Mental health of university students twenty months after the beginning of the full-scale Russian-Ukrainian war.

Background: Russia's full-scale military invasion of Ukraine on February 24, 2022 led to an increase of anxiety and depressive states, psychosomatic manifestations, and a tendency to abuse alcohol and psychoactive substances in the population. The aim of this paper is to examine the mental health burden among university students twenty months after war and to identify risk and protective factors for mental health problems.

Methods: A cross-sectional study was conducted among Ukrainian students in October 2023 (n = 1398). The online survey included sociodemographic data collection, evaluation of psychological well-being and measured depression, anxiety, PTSD symptoms and insomnia. Normality of included variables was verified by Kolmogorov-Smirnov test. An independent-samples t-test, Mann-Whitney U-test, χ2 test and analysis of variance were used to compare the data. Differences in PHQ-9 and GAD-7 levels based on sociodemographic characteristics were analyzed using ANOVA. Correlation between variables was calculated with Pearson correlation, adjusted with Benjamini-Hochberg procedure. To develop the predictive model the XGBoost algorithm was employed, additionally, the SHAP algorithm was utilized.

Results: Symptoms of PTSD, as well as moderate and severe symptoms of anxiety, depression, and insomnia, were reported by 48.1%, 34.1%, 33.6%, and 19.3% of students, respectively. The severity of these symptoms varied based on factors such as sex, age, prior trauma experiences, and living conditions. Additionally, the type of relocation (within Ukraine or abroad) significantly influenced mental health outcomes. A majority of participants (68.5%) reported the experience of war-related traumatic events. Factors linked to higher depression symptom scores included lower initial well-being, greater social media use, female gender, exposure to multiple traumatic events, experiences of assault or sexual violence, the loss of a loved one, pre-existing and ongoing mental health treatment during the war, and the use of psychotropic medications.

Conclusions: Ukrainian university students face a significant mental health burden due to the ongoing war, with high rates of reported PTSD, anxiety, depression, and insomnia symptoms. These findings highlight the importance of tailored mental health interventions through different stakeholders that take into account individual needs, past experiences, burdens and social media usage.