The Ukrainian paediatric mental health system: challenges and opportunities from the Russo–Ukrainian war

Martsenkovskyi, Dmytro; Martsenkovsky, Igor; Martsenkovska, I.I.; Lorberg, Boris

doi:10.1016/s2215-0366(22)00148-1

Cited by 10 publications

(6 citation statements)

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“…For example, the population prevalence of major depressive disorder and alcohol use disorders has been reported to be higher in Ukraine than other areas in Eastern Europe . In addition, the country’s mental health care system has faced challenges: psychosocial interventions are not widely available in Ukraine; instead, Ukraine’s psychiatry services rely on inpatient care and a medication-focused approach . Furthermore, Russia first invaded Ukraine in 2014, and Ukrainian adolescents have experienced mental health sequelae since the first invasion.…”

Section: Discussionmentioning

confidence: 99%

“…Even before the war, the population of Ukraine had substantial mental health needs. [33][34][35][36] For example, the population prevalence of major depressive disorder and alcohol use disorders has been reported to be higher in Ukraine than other areas in Eastern Europe. 34 In addition, the country's mental health care system has faced challenges: psychosocial interventions are not widely available in Ukraine; instead, Ukraine's psychiatry services rely on inpatient care and a medication-focused approach.…”

Section: Discussionmentioning

confidence: 99%

“…34 In addition, the country's mental health care system has faced challenges: psychosocial interventions are not widely available in Ukraine; instead, Ukraine's psychiatry services rely on inpatient care and a medication-focused approach. 33,34,37,38 Furthermore, Russia first invaded Ukraine in 2014, and Ukrainian adolescents have experienced mental health sequelae since the first invasion. For instance, Osokina and colleagues 39 compared adolescents in the war-torn Donetsk region of Ukraine and (at the time) peaceful Kirovograd, Ukraine from 2016 to 2017 to find that adolescents in Donetsk were more likely to have PTSD, anxiety, and depression.…”

Section: Discussionmentioning

confidence: 99%

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Mental Health of Adolescents Exposed to the War in Ukraine

Goto,

Pinchuk,

Kolodezhny

et al. 2024

JAMA Pediatr

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ImportanceWith exposure to traumatic events and reduced access to mental health care, adolescents of Ukraine during the Russian invasion since February 2022 are at high risk of psychiatric conditions. However, the actual mental health burden of the war has scarcely been documented.ObjectiveTo investigate the prevalence of a positive screen for psychiatric conditions among adolescents amidst the ongoing war in Ukraine as well as their associations with war exposure.Design, Setting, and ParticipantsThis cross-sectional study reports the results from the first wave of the Adolescents of Ukraine During the Russian Invasion cohort, the largest cohort study on Ukrainian adolescents’ mental health during the Russian invasion since 2022. Using self-reported questionnaires, the national-level prevalence of a positive screen for various psychiatric conditions was estimated among adolescents aged 15 years or older attending secondary school in Ukraine in person or online (including those residing abroad but attending Ukrainian secondary school online) and the prevalence among Ukrainian adolescents living abroad due to the war.ExposureSelf-reported exposure to war.Main Outcomes and MeasuresA positive screen for psychiatric conditions. The association between self-reported war exposure and a positive screen for each of the psychiatric conditions was also evaluated.ResultsA total of 8096 Ukrainian adolescents (4988 [61.6%] female) living in Ukraine or abroad were included in the analyses. Based on national-level estimates, 49.6% of the adolescents were directly exposed to war, 32.0% screened positive for moderate or severe depression, 17.9% for moderate or severe anxiety, 35.0% for clinically relevant psychological trauma, 29.5% for eating disorders, and 20.5% for medium risk or higher of substance use disorder. The burden of psychiatric symptoms was similarly large among Ukrainian adolescents living abroad. Adolescents exposed to war were more likely to screen positive for depression (prevalence ratio [PR], 1.39; 95% CI, 1.29-1.50), anxiety (PR, 1.62; 95% CI, 1.45-1.81), clinically relevant psychological trauma (PR, 1.41; 95% CI, 1.32-1.50), eating disorders (PR, 1.21; 95% CI, 1.12-1.32), and substance use disorder (PR, 1.11; 95% CI, 0.98-1.25).Conclusions and RelevanceThe findings of this study suggest that the mental health burden of Ukrainian adolescents amidst the Russian invasion of Ukraine is substantial. Mental health care efforts to alleviate the mental health burden of Ukrainian adolescents are needed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Mental Health of Adolescents Exposed to the War in Ukraine

Goto,

Pinchuk,

Kolodezhny

et al. 2024

JAMA Pediatr

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“…About conflict settings, in general, there is little guidance on how to deliver mental health interventions that are suitable (Slobodin and de Jong, 2015 ; Gaffey et al, 2021 ), especially during the active phase of war (Martsenkovskyi et al, 2022 ). Acarturk et al ( 2022 ), assessing the effectiveness of a WHO self-help psychological intervention for preventing mental disorders among Syrian refugees in Turkey, found that although the self-help approach was not effective immediately post-intervention participants enrolled in the self-help program were significantly less likely to have any mental disorders and also saw beneficial effects in terms of depression and quality of life at the six-month follow-up compared to those in the enhanced care as usual group.…”

Section: War Refugees Dedicated Interventions and Their Effectivenessmentioning

confidence: 99%

Meaning-centered therapy in Ukraine's war refugees: An attempt to cope with the absurd?

et al. 2022

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“…Over 40% of schools were destroyed, and at least 972 children died or were severely injured due to war (United Nations Children’s Fund, 2022). The ongoing war was accompanied by massive bombardments of civil infrastructure and medical facilities, including those located at a distance from the frontline (Goto et al, 2023; Haque et al, 2022), which along with the preexisting biomedical focus of treatment and low accessibility of mental health care, exacerbated by the forced evacuation of pediatric mental health specialists, reduced the already limited human resources, and accessibility of evidence-based mental health care both for children and adults (Martsenkovskyi et al, 2022; Roberts et al, 2019).…”

mentioning

confidence: 99%

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

Martsenkovskyi,

Karatzias,

Hyland

et al. 2023

Psychological Trauma: Theory, Research, Practice, and Policy

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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 .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. Dmytro Martsenkovskyihttps://orcid.org/0000-0002-6030-2698 We would like to thank Vitaliy Ostropytskyy from Ulster University for his hard work in assisting with the translations of the psychological measures. The authors report no conflicts of interest. Research data are not shared.Dmytro Martsenkovskyi served as lead for writing-original draft and contributed equally to investigation. Menachem Ben-Ezra served in a supporting role for conceptualization and data curation. Eoin McElroy served in a supporting role for conceptualization, data curation, and methodology. Enya Redican served in a supporting role for conceptualization. Maria Louison Vang served in a supporting role for methodology and writing-review and editing. Marylene Cloitre served in a supporting role for conceptualization and formal analysis. Grace W. K. Ho served in a supporting role for conceptualization. Boris Lorberg served in a supporting role for formal analysis and methodology. Igor Martsenkovsky served in a supporting role for methodology and writingoriginal draft.

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The Ukrainian paediatric mental health system: challenges and opportunities from the Russo–Ukrainian war

Cited by 10 publications

References 7 publications

Mental Health of Adolescents Exposed to the War in Ukraine

Mental Health of Adolescents Exposed to the War in Ukraine

Meaning-centered therapy in Ukraine's war refugees: An attempt to cope with the absurd?

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

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