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M. Ahmed AB, Yeddi AA, Alrawa SS, Alfadul ESA. Anxiety and depression symptoms among a sample of Khartoum civilians during the 2023 Sudan armed conflict: A cross-sectional study. PLoS One 2024; 19:e0307648. [PMID: 39052622 PMCID: PMC11271933 DOI: 10.1371/journal.pone.0307648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 07/10/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Mental health during armed conflicts is of paramount importance, as such situations often lead to increased risks of anxiety and depression symptoms among civilians. The military conflict between the Sudanese army and Rapid Support Forces, which began on April 15, 2023, is currently ongoing mainly in Khartoum State. Despite the significant impact of the conflict on the region, there is a lack of data regarding the mental health status of the residents. The aim of this study is to assess anxiety and depression symptoms among residents of Khartoum State during the first months of the 2023 military conflict. METHOD We conducted a cross-sectional study among residents of Khartoum State between May 27 and June 19 using an online questionnaire. We used standardized screening questionnaires, namely the Generalized Anxiety Disorder (GAD-7) for anxiety and the Patient Health Questionnaire (PHQ-9) for depression. Multiple logistic regression was used to identify sociodemographic factors that are associated with anxiety and depression symptoms. RESULTS Out of the 393 participants in the study, 70% had symptoms suggestive of depression and 57.3% suffered from anxiety symptoms. Both anxiety and depression were associated with being female (p < 0.001). Being married was a predictor of anxiety (p = 0.028) but not depression (p = 0.3). Other predictors were not significant (p > 0.05). CONCLUSION High levels of anxiety and depression symptoms were prevalent among Khartoum residents during the conflict, with females and married individuals at higher risk. Immediate medical assessment is essential for identifying cases and providing support. Mental health services should be integrated into emergency response efforts, particularly focusing on vulnerable groups. Future research should address study limitations and explore coping strategies for anxiety and depression in Sudanese adults.
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Affiliation(s)
| | - Ahmed A. Yeddi
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Salma S. Alrawa
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
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Kassa MA, Anbesaw T, Nakie G, Melkam M, Azmeraw M, Semagn EG, Abate BB. Investigating war trauma, its effects, and associated risk factors on anxiety among high school students in Woldia town, northeast Ethiopia, 2022. Front Psychiatry 2024; 15:1368285. [PMID: 39056017 PMCID: PMC11270624 DOI: 10.3389/fpsyt.2024.1368285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 06/13/2024] [Indexed: 07/28/2024] Open
Abstract
Background Anxiety symptoms are the most frequent mental health problems in the world, and it is a serious public health concern, especially among adolescents, because if left untreated, adolescent anxiety can have a number of detrimental effects, including lower academic performance, strained relationships with friends and family, substance addiction, thoughts of suicide and homicide, and trouble finding work. While this vulnerability is concerning in all situations, it is particularly critical in armed conflict areas. Ethiopia is one of the most recent war-affected countries, but to the best of our knowledge, limited studies focused on adolescents in this context. Therefore, this study assessed the experience of war trauma and its effects on anxiety symptoms among high school students in Woldia town, Ethiopia. Objective We assessed the experience of war trauma and its effects on anxiety among high school students, as well as associated risk factors, in war-affected areas in Woldia town, northeast Ethiopia. Methods A cross-sectional study design was conducted from May 23 to June 08 2022. Data were collected from high school students in Woldia town. Bivariable and multivariable logistic regression analyses were used to identify independent factors associated with anxiety. Results A total of 624 out of 660 students participated in the study (94.5% response rate). The prevalence of anxiety among high school students in Woldia town was 39.7%. In the multivariable analysis, having depression (AOR = 9.24, 95% CI: 6.27, 13.64), witnessing the murder of family/friends (AOR = 1.93, 95% CI: 1.05, 3.57), being of female sex (AOR=1.59, 95% CI: 1.08, 2.36), and having a family history of mental illness (AOR=1.69, 95% CI: 1.00, 2.85) were factors significantly associated with anxiety. Conclusions and recommendations The prevalence of anxiety in this study was approximately two in five high school students. Therefore, we recommend that the Ministry of Education collaborate with the Ministry of Health to expand and implement mental health services in high schools to promote the wellbeing of students for the prevention of anxiety.
