ivan Barbot Neuropsychiatric Hospital (Croatian patients, n = 89) with either major depression (n = 150), schizophrenia (n = 26), or bipolar disorder (n = 2). Measurements included Posttraumatic Diagnostic Scale and the Symptom Check List-90-R. Participants were matched according to age, sex, and diagnosis. Results Croatians reported significantly more war traumatic events (64/82 vs 5/74, χ2 1 = 77.142, P < 0.001) and significantly more Croatians met the criteria for posttraumatic stress disorder (55/89 vs 27/89, χ2 1 = 17.73, P < 0.001). They also suffered from a higher level of psychopathological distress as they scored significantly higher at all Symptom Check List-90-R revised version subscales (P < 0.001). The regression models demonstrated that predictors of general psychopathological distress were war trauma (P < 0.001), posttraumatic stress disorder (P < 0.001), and diagnosis (P = 0.01). Conclusion This is the first study comparing the impact of war trauma on psychopathology of participants with severe mental illness between two nations. Our results clearly indicate the importance of trauma assessment in subjects with severe mental illness, particularly in postconflict settings