Mental health in Ukraine in 2023.

BACKGROUND: Very little is known about the mental health of the adult population of Ukraine following Russia's full-scale invasion in February 2022. In this study, we estimated the prevalence of seven mental health disorders, the proportion of adults screening positive for any disorder, and the sociodemographic factors associated with meeting requirements for each and any disorder. METHODS: A non-probability quota sample (N = 2,050) of adults living in Ukraine in September 2023 was collected online. Participants completed self-report questionnaires of the seven mental health disorders. Logistic regression was used to determine the predictors of the different disorders. RESULTS: Prevalence estimates ranged from 1.5% (cannabis use disorder) to 15.2% (generalized anxiety disorder), and 36.3% screened positive for any of the seven disorders. Females were significantly more likely than males (39.0% vs. 33.8%) to screen positive for any disorder. Disruption to life due to Russia's 2014 invasion of Ukraine, greater financial worries, and having fewer positive childhood experiences were consistent risk factors for different mental health disorders and for any or multiple disorders. CONCLUSION: Our findings show that approximately one in three adults living in Ukraine report problems consistent with meeting diagnostic requirements for a mental health disorder 18 months after Russia's full-scale invasion. Ukraine's mental healthcare system has been severely compromised by the loss of infrastructure and human capital due to the war. These findings may help to identify those most vulnerable so that limited resources can be used most effectively.

Parent-reported posttraumatic stress reactions in children and adolescents: Findings from the mental health of parents and children in Ukraine study.

BACKGROUND: Despite the long-standing ongoing war in Ukraine, information regarding war-related negative mental health outcomes in children is limited. A nationwide sample of parents in Ukraine was surveyed to assess posttraumatic stress disorder (PTSD) symptoms in their children and to identify risk factors associated with child PTSD status. METHOD: A nationwide opportunistic sample of 1,238 parents reported on a single randomly chosen child within their household as part of The Mental Health of Parents and Children in Ukraine Study. Data were collected approximately 6 months after the war escalation in February 2022. The prevalence of PTSD was estimated using the parent-reported Child and Adolescent Trauma Screen (CATS). RESULTS: Based on parental reports, 17.5% of preschoolers and 12.6% of school-age children met Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria for PTSD. Delay in milestone development (AOR = 2.38, 95% confidence interval [CI] [1.38-4.08]), having a parent affiliated with the emergency services or army (AOR = 2.13, [1.28-3.53]), parental PTSD/complex PTSD status (AOR = 1.88, [1.22-2.89]), and mean changes in parental anxiety (AOR = 1.98, [1.44-2.72]) were among the strongest predictors of increased risk of pediatric PTSD. CONCLUSION: Russia's war escalation in Ukraine resulted in an increased estimated prevalence of war-related PTSD in children of various ages. Urgent efforts to increase the capacity of national pediatric mental health services are critically needed to mitigate these challenges in an environment of limited financial and human resources. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Depression, anxiety, stress and trauma-related symptoms and their association with perceived social support in medical professionals during the COVID-19 pandemic in Ukraine.

Purpose: In a public health crisis medical professionals face immense psychological tension that leads to onset of negative mental health outcomes. We aimed to estimate the self-reported level of posttraumatic, anxiety, depression, and stress-related symptoms and their association with the level of perceived social support among healthcare professionals during the coronavirus (COVID-19) pandemic in Ukraine. Methods: A cross-sectional web-based survey conducted during the second wave of the pandemic involved 330 participants. Mental health variables were assessed via the Depression Anxiety Stress Scale (DASS-21) and PTSD Checklist for DSM-5 (PCL-5). The level of perceived social support was assessed via the Multidimensional Scale of Perceived Social Support (MSPSS). Results: The DASS-21 median score was 42.0 (IQR = 28.0-56.0), with 50.5% of respondents reporting moderate-to-severe depressive symptoms; 55.4% had moderate-to-severe anxiety levels; 42.4% had moderate-to-severe stress levels. The PCL-5 median score was 21.0 (IQR = 12.0-32.0), with 20% of the participants meeting the full criteria for PTSD. The MSPSS median score was 5.3 (IQR = 4.3-6.1), with 61.8% of the participants reporting high, 29.4% medium, and 8.8% low levels of social support, respectively. Logistic analysis revealed that being a younger person, female, having had previous exposure to COVID-19, working in inpatient facilities with COVID patients, and experiencing a lower level of social support were significant risk factors for the onset of mental disorders. Almost 75% of participants exhibited low-to-moderate adherence to psychological/psychiatric care. Conclusions: Health professionals working with COVID patients need to be screened for mental disorders. A campaign aimed at achieving the de-stigmatization of mental care is required.

Delivering psychiatric services in primary care: is this the right way to go for Ukraine?

Ukraine is a newly independent state with a population of about 48 million. It inherited its national health system from the USSR. The Soviet system was conceived as part of a massively expensive socialist planning economy that was generally delivering poor value for money. Some aspects of the Soviet health system were, however, undoubtedly sound and certain public health measures were superior to those in the West. For example, infant mortality, despite possible underreporting, was probably lower in the USSR than in many Western countries (Anderson & Silver, 1986). The health system became increasingly corrupt and inefficient during the final years of the USSR's existence. Since independence, the health system has not been a state priority and has been chronically under-funded. In the past few years of rapid economic development in Ukraine, the share of the state budget allocated to the health system has remained static, leaving Ukraine in a disadvantaged state compared with other European countries (United Nations, 2007).