War in Ukraine is increasing the prevalence of mental health conditions in children, new study finds

(Press-News.org) A new study presented at the European Psychiatric Association Congress 2024 reveals a significant rise in mental health issues among children and adolescents displaced by the war in Ukraine. The research, conducted by the Institute of Forensic Psychiatry of MoH of Ukraine, highlights the devastating impact of prolonged exposure to violence and displacement on the mental well-being of young people.

As per UNICEF’s recent report on “The State of the World’s Children 2021”, the current COVID-pandemic is considered the tip of the mental health iceberg for young people across the world.[1] The war in Ukraine is taking a devastating mental toll on children across Europe. Beyond those directly in the conflict zone, the constant media coverage spreads fear and anxiety, fueling a hidden mental health crisis. This weighs heavily on children already burdened by the lingering impacts of the COVID-19 pandemic. [2] [3] Experiences of war and military aggression can have a long-term and persistent impact on the physical and mental health of children, with far-reaching and long-term consequences for their development. [4] These consequences can stem from a variety of challenges such as inadequate healthcare, malnutrition, infectious diseases, and familial distress, all of which can have a significant impact on mental health. [5] [6] [7] [8]

Key findings from the study include:

The study examined 785 teenagers displaced from war-torn regions of Ukraine. Researchers observed a significant increase in the prevalence of various mental health conditions over a period of 6 to 12 months following displacement: Post-traumatic stress disorder (PTSD): 9.8% to 21.9% Attention deficit hyperactivity disorder (ADHD): 10.2% to 12.6% Depressive disorders (DD): 22.3% to 33.3% Anxiety disorders (AD): 30.8% to 11.5% Conduct disorders (CD): 15.4% to 18.0% The study also identified female sex and secondary traumatization (exposure to additional traumatic events after displacement) as risk factors for developing depression, pervasive developmental disorders, and ADHD. Additionally, the research suggests that children with existing PTSD are more susceptible to developing other mental health conditions and demonstrate increased sensitivity to further traumatic events. Prof. Igor Martsenkovsky, Head of the Department of Mental Disorders of Children and Adolescents at the SI Institute of Forensic Psychiatry of the Ministry of Health of Ukraine commented on the findings, stating “This study provides important information about the state of mental health in the child population of Ukraine in 2022-2023. About one-third of the child population has clinically relevant problems related to anxiety, traumatic stress, developing depression, conduct behaviour and ADHD. Key risk factors for these mental health problems include younger age, no longer being in a committed relationship, having fewer positive childhood experiences within one’s family context, and experiencing serious disruption to one’s life due to Russian aggression.”

“These findings paint a concerning picture of the lasting impact of war on the mental health of young Ukrainians. They underscore the urgent need for increased access to mental health services for children and adolescents affected by the war, both within Ukraine and in host countries, specialised support for children with PTSD and other mental health conditions, trauma-informed approaches in education and social services to help children cope with the emotional consequences of war and continued support for families displaced by the war, acknowledging the unique challenges they face in ensuring the well-being of their children,” explains Professor Geert Dom, President of the European Psychiatric Association.

The European Congress of Psychiatry takes place from 6-9 April 2024 in Budapest, Hungary, and represents Europe’s largest congress dedicated to psychiatry, with over 4000 participants: epa-congress.org.

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Notes to editors

A longitudinal study of child and adolescent psychopathology in conditions of the war in Ukraine (O0073)

Introduction: According to UNICEF, 2 million children have left the country since the beginning of the war. 2.5 million Ukrainian children are internally displaced persons. Minors often become victims or witnesses of violence. The events of 2022-2023 are the largest military conflict in the world since World War II. The impact on the mental health of the population is characterized by the variety and mass of traumatizing factors. Mental trauma causes PTSD, depressive disorders (DD), anxiety disorders (AD), behavioral disorders (CD), attention deficit hyperactivity disorder (ADHD).

Objectives: The aim of the study was to determine the prevalence of PTSD and its comorbidities at different stages of experiencing a traumatic experience.

Methods: 785 teens displaced from the zone of military operations, occupied territories were surveyed. Examinations included: K-SADS-PL, PSC-17, SCARED, CATS. 260 teens were examined during - 6, 400 – 6–12 months after traumatization.

Results: After 6 months of trauma, PTSD was diagnosed in 9.8%, ADHD – 10.2%, DD-22.3%, AD-30.8%, CD – 15.4%, 28.8%; examined 6 to 12 months after the injury, respectively: 21.9%, 12.6, 33.3%, 11.5%, 18.0%.

Conclusions: In war-affected children, PTSD is a risk factor for the subsequent development of comorbid depression, anxiety, conduct disorders, and ADHD. Female sex, secondary traumatization after displacement increase the risk of developing depression, signs of pervasive development and ADHD - the risk of destructive and self-injurious behavior. The prevalence of PTSD, DD, ADHD increases within 6-12 months after the trauma, the sensitivity of children with PTSD to secondary traumatic events increases.

Disclosure of interest: None declared.

About the European Psychiatric Association

With active individual members in as many as 88 countries and 44 National Psychiatric Association Members who represent more than 78,000 European psychiatrists, the European Psychiatric Association is the main association representing psychiatry in Europe. The EPA’s activities address the interests of psychiatrists in academia, research and practice throughout all stages of career development. The EPA deals with psychiatry and its related disciplines and focuses on the improvement of care for the mentally ill as well as on the development of professional excellence. More information: https://www.europsy.net/

References

[1] UNICEF (2021) The state of the world's children 2021: on my mind—promoting, protecting and caring for children's mental health. Link: https://www.unicef.org/reports/state-worlds-children-2021. Last Accessed: 28.02.24.

[2] Ravens-Sieberer U, Kaman A, Erhart M, Devine J, Schlack R, Otto C. Impact of the COVID-19 pandemic on quality of life and mental health in children and adolescents in Germany. Eur Child Adolesc Psychiatry. 2021 doi: 10.1007/s00787-021-01726-5.

[3] Ravens-Sieberer U, Kaman A, Erhart M, Otto C, Devine J, Loffler C, Hurrelmann K, Bullinger M, Barkmann C, Siegel NA, Simon AM, Wieler LH, Schlack R, Holling H. Quality of life and mental health in children and adolescents during the first year of the COVID-19 pandemic: results of a two-wave nationwide population-based study. Eur Child Adolesc Psychiatry. 2021 doi: 10.1007/s00787-021-01889-1.

[4] Bürgin D, Anagnostopoulos D; Board and Policy Division of ESCAP; Vitiello B, Sukale T, Schmid M, Fegert JM. Impact of war and forced displacement on children's mental health-multilevel, needs-oriented, and trauma-informed approaches. Eur Child Adolesc Psychiatry. 2022 Jun;31(6):845-853. doi: 10.1007/s00787-022-01974-z. PMID: 35286450; PMCID: PMC9209349.

[5] Goldson E. The effect of war on children. Child Abuse Negl. 1996;20(9):809–819. doi: 10.1016/0145-2134(96)00069-5.

[6] Kadir A, Shenoda S, Goldhagen J. Effects of armed conflict on child health and development: a systematic review. PLoS ONE. 2019;14(1):e0210071. doi: 10.1371/journal.pone.0210071.

[7] Santa Barbara J. Impact of war on children and imperative to end war. Croat Med J. 2006;47(6):891–894.

[8] Yule W. Emanuel Miller lecture from pogroms to “ethnic cleansing”: meeting the needs of war affected children. J Child Psychol Psychiatry. 2003;41(6):695–702. doi: 10.1111/1469-7610.00657.

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