“Many people continue to face the threat of shelling, displacement, bereavement and uncertainty in their daily lives, highlighting the urgent need for sustained mental health support”
A national survey of Ukrainian residents provides one of the clearest estimates to date of the psychological impact of the ongoing war.
Published today in the European Journal of Psychotraumatology, the peer-reviewed study analysed data from a nationally representative survey of civilians living in government-controlled regions of Ukraine.
It provides new estimates of post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD), finding that 31.2% of respondents met the criteria for one of these mental health conditions.
People living in conflict zones face a heightened risk of traumatic experiences, such as physical violence, forced displacement and the loss of loved ones. PTSD can develop after experiencing or witnessing trauma, causing persistent symptoms including intrusive memories, anxiety, irritability and sleep problems. CPTSD is a related but more severe condition that typically follows prolonged or repeated trauma, such as chronic abuse or captivity.
The findings indicate that PTSD and CPTSD are common among Ukrainian civilians living through an active and ongoing war.
“A decade of Russian aggression, followed by a full-scale invasion in February 2022, has placed a profound psychological burden on the population. Many people continue to face the threat of shelling, displacement, bereavement and uncertainty in their daily lives, highlighting the urgent need for sustained mental health support. And, what stands out most from these findings is the sheer scale of trauma exposure,” says Senior Author Dr Deirdre MacManus, a Clinical Reader in Forensic Psychiatry, at King’s College London (KCL).
“The vast majority of people we surveyed had experienced multiple traumatic events across their lives, and many had also been directly affected by the ongoing war through displacement, bereavement, destruction of their communities, or concern for loved ones. Despite this, many Ukrainians continue to function and adapt in extraordinarily challenging circumstances.”
Co-author Professor Volodymyr Kulyk, from the Department of Social Sciences, at Kyiv School of Economics, adds: “It is important to keep in mind that PTSD and CPTSD are not limited to veterans or people close to combat zone but also are widespread among other categories of people heavily affected by the war, such as Internally Displaced Persons, people who suffered from missiles and drones attacking their cities and towns far from frontline, and those taking care of wounded or traumatized people.”
Involved in the study was – what the authors themselves describe as – “an unusual collaboration” of mental health researchers and social scientists. All had a specific interest in the impact of psychological trauma in Ukraine, on both mental health and sociopolitical outcomes.
Alongside those at KCL and Kyiv School of Economics, the team of expert researchers included academics from The George Washington University; The University of Manchester; The Centre for East European and International Studies (ZOiS); and Combat Stress, the UK’s leading mental health charity for veterans. The study was initiated by the research network “Conflict and Cooperation in Eastern Europe” (KonKoop), led by Professor Gwendolyn Sasse (ZOiS) and funded by the German Federal Ministry of Research, Technology and Space.
Assembling a truly interdisciplinary team enabled rare access – in the current circumstances – to a robust, national representative sample, which (via a telephone survey) assessed lifetime exposure to traumatic events, war-related traumas, and symptoms of trauma-related mental health conditions.
From the total sample of 2,504 adults, the results showed:
Broken down
Factors associated with a greater likelihood of PTSD or CPTSD included being female, older age, lower educational attainment, previous military service, displacement due to the war, and a greater number of lifetime traumatic events and war-related stressors.
Being single was the only factor specifically associated with CPTSD rather than PTSD.
Because data were collected at a single point in time during an active conflict, the findings represent a snapshot of the population’s mental health rather than how symptoms change over time.
“One finding we found particularly interesting was that PTSD was much more common than Complex PTSD in this representative national sample,” says lead author, child and adult clinical psychologist, Dr Emma Facer-Irwin, who is a clinical lecturer at KCL.
“This may suggest that psychological responses to ongoing war do not always fit neatly into models developed in post-conflict settings. When the threat remains active and unpredictable, the ways people experience and adapt to traumatic stress may be different, and this is an important area for future research.”
Professor Kulyk adds: “As pressure on Ukraine’s health system grows and uncertainty around future humanitarian support increases, understanding the prevalence of PTSD and complex PTSD is essential for planning both immediate and long-term mental health services.
“Further research will be essential to understand how the psychological impact of the war develops among the general population evolve as the conflict continues.”
Principal Investigator, Professor Gwedolyn Sasse, who is the Director of ZOiS, which is based in Berlin, concludes: “As a collaborative, we were acutely aware of the need to expand the discussion about resilience in wartime into sound empirical research on trauma.
“Our hope is that our results help inform both immediate and long-term investment in mental health services in Ukraine.
“Trauma-focused treatments are important, but our findings also highlight the value of community support, social connection and population-level mental health initiatives. As the war continues, supporting the psychological wellbeing of civilians must remain a public health priority.”
As a limitation of their research, the authors note that the study relied on self-reported symptoms – which may be influenced by how participants interpreted the survey questions.
The next area of research they are looking to tackle is understanding, better, the potential effects of trauma on political attitudes.