The mental health impact of the ongoing Russian-Ukrainian war 6 months after the Russian invasion of Ukraine

'I worry about you more': insights from older care recipients' experiences during the Israel-Hamas war

OBJECTIVES

This study explored the experiences and challenges of older adults with functional disabilities in Israel during the ongoing Israel-Hamas war, particularly those receiving care from migrant live-in carers. The main objectives were to identify their main concerns and coping strategies during this period.

METHOD

A qualitative methodology was employed, involving face-to-face interviews with 13 older adults (mean age 91.33, SD = 5.31). All participants liveded in separate housesholds with the assistance of migrant live-in carers. They were recruited through purposive and snowball sampling techniques. The interviews were analyzed using thematic content analysis.

RESULTS

Two main themes emerged from data analysis: 1) Concerns for others affected by the war and concerns for oneself, and 2) Coping strategies, including utilizing personal resources such as optimism and distraction, seeking connections with family members and carers, and contributing to the community.

CONCLUSION

The study highlights the interplay between the vulnerabilities and strengths of older adults during wartime. Their ability to mobilize both internal and external coping strategies reflects an active approach to managing the stress and uncertainties of war, underscoring their resilience and agency and challenging the perception of older adults as passive recipients of care.

Hope and Distress: A Cross-Country Study Amid the Russian-Ukrainian War

Conflict deeply affects human experiences, frequently testing individual resilience to its breaking point and leaving enduring psychological and societal wounds. The current conflict in Ukraine, initiated by Russia's invasion in 2022, illustrates this phenomenon by altering regional relationships and triggering a major humanitarian crisis marked by extensive displacement, loss of life, and emotional turmoil. This study explores the factors influencing hope and distress in Ukraine alongside six nearby European countries during the ongoing conflict. A cross-sectional survey collected data primarily via internet panel samples from the Czech Republic, Georgia, Lithuania, Poland, Romania, Slovakia, and Ukraine in the second year since the war's initiation. The current study utilised validated instruments, collecting data on levels of hope, distress, individual resilience, community resilience, societal resilience, morale, sense of danger, perceived security threats, and demographic characteristics. Hope and distress levels differ across countries, with Ukraine exhibiting the highest levels of both (3.74 ± 1.02 and 2.89 ± 0.87, respectively). Overall, average scores of hope were higher than average distress levels. Across the regression models for the seven countries, hope showed strong associations with individual (between β = 0.089 and β = 0.327) and societal resilience (between β = 0.206 and β = 0.514), while morale (between β = -0.104 and β = -0.479) and individual resilience (between β = -0.077 and β = -0.335) displayed a protective relationship against distress (all β values were significant, p < 0.01). Monitoring hope and distress is crucial during the Russian-Ukrainian war and other adversities, as these factors give insight into the current and future psychological states of affected populations. The results offer valuable information that can guide the development of tailored strategies to enhance hope and buffer distress in war-impacted countries, as well as those experiencing its broader effects. Fostering individual and societal resilience, alongside enhancing morale, may strengthen hope and mitigate distress amid adversity. Developing targeted interventions that address each population's unique needs, as well as their sociocultural and geopolitical contexts can enhance efficacy.

A Scoping Review of Prevention Classification in Mental Health: Examining the Application of Caplan's and Gordon's Prevention Frameworks (2018-2024)

Mental health prevention is a global priority owing to the increasing burden of mental disorders exacerbated by global crises such as the COVID-19 pandemic, climate change, economic instability, and armed conflicts. These crises have heightened the need for effective preventive strategies addressing mental health across different life stages and populations. To structure and classify such strategies, Caplan's and Gordon's frameworks have been widely used, with one focusing on disease progression and the other on population risk. Although both frameworks are frequently used in mental health prevention, their application in clinical trials remains unexplored. This review addresses this gap by examining how Caplan's and Gordon's frameworks have been applied in mental health prevention, identifying research gaps, and exploring their potential for their combined application to enhance prevention strategies. A scoping review was conducted following PRISMA-ScR guidelines. Studies were selected based on predefined criteria and the data were synthesized. The search spanned PubMed, Scopus, APA PsycArticles, and PubPsych, covering peer-reviewed clinical trials, including randomized controlled trials, published between 2018 and 2024 in English or German. Eligible studies classified interventions based on Caplan's framework, which focuses on disease stage (primary, secondary, tertiary), or Gordon's framework, which categorizes prevention by population risk (universal, selective, indicated). Studies had to focus on mental health prevention, include populations relevant to mental health and well-being, and report mental health or well-being outcomes. Of the 40 included studies, six applied Caplan's framework, 30 applied Gordon's framework and three used a modified classification based on Gordon's approach. One study applied both frameworks, highlighting that their complementary use is rare. Studies were conducted in 19 countries, with the highest number from Germany (n = 8), the USA (n = 8), and the Netherlands (n = 6), across four continents (Asia, n = 5; Australia, n = 5; Europe, n = 22; North America, n = 8). Gordon's framework was applied more frequently, particularly in universal (n = 15) and indicated prevention (n = 12), while Caplan's framework was used mainly in primary prevention (n = 4). Depression (n = 25), anxiety (n = 21), stress (n = 8), and general mental health (n = 8) were the most frequently assessed outcomes. The studies targeted diverse populations, including children (n = 7), adolescents (n = 8), children and adolescents (n = 1) parents and their children or adolescents (n = 2), university students (n = 6), working adults (n = 7), older adults (n = 1), and adults without specifying (n = 8). This review highlights the underutilized potential of integrating Caplan's and Gordon's frameworks in mental health interventions. Two application examples illustrate how these frameworks can be combined to structure prevention strategies more effectively. Future research should explore combining these frameworks to enhance prevention strategies and address the emerging global health challenges.