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Affiliation(s)
- Mulat Awoke Kassa
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Tamrat Anbesaw
- Department of Psychiatry, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Girum Nakie
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mamaru Melkam
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Molla Azmeraw
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Elsabet Gezmu Semagn
- Department of Veterinary Parasitology, College of Veterinary Medicine, Wollo University, Dessie, Ethiopia
| | - Biruk Beletew Abate
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
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Cleofas JV. Gender, society and mental health: The moderated mediating role of depression and gender on national resilience and life satisfaction among emerging adults. Int J Ment Health Nurs 2024; 33:660-670. [PMID: 38050873 DOI: 10.1111/inm.13272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 11/23/2023] [Indexed: 12/07/2023]
Abstract
Recent threats to human security (i.e., COVID-19 pandemic, conflicts, climate change events) call for nurses to have an increased understanding of how sociopolitical environments induce mental health problems and impact the well-being of citizens. This study examines the relationship between national resilience and life satisfaction among Filipino emerging adults, how depression mediates this relationship, and how these correlations are moderated by gender. Drawing from an online survey sample of 1020 Filipino emerging adults (18-29 years old), this cross-sectional study utilised a moderated mediation analysis. Key constructs were measured using the short version of the National Resilience Scale (NR-13), the depression component of the Kessler Psychological Distress (K10) scale and the Satisfaction with Life Scale (SWLS). Gender was measured as sex assigned at birth. Descriptive results show that more than half of the respondents are female (64.2%) and demonstrate below-average levels of national resilience and depression, and high levels of life satisfaction. Also, findings indicate that depression has significant negative relationships with, and partially mediates the positive relationship between national resilience and life satisfaction. Moreover, moderation analysis results suggest that being female synergizes the negative relationship between depression and life satisfaction, and being male strengthens the positive relationship between national resilience and life satisfaction (p < 0.01). The results highlight how the national resilience of emerging adults neutralises their risk for depression and, ultimately, improves life satisfaction. Moreover, the findings emphasise the importance of nursing advocacy actions to ensure that social policies for improving public mental health are gender-sensitive, given that macro-social and psychological factors have varied effects on individuals' lives based on gender.
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Affiliation(s)
- Jerome Visperas Cleofas
- Department of Sociology and Behavioral Sciences, De La Salle University, Manila, Philippines
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Boltivets S, Gonchar T, Gonchar O, Uralova L, Chelyadyn Y. Neurotic Disorders in Children and Adults Under Social Stress Neurosis in Kids and Adults: Social Stress. J Nerv Ment Dis 2024; 212:317-324. [PMID: 38536041 DOI: 10.1097/nmd.0000000000001774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
ABSTRACT The relevance of the research subject is to explore the neurotic disorders that arise in people affected by the Russian-Ukrainian war and who witness violence and war crimes. The purpose of the research is to reflect the specific features of the mental reaction of children and adults to military actions as an example of global social stress. Bibliographic, bibliosemantic, and statistical research methods were used in the research. Since the beginning of the full-scale invasion, the number of patients with prolonged depression and schizophrenia has increased, and neurotic disorders has become more severe and acute. Particular attention should be devoted to assistance to military personnel who have been in the combat zone for a long time and former military prisoners of war. Attention should be devoted to the psyche, emotionality, and behavior of people with labile and unformed nervous systems-children, adolescents, pregnant women, and people of retirement age.
