Depression, anxiety and post-traumatic stress during the 2022 Russo-Ukrainian war, a comparison between populations in Poland, Ukraine, and Taiwan

Abstract

Ukraine has been embroiled in an increasing war since February 2022. In addition to Ukrainians, the Russo-Ukraine war has affected Poles due to the refugee crisis and the Taiwanese, who are facing a potential crisis with China. We examined the mental health status and associated factors in Ukraine, Poland, and Taiwan. The data will be used for future reference as the war is still ongoing. From March 8 to April 26, 2022, we conducted an online survey using snowball sampling techniques in Ukraine, Poland, and Taiwan. Depression, anxiety, and stress were measured using the Depression, Anxiety, and Stress (DASS)-21 item scale; post-traumatic stress symptoms by the Impact of Event Scale-Revised (IES-R) and coping strategies by the Coping Orientation to Problems Experienced Inventory (Brief-COPE). We used multivariate linear regression to identify factors significantly associated with DASS-21 and IES-R scores. There were 1626 participants (Poland: 1053; Ukraine: 385; Taiwan: 188) in this study. Ukrainian participants reported significantly higher DASS-21 (p < 0.001) and IES-R (p < 0.01) scores than Poles and Taiwanese. Although Taiwanese participants were not directly involved in the war, their mean IES-R scores (40.37 ± 16.86) were only slightly lower than Ukrainian participants (41.36 ± 14.94). Taiwanese reported significantly higher avoidance scores (1.60 ± 0.47) than the Polish (0.87 ± 0.53) and Ukrainian (0.91 ± 0.5) participants (p < 0.001). More than half of the Taiwanese (54.3%) and Polish (80.3%) participants were distressed by the war scenes in the media. More than half (52.5%) of the Ukrainian participants would not seek psychological help despite a significantly higher prevalence of psychological distress. Multivariate linear regression analyses found that female gender, Ukrainian and Polish citizenship, household size, self-rating health status, past psychiatric history, and avoidance coping were significantly associated with higher DASS-21 and IES-R scores after adjustment of other variables (p < 0.05). We have identified mental health sequelae in Ukrainian, Poles, and Taiwanese with the ongoing Russo-Ukraine war. Risk factors associated with developing depression, anxiety, stress, and post-traumatic stress symptoms include female gender, self-rating health status, past psychiatric history, and avoidance coping. Early resolution of the conflict, online mental health interventions, delivery of psychotropic medications, and distraction techniques may help to improve the mental health of people who stay inside and outside Ukraine.

Anxiety, depressive symptoms, and distress over the course of the war in Ukraine in three federal states in Germany

“…Less affluent persons were more affected by fears regarding their personal financial situation related to the war than more affluent persons. The findings are relevant on a global level, as studies conducted immediately after the start of the war demonstrate a significant impact on mental health in countries beyond Ukraine and its neighboring countries ( 5 , 15 ). Our study contributes to this body of knowledge by showing that the effects persist for up to 6 months after the initial shock of the war and may result in persistent mental health sequelae, particularly for already vulnerable groups.…”

“…A war has been shown to lead to higher prevalence of anxiety, mood disorders and posttraumatic stress disorder (PTSD) in the general population of the affected country during and for years post-war ( 2 , 3 ). The ongoing war in Ukraine has already been shown to have detrimental impacts on the mental health of Ukrainian military and civilian combatants ( 4 ) and the Ukrainian general population ( 5 ) with nearly half of the participants in both studies displaying clinically relevant symptoms of depression and anxiety. Persons who are internally displaced due to the ongoing conflict between Russia and Ukraine are at an especially high risk for mental health sequelae ( 6 , 7 ).…”

“…The effect of the early stages of the war on mental health has also been shown in other countries not directly involved in the war. Taiwanese and Polish participants in a study by Chudzicka-Czupała et al showed high levels of distress caused by media war scenes ( 5 ). Another study found high proportions of moderate to severe levels of anxiety and depression among college students in Czech Republic in the month after the invasion and symptoms were positively correlated to feeling concerned about the war ( 13 ).…”

The Economic Costs of the Russia-Ukraine War: A Synthetic Control Study of (Lost) Entrepreneurship

“…show that sources of decreased GDP include trade and financial market frictions, respectively. Further, the disappearance of entrepreneurial activity might be one factor behind the identified mental health consequences of the Russo-Ukrainian war (Bai et al, 2022;Chudzicka-Czupała et al, 2023;Jawaid et al, 2022;Kossowska et al, 2023).…”

Anxiety and watching the war in Ukraine

“…In an online cross‐sectional study of the psychological effects of the Russian‐Ukrainian war, Chudzicka‐Czupała et al (2023) examined the mental health status of participants from Ukraine, Poland and Taiwan. Findings showed that Ukrainian participants reported significantly higher scores in depression, anxiety, stress and post‐traumatic stress.…”