The feminine and the war: A systematic review on gender-sensitive research during Russia-Ukraine war

Researchers investigating the psychological impact of the Russia-Ukraine conflict indicate that women are at heightened risk of developing psychological disturbances compared to men. Thus, an in-depth examination of how psychological research address the mental health status and experiences of Ukrainian women during the current conflict is warranted. Following PRISMA guidelines, we conducted a systematic review on psychological research on Ukrainian women during the Russia-Ukraine conflict. 7 articles were deemed eligible for inclusion and three primary research trajectories were identified: Women Caring for Women; Where War Destroys, Life Reemerges; Negotiations and Resistance. Overall, research on this topic is underdeveloped. Given the vulnerability of this population, further studies adopting a gender-sensitive approach are urgently needed. The identified research trajectories illuminate key themes investigated by the international scientific community, also offering insights into how researchers in the field of psychology engage with the extreme trauma of war and its intersection with feminine experiences.

Mental health during the 2022 Russo-Ukrainian War: A scoping review and unmet needs

INTRODUCTION

The Russo-Ukrainian War (RUW) poses a significant mental health burden, warranting a scoping review of the evidence to shed light on the unmet needs.

METHODS

MEDLINE/PubMed and EMBASE databases were inquired from inception until September 1st, 2023, to address the following a-priori-formulated questions: i) "Which psychiatric population has been assessed? How did the conflict affect the functioning of people with established mental health conditions (e.g., treatment adherence, hospitalization rates, and use of illicit substances)?" ii) "Did any psychiatric symptoms or disorders arise because of the RUW? If so, among which groups (e.g., civilians, combatants, refugees, caregivers) and in what geographical regions?", iii) "The impact of the Russo-Ukrainian war: what evidence focused on pre- and post-mental health status?", iv) "Did the conflict affect the rates of suicidal ideation or behaviors (e.g., attempt and death by suicide)? How did the war affect mental status, especially among vulnerable populations?", v) "What psychosocial or medical interventions have been adopted for internally displaced people or refugees complaining of mental health disturbances?", vi) "What rating tools or ad-hoc measures have been developed/adopted?", vii) "How did the existing evidence compare the RUW with other conflicts in different geographical regions or periods?".

RESULTS

Twenty-seven records addressed questions 1-3 and 5-6, with the female gender facing the highest burden. Reliable records about the Russian side of the conflict are needed.

CONCLUSION

Cohort studies across different phases of the RUW and populations are required to deliver effective clinical and public health interventions, especially to at-risk populations.

Exploring the psychological effects of war on indirectly affected groups: a cross-sectional study on residents of Jordan

The Gaza War has significantly escalated conflict and humanitarian crises in the Gaza Strip, causing profound human suffering and psychological impact. This study investigates the mental health of residents of Jordan, examining anxiety and depression levels, sociodemographic factors, and resilience mechanisms to understand the psychological resilience of communities facing conflict-related stressors. This cross-sectional study used a convenience sampling method to collect data from Jordanian residents over 18 years of age. An online questionnaire shared on social media platforms was used, the Patient Health Questionnaire-4 (PHQ-4) was used to measure anxiety and depression, the Perceived Stress Scale (PSS) 4-item questionnaire was used to measure perceived stress, and the Brief Resilience Scale was used to measure population resilience. A total of 1,664 participants were included in the study. The mean stress score was reported as 8.72 (SD +/-2.342). Stress, anxiety, and depression were significantly associated with age and sex, with younger populations and female participants reporting higher stress scores. Among the sample, 65.0% of individuals displayed both anxiety and depression indicators, with 25.9% exhibiting severe, 66.4% exhibiting moderate and 33.6% exhibiting mild level. A comprehensive, multi-institutional approach is needed to increase awareness and screening of mental health conditions.