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Affiliation(s)
- Sergii Boltivets
- Department of Youth Policy Development, State Institute of Family and Youth Policy of Ukraine
| | - Tymur Gonchar
- Departments of Psychiatry, Psychotherapy, and Medical Psychology
| | - Oleksiy Gonchar
- Radiology, Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
| | - Lyudmila Uralova
- Departments of Psychiatry, Psychotherapy, and Medical Psychology
| | - Yuliya Chelyadyn
- Departments of Psychiatry, Psychotherapy, and Medical Psychology
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Rzońca P, Podgórski M, Łazarewicz M, Gałązkowski R, Rzońca E, Detsyk O, Włodarczyk D. The prevalence and determinants of PTSD, anxiety, and depression in Ukrainian civilian physicians and paramedics in wartime-An observational cross-sectional study six months after outbreak. Psychiatry Res 2024; 334:115836. [PMID: 38452498 DOI: 10.1016/j.psychres.2024.115836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/01/2024] [Accepted: 03/02/2024] [Indexed: 03/09/2024]
Abstract
Russia's invasion of Ukraine is the largest European land offensive since World War II. Individuals affected by conflicts such as war are at an increased risk of mental disorders, which result from frequent exposure to traumatic events and the breakdown of supportive social networks. The aim of the study was to assess the prevalence and determinants of PTSD, anxiety, and depression in Ukrainian civilian physicians and paramedics six months after the Russian invasion of Ukraine. A cross-sectional study was conducted using validated questionnaires: The Life Events Checklist, PTSD Checklist for DSM-5, The International Trauma Questionnaire (ICD-11), The Generalized Anxiety Disorder-7, The Patient Health Questionnaire-9, The World Health Organization Disability Assessment Schedule 2.0. The study showed that 61.1 % of participants indicated combat or exposure to a war zone as the most bothersome event in their experience. Physicians and paramedics did not differ in the prevalence of PTSD according to the DSM-5 diagnostic rule and of depression (criteria met by 14.5 % and 9 % of participants, respectively). However, more physicians than paramedics met the criteria of PTSD according to the ICD-11 diagnostic rule (5.1 % vs. 1.2 %) and of anxiety (16.5 % vs. 10.0 %). The risk factors for the mental health problems included personal combat experience, total trauma exposure, parenthood, and economic situation. Despite the differences found in the prevalence of PTSD depending on the criteria used, the severity of mental problems and disability in this group is significant. It is advisable to monitor the mental state and need for help among Ukrainian civilian medical personnel.
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Affiliation(s)
- Patryk Rzońca
- Department of Human Anatomy, Medical University of Warsaw, Warsaw, Poland.
| | - Marcin Podgórski
- Department of Emergency Medical Services, Medical University of Warsaw, Warsaw, Poland
| | | | - Robert Gałązkowski
- Department of Emergency Medical Services, Medical University of Warsaw, Warsaw, Poland
| | - Ewa Rzońca
- Department of Obstetrics and Gynecology Didactics, Medical University of Warsaw, Warsaw, Poland
| | - Oryna Detsyk
- Department of Social Medicine and Public Health, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Dorota Włodarczyk
- Department of Health Psychology, Medical University of Warsaw, Warsaw, Poland
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Kazlou A, Bornukova K, Wickham A, Slaykovskiy V, Peven K, Klepchukova A, Ponzo S, Garfinkel S. Effects of stress on pain in females using a mobile health app in the Russia-Ukraine conflict. NPJ MENTAL HEALTH RESEARCH 2024; 3:2. [PMID: 38609485 PMCID: PMC10956037 DOI: 10.1038/s44184-023-00043-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 10/27/2023] [Indexed: 04/14/2024]
Abstract
The chronic and acute effects of stress can have divergent effects on health; long-term effects are associated with detrimental physical and mental health sequelae, while acute effects may be advantageous in the short-term. Stress-induced analgesia, the attenuation of pain perception due to stress, is a well-known phenomenon that has yet to be systematically investigated under ecological conditions. Using Flo, a women's health and wellbeing app and menstrual cycle tracker, with a world-wide monthly active usership of more than 57 million, women in Ukraine were monitored for their reporting of stress, pain and affective symptoms before, and immediately after, the onset of the Russian-Ukrainian conflict. To avoid potential selection (attrition) or collider bias, we rely on a sample of 87,315 users who were actively logging multiple symptoms before and after the start of the war. We found an inverse relationship between stress and pain, whereby higher reports of stress predicted lower rates of pain. Stress did not influence any other physiological symptoms with a similar magnitude, nor did any other symptom have a similar effect on pain. This relationship generally decreased in magnitude in countries neighbouring and surrounding Ukraine, with Ukraine serving as the epicentre. These findings help characterise the relationship between stress and health in a real-world setting.
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Affiliation(s)
| | - Kateryna Bornukova
- BEROC Economic Research Center, Minsk, Belarus
- Universidad Carlos III de Madrid, Department of Economics, Madrid, Spain
| | | | | | | | | | - Sonia Ponzo
- Flo Health UK Limited, London, United Kingdom
- University College London, Institute of Health Informatics, London, United Kingdom
| | - Sarah Garfinkel
- University College London, Institute of Cognitive Neuroscience, London, United Kingdom
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Fel S, Jurek K, Lenart-Kłoś K. The relationship between socio-demographic factors and depression: a cross sectional study among civilian participants in hostilities in Ukraine. Sci Rep 2023; 13:21897. [PMID: 38082045 PMCID: PMC10713780 DOI: 10.1038/s41598-023-49289-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 12/06/2023] [Indexed: 12/18/2023] Open
Abstract
There is still a gap in scientific knowledge in relation to civilian participants in hostilities. This is despite the fact that there is an extensive body of literature on major depressive disorder (MDD) in individuals who have experienced armed conflict. The purpose of this article is to identify socio-demographic factors which are related to levels of depression among civilian participants in the war in Ukraine, based on a cross-sectional study that was conducted in 2019 from a convenience sample of 314 Ukrainian adults (235 males). Depression was assessed via the Beck Depression Inventory. Multiple regression analyses were conducted to identify possible predictors of depression. Significant predictors were: loss of a loved one, place of residence, age, health insurance, financial situation, and marital status (F (6, 224) = 10.515, p < 0.001, R2 = 0.21; Adjusted R2 = 0.19). They also show that symptoms of depression resulting from the loss of a loved one due to war can be reduced through participation in an educational system. Having children is associated with a risk of more severe depression. Specialists are encouraged to engage in face-to-face interviews and to maintain a supportive and safe environment for participants in hostilities, e.g., in the area of education.
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Affiliation(s)
- Stanisław Fel
- The John Paul II Catholic University of Lublin, Lublin, Poland
| | - Krzysztof Jurek
- The John Paul II Catholic University of Lublin, Lublin, Poland.
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Stieger S, Lewetz D, Paschenko S, Kurapov A. Examining terror management theory in Ukraine: impact of air-raid alarms and explosions on mental health, somatic symptoms, and well-being. Front Psychiatry 2023; 14:1244335. [PMID: 38025457 PMCID: PMC10644072 DOI: 10.3389/fpsyt.2023.1244335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Objective This study sought to evaluate Terror Management Theory (TMT) assumptions about death awareness and its psychological impact in the context of a real-world war situation with high external validity. We examined if factors such as habituation to war circumstances and psychological resilience could buffer the effects on civilians' anxiety, physical and mental health, and affect. Method We implemented a pre-registered smartphone-based experience sampling method study over four weeks, with 307 participants (k = 7,824) living in war-affected areas in Ukraine whereby participants were regularly exposed to war situations, including air-raid alarms, explosions, and infrastructural problems. Results The data indicated that war situations significantly increased anxiety, negatively impacting mental health, and raising somatic symptom severity. While habituation showed a mild buffering effect on these impacts, resilience did not. Conclusion This real-world investigation supports TMT's fundamental assumptions about death awareness and its psychological implications. However, even amidst the presence of real, life-threatening situations, the buffering effects of habituation were surprisingly minimal. This suggests that further exploration of TMT's buffering factors in real-world scenarios is warranted.
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Affiliation(s)
- Stefan Stieger
- Department of Psychology and Psychodynamics, Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria
| | - David Lewetz
- Department of Psychology and Psychodynamics, Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria
| | - Svitlana Paschenko
- Faculty of Psychology, Taras Shevchenko National University of Kyiv, Kyiv, Ukraine
| | - Anton Kurapov
- Faculty of Psychology, Taras Shevchenko National University of Kyiv, Kyiv, Ukraine
- Department of Psychology, Faculty of Natural Sciences, University of Salzburg, Salzburg, Austria
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