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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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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 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]
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“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]
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Lushchak, O. V., Velykodna, M., Bolman, S., Strilbytska, O. M., Berezovskyi, V., & Storey, K. B. (2023) · The Lancet Regional Health - Europe · doi:10.1016/j.lanepe.2023.100773 · Cited by 161
War trauma and strategies for coping with stress among Ukrainian refugees staying in Poland
Długosz, P. (2023) · Journal of Migration and Health · doi:10.1016/j.jmh.2023.100196 · Cited by 133
Seleznova, V., Пінчук, І., Feldman, I., Вирченко, В., Wang, B., & Skokauskas, N. (2023) · International Journal of Mental Health Systems · doi:10.1186/s13033-023-00598-3 · Cited by 84
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Metadata
- 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
- Published
- 2023-03-03
- Volume
- 13
- Issue
- 1
- Pages
- 3602-3602
- ISSN
- 2045-2322 (ISSN-L)
- PMC
- PMC9982762
- OpenAlex
- W4323042680
- Cited by
- 187
- References
- 34
- Citations by year
- 2026: 29 · 2025: 61 · 2024: 61 · 2023: 34
- FWCI
- 53.72
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- 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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