Suicides in Czech Republic, Slovakia, Hungary, and Poland in 1990-2019: Epidemiological Patterns and Trends in European and Global Context

BACKGROUND

Suicides are a major public health problem with serious consequences for societies.

AIM

To compare epidemiological patterns and trends of suicides in the Czech Republic, Slovakia, Hungary, and Poland in 1990-2019, and analyze them in the European and global context.

METHODS

A trend analysis was conducted in Czech Republic, Slovakia, Hungary, Poland, in Western Europe and on global level for 1990-2019. All data were obtained from the Global Burden of Diseases study 2019. Numbers and age-standardized rates of deaths and Years of Life Lost (YLL) due to suicides were analyzed, stratified by sex and age (0-14 years old, 15-49 years old, 50-69 years old, 70+ years).

RESULTS

In 2019, 759,028 suicides occurred globally, 17,408 (2.3%) in Central Europe. The proportion of males was substantially larger, compared to the global and Western European levels (e.g., 82 vs. 69 and 75%, respectively). The highest rates of suicide were in Hungary (19.7 per 100,000), lowest in Slovakia (12.8); the rate in Central Europe was higher than the global rate (15.2 vs. 9.8), and the rate in Western Europe (11.4). A steady decline of rates was observed in all countries, particularly in Hungary. In Czech Republic we found an increasing relative importance of suicides among people 70 years and older.

CONCLUSIONS

Death rates due to suicides have been declining in the analyzed countries, but some characteristics and trends when compared to global and regional estimates, such as substantially higher proportion of male suicides or high death rates among the elderly warrant specifically tailored preventative action coordinated by governments with community involvement.

Resilience of Primary Health Care in Ukraine: Challenges of the Pandemic and War

This commentary examines the resilience of primary health care in Ukraine amidst the ongoing war, drawing a few reflections relevant for other fragile and conflict-affected situations. Using personal observations and various published and unpublished reports, this article outlines five reflections on the strengths, challenges, and necessary adaptations of Primary Health Care (PHC) in Ukraine. It underscores the concerted efforts of the government to maintain public financing of PHC, thereby averting system collapse. The research also highlights the role of strategic adaptations during the COVID-19 pandemic in fostering resilience during the war, including the widespread use of digital communication and skills training. The commentary emphasizes the role of managerial and financial autonomy in facilitating quick and efficient organizational response to crisis. It also recognizes emerging challenges, including better access to PHC services among the internally displaced persons, shifting patient profiles and service needs, and challenges related to reliance on local government financing. Finally, the authors advocate for a coordinated approach in humanitarian response, recovery efforts, and development programs to ensure the sustainability and effectiveness of PHC in Ukraine.

Anxiety among Ukrainian academic staff during wartime

The ongoing war in Ukraine has significantly impacted the mental health of academic staff, with anxiety emerging as a predominant issue. This study aimed to assess the prevalence and severity of generalized anxiety disorder (GAD) among Ukrainian academic staff and determine the influence of sociodemographic factors, such as gender, age, migration status, scientific degree, and job title, on anxiety levels. The research was conducted using a cross-sectional online survey between December 2023 and February 2024. The sample included 429 participants from various Ukrainian universities, representing both male and female academic staff, holding job positions such as assistants, senior lecturers, associate professors, and full professors. The findings revealed that 44.3% of participants experienced moderately severe to severe anxiety, with migration due to the full-scale war being a significant predictor of higher anxiety levels. Notably, male academic staff exhibited higher anxiety levels than their female counterparts, contrary to typical peacetime trends, suggesting that wartime responsibilities and societal expectations may play a crucial role. The data underscore the need for targeted mental health support, particularly for displaced academic staff, and highlight the importance of developing gender-specific interventions. These insights are vital for informing policies and support programs to enhance academic staff's mental health and productivity in conflict zones, ensuring the continuity and quality of scientific research during and after the war.

Assessment of psycho-oncology in the Middle East and North Africa region: a systematic review and meta-analysis

BACKGROUND

The Middle East and North Africa (MENA) region is expected to witness a significant increase in the burden of cancer. Contrary to Western literature, the burden of psycho-oncology is yet to be established within the MENA region. This study reviews all available evidence characterizing the psychological burden among patients with cancer across the MENA region.

