March 27, 2024
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Key takeaways:
- Approximately 50% of adolescents in Ukraine have been exposed to war.
- Around one-third of them have moderate or severe depression.
Russia’s 2022 invasion of Ukraine caused PTSD and worsened the mental health of adolescents and teens in the region, according to two studies.
“I’ve been doing research on children and adolescents’ health in humanitarian settings for over 5 years now,” Ryunosuke Goto, MD, a pediatrician at the University of Tokyo Hospital and Nagano Children’s Hospital in Japan, told Healio. “Very little was known on the mental health burden of the war on civilians.”
Data derived from Goto R, et al. JAMA Pediatr. 2024;doi:10.1001/jamapediatrics.2024.0295.
‘We were surprised’
A study by Goto and colleagues is the first of the Adolescents of Ukraine During the Russian Invasion Cohort, a longitudinal study on the mental health of adolescents in Ukraine amid the ongoing war. It included data from 8,096 Ukrainian adolescents aged 15 years or older — 7,493 residing in Ukraine and 603 living abroad — who were attending secondary school in Ukraine in person or online.
Among the participants, 32% screened positive for moderate or severe depression, 17.9% for moderate or severe anxiety, 35% for clinically relevant psychological trauma, 29.5% for eating disorders and 20.5% for medium risk or higher of substance use disorder. Additionally, 33.2% were estimated to have been displaced, and 20.7% were estimated to have been separated from their parents.
Based on national level estimates, 49.6% of the respondents were directly exposed to war and 92.3% were exposed to some kind of psychological trauma. Among respondents living abroad, 73.6% reported having been exposed to war.
“We were surprised by the very large proportion of adolescents screening positive for each of the psychiatric conditions,” Goto said. “It’s much higher than what has been reported in other war settings.”
“We think many primary care providers, pediatricians, and psychiatrists around the world are seeing patients [who] have been displaced from Ukraine, especially in Europe,” Goto continued. “We hope our study gives them an idea of how big of a burden the war — or war in general — has put on Ukrainian adolescents.”
Goto said future studies should focus on interventions for Ukranian adolescents, and that other studies should track the mental health of Ukranians longitudinally.
“On a more macro level, we think mental healthcare efforts for the Ukrainian people within and outside Ukraine need to be scaled up to meet the very high demand for mental health care due to the war,” Goto said.
‘An accumulation of risk factors’
A second study published in February by researchers at Ulm University in Germany enlisted Ukranian therapists to evaluate their patients through the Child and Adolescent Trauma Screen and decide whether to implement trauma-focused cognitive behavioral therapies.
Among a cohort of 200 Ukranian children and adolescents ranging in age from 4 to 21 years, 68.7% reported experiencing war, 39.7% reported bullying threats and 38% reported domestic violence.
About 70% of the participants fulfilled the criteria for PTSD in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, with 31% fulfilling the ICD-11 PTSD criteria and 21% fulfilling the ICD-11 complex PTSD. Additionally, 95% of preschool children were diagnosed with PTSD.
According to the authors, Ukrainian children and adolescents seeking treatment have experienced multiple other traumatic events in addition to war, “which should be taken into account in trauma-focused psychotherapy.”
“These children and families will face an accumulation of risk factors at different socioecological levels during the ongoing war, resulting in a high probability of suffering from mental health problems, calling for adequate mental health care programs for war‐traumatized communities including both individual and family level approaches,” they wrote.
References:
Goto R, et al. JAMA Pediatr. 2024;doi:10.1001/jamapediatrics.2024.0295.
Pfeiffer E, et al. Child Adolesc Psychiatry Ment Health. 2024;doi: 0.1186/s13034-024-00715-1.
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