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Cited by 187Posttraumatic Stress Disorder ResearchCOVID-19 and Mental HealthMigration, Health and Trauma

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

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Chudzicka-Czupała, Agata, Hapon, Nadiya, Chiang, Soon-Kiat, Żywiołek-Szeja, Marta, Karamushka, Liudmyla, Lee, Charlotte T., Grabowski, Damian, Paliga, Mateusz +4 more·2023·Scientific Reports
DOI 10.1038/s41598-023-28729-3PMC PMC9982762

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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.

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  • Individuals living in chronic situations seem to be mainly concerned with the future, that is, with anticipated future danger and threat, and their thinking is dominated by fantasies of what might happen and ways of avoiding it.

    “Individuals living in such chronic situations seem to be mainly concerned with the future, that is, with anticipated future danger and threat, and their thinking is dominated by fantasies of what might happen and ways of avoiding it [54,55].”

    From Impact of Media-Induced Uncertainty on Mental Health: Narrative-Based Perspective. (2025) · cites this paper as [55]

    The Discussion (page not provided) suggests that Taiwanese participants might anticipate a future war with China and avoid discussing it. It does not establish that people living in chronic situations generally are mainly concerned with future threats, or that fantasies about what might happen dominate their thinking. (LLM, conf=0.82)

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  • War-related uncertainty, particularly media-induced exposure to conflict, has significantly augmented levels of stress, anxiety, depression, and posttraumatic stress in Czech, Slovak, German, Polish, Italian, and even Taiwanese populations.

    “Recent research highlights that war-related uncertainty, particularly media-induced exposure to conflict, has significantly augmented levels of stress, anxiety, depression, and posttraumatic stress in Czech, Slovak, German, Polish, Italian, and even Taiwanese populations [55,81-83].”

    From Impact of Media-Induced Uncertainty on Mental Health: Narrative-Based Perspective. (2025) · cites this paper as [55]

    The Discussion reports depression, anxiety, stress and post-traumatic stress among participants in Poland, Ukraine and Taiwan; the Results say many Polish and Taiwanese participants were distressed by media war scenes. The study does not examine Czech, Slovak, German or Italian populations, and its findings do not establish that media exposure significantly increased all four outcomes in the populations named. Page numbers were not available in our copy. (LLM, conf=0.88)

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  1. [28]Aldwin, C. M. Culture, coping and resilience to stress. in Gross National Happiness and Development - Proceedings of the First International Conference on Operationalization of Gross National Happiness. 563–573 (Centre for Bhutan Studies, Thimphu, 2004).

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Authors
Chudzicka-Czupała, A., Hapon, N., Chiang, S.-K., Żywiołek-Szeja, M., Karamushka, L., Lee, C. T., Grabowski, D., Paliga, M., Rosenblat, J. D., Ho, R., McIntyre, R. S., & Chen, Y.-L.
Affiliations
  • Uniwersytet SWPS (PL)
  • Lviv University (UA)
  • National University of Singapore (SG)
  • National Academy of Educational Sciences of Ukraine (UA)
  • University of Silesia in Katowice (PL)
  • University Health Network (CA)
  • Asia University (TW)
Corresponding author
Ho, Roger
ORCID
Venue
Scientific Reports
Publisher
Springer Science and Business Media LLC
Published
2023-03-03
Volume
13
Issue
1
Pages
3602-3602
ISSN
2045-2322 (ISSN-L)
DOI
10.1038/s41598-023-28729-3
PMC
PMC9982762
OpenAlex
W4323042680
Cited by
187
References
34
Citations by year
2026: 29 · 2025: 61 · 2024: 61 · 2023: 34 · 2022: 2
FWCI
53.72
Type
journal article
Language
en
Open access
Licence
Locations
  • Scientific Reports (publishedVersion, cc-by)
  • Research Square (acceptedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Rare & Special e-Zone (The Hong Kong University of Science and Technology) (submittedVersion)
Funders
  • National University of Singapore, Department of Psychological Medicine (R-177-000-100-001/R-177-000-003-001/ R177000702733)
  • National University of Singapore, iHeathtech (R-722-000-004-731)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
  • Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
Keywords
depression, anxiety, post-traumatic stress, psychological distress, war trauma, coping strategies, avoidance coping, help-seeking barriers, refugees, cross-national comparison, Ukraine, Poland, Taiwan, DASS-21, Impact of Event Scale-Revised, Brief COPE, gender differences, citizenship, household size, self-rated health
MeSH terms
Anxiety, Depression, Female, Humans, Poland, Stress Disorders, Post-Traumatic, Taiwan, Ukraine

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