METHODS

We systematically explored the PubMed/MEDLINE, Cochrane/CENTRAL, and Web of Science (WoS) databases for reports on the psychiatric burden among patients with cancer residing within the MENA region from January 2000 until January 2023. Raw proportion were extracted and analyzed using a random-effects model.

FINDINGS

Eighty-three studies comprised of 16 810 participants, representing 14 countries, met our inclusion criteria. Across the MENA region, the prevalence of depression, anxiety, and distress were 44% (95% CI, 39%-50%), 47% (95% CI, 40%-54%), and 43% (95% CI, 30%-56%), respectively. Prevalence of depression was significantly different across countries, with Palestine (73%; 95% CI, 42%-91%) reporting the highest rate while Morocco (23%; 95% CI, 7%-56%) reported the lowest. Similarly, anxiety significantly differed across MENA nations ranging from 64% (95% CI, 3%-99%) in Morocco to 28% (95% CI, 18%-42%) in Tunisia. Rates of depression and anxiety were significantly different across measurement tools but not between Arabic-speaking versus Persian/Farsi-speaking countries. Meta-regression models showed that neither publication year nor age affected the prevalence of both anxiety and depression (P = .374 and .091 for depression and P = .627, and .546 for anxiety, respectively).

INTERPRETATION

We report an abnormally high rate of psychiatric burden among patients with cancer in the MENA region. Thus, establishing appropriate psycho-oncologic interventions within the MENA region is of utmost importance.

Associations between mental health symptoms, trauma, quality of life and coping in adults living in Ukraine: A cross-sectional study a year after the 2022 Russian invasion

We aimed to assess the mental health of adults living in Ukraine one year after onset of the Russo-Ukrainian war, along with quality of life and coping strategies. Quota sampling was used to collect online survey data from 2364 adults aged 18-79 years living in Ukraine from April 5, 2023 to May 15, 2023. Among adults living in Ukraine, 14.4 % had probable post-traumatic stress disorder (PTSD), another 8.9 % had complex PTSD (CPTSD), 44.2 % had probable depressive disorder, 23.1 % had anxiety disorder and 38.6 % showed significant loneliness. In adjusted models, the number of trauma events experienced during the war showed a dose-response association with PTSD/CPTSD and was associated with depressive disorder and anxiety disorder. Quality of life domains, particularly physical quality of life, were negatively associated with PTSD/CPTSD, depressive disorder, anxiety disorder, and number of trauma events. Maladaptive coping was positively associated with depressive disorder, anxiety disorder, PTSD/CPTSD and loneliness. All quality of life domains were positively associated with using adaptive coping strategies. Mental health disorders are highly prevalent in adults living in Ukraine one year into the war. Policy and services can promote adaptive coping strategies to improve mental health and quality of life for increased resilience during war.

Resilience, avoidant coping and post-traumatic stress symptoms among female Ukrainian refugees and internally displaced people

BACKGROUND

Since the Russian full-scale invasion of Ukraine, over 10 million Ukrainians have been displaced from their homes. This has contributed to an increase in post-traumatic stress (PTS) symptoms in both refugees and internally displaced persons (IDPs). Previous research has suggested that refugees may experience higher levels of PTS due to additional stressors inherent in migration to a new country, language barriers and separation from family and social support. PTS symptoms may also be exacerbated by avoidant coping which we proposed would be more prevalent amongst refugees because of the isolating effects of migration-related stressors.

AIMS

The present study aimed to investigate the relationship between PTS symptoms, resilience and avoidant coping in refugees and IDPs. We predicted that refugees would report higher levels of PTS symptoms and use of avoidant coping strategies, and that avoidant coping would mediate the effect of resilience on PTS symptoms. We tested a moderated mediation model to examine whether this effect differed between IDPs and refugees.

METHODS

A total of 229 women (108 IDPs and 121 refugees), who were displaced after the full-scale invasion, were recruited using online platforms and volunteering centres. They completed an online questionnaire comprising measures of PTS, resilience and coping.

RESULTS

We found no significant differences in resilience, PTS symptoms or reported use of avoidance coping strategies between refugees and IDPs. As expected, avoidance coping mediated the negative association between resilience and PTS symptoms, but no group differences in this effect were observed.

CONCLUSIONS

Contrary to previous research, our findings indicate that PTS symptoms may be similarly problematic for refugees and IDPs. This may be due to increased time since the invasion as many refugees may have had time to adjust. Use of avoidant coping strategies may exacerbate PTS symptoms and our study highlights the need for mental health interventions aimed at reducing PTS symptoms in Ukrainian IDPs and refugees through fostering resilience and adaptive coping strategies.

Impact of war on stroke incidence in Ivano-Frankivsk, Ukraine

Stroke is an extensive health problem in Ukraine, the prominence and effects of which are aggravated by the burden of the ongoing Russo-Ukrainian War. In this study, we aimed to holistically examine the overall stroke epidemiology in Ivano-Frankivsk using data from a secondary healthcare center in the city. We determine an increasing trend in stroke admissions since 2020, with a notable 22.4% increase in 2023, mainly due to ischemic stroke occurrence. In the same year, a significant non-linear relationship between stroke incidence and frequency of news about attacks was observed. Ordinal regression analysis of general sociodemographic, clinical, and healthcare-related factors influencing outcomes for intravenous thrombolysis-treated patients, revealed the significance of the 24-h National Institutes of Health Stroke Scale score (0.32 ± 0.03) and interaction of age and Door-to-Needle Time (- 0.28 ± 0.08). However, the extension of the latter independently is not significantly correlated with patient outcomes. In conclusion, war-induced stress, intranational migrations, and lack of adequate chronic cardiovascular disease management are primarily responsible for these results. Modulations and improvements to the current healthcare system, including managing chronic diseases and early stroke symptom recognition, are necessary to optimize patient outcomes.

The moderating effect of perceived hope in the relationship between anxiety and posttraumatic growth during the Russian-Ukrainian war

Introduction

This study examines the relationships between perceived hope, posttraumatic growth, well-being, anxiety, and perceived threat of the Russian-Ukrainian War (RUW) in the Czech adult population. Drawing on the evidence of posttraumatic growth (PTG) amidst crisis, we hypothesized that perceived hope moderates the effects of perceived threat of war and anxiety on PTG.

Methods

Data were obtained from 1,000 Czech respondents via an online questionnaire ten months post-invasion. The form included measures of posttraumatic growth, perceived hope, well-being, anxiety and depression, and perceived threat of war.

Results

Our findings reveal that perceived hope acted as a moderator enhancing the positive effects of perceived threat and anxiety on PTG. However, perceived hope did not significantly moderate the direct effects of perceived threats and anxiety on well-being.

Discussion

This study highlights the significant role of hope amidst adversity and underscores its potential as a target for interventions aiming to foster PTG in populations who navigate traumatic experiences. Furthermore, it advocates for continued exploration of the factors interacting to enhance well-being and facilitate PTG in affected communities.

Explaining post-traumatic stress symptoms and sleep disturbance in Ukrainian civilians: perceived threat versus objective war exposure

Objective: This study investigated the impact of war exposure on post-traumatic stress symptoms (PTSS) and sleep disturbance across Ukraine. Subjective and objective indicators of war exposure were modelled as predictors of these symptoms.Methods: We created two predictors: first, we used governmental and crowd-sourced data to create an objective war exposure index for each of the 21 non-occupied regions of Ukraine, based on the number of air raid alarms, explosions, and proximity to frontline; and second, we obtained self-report cross-sectional data, using convenience sampling, from a nation-wide survey (N = 991) on subjective experience of threat triggered by the war. The survey also measured the outcome variables of PTSS and sleep disturbance. Hierarchical multilevel regressions modelled the relationship of this objective war exposure index with the two outcome variables, after accounting for demographics. A final regression step modelled subjective threat as predictor of these symptoms.Results: We observed strongly elevated levels of PTSS and sleep disturbance and strong regional differences in objective and subjective war indicators. Objective war exposure predicted PTSS but not sleep disturbance, whereas subjective threat predicted both symptom domains.Conclusion: The study demonstrates the utility of objective war exposure data for predicting the prevalence of PTSS in the different regions. The results further underscore the prominent role of subjective appraisal processes in the symptomatology of PTSS and sleep disturbance, thus informing theories on trauma-related disorders. Our results can guide the allocation of mental health services by identifying highly affected regions.

War-related stress scale

BACKGROUND

The current war in Ukraine has affected the well-being of people worldwide. In order to understand how difficult the situation is, specific stressors associated with war need to be measured. In response, an inventory of war-related stressors including its short form, has been developed.

METHODS

A list of potential war-related stressors was created, and the content validity of each item assessed. The list, along with other validated scales, was administered to a representative sample of the Slovak population (effective N = 1851). Exploratory factor analysis, confirmatory factor analysis, convergent validity analysis and network analysis were carried out to determine the optimal scale (long and short form) focused on war-related stressors.

RESULTS

The full version of the scale consists of 21 items, further divided into three factors: society-related stressors, person-related stressors, and security-related stressors. The short version of the scale comprises nine items loaded onto one factor. These items cover concerns for one's safety and future, access to necessities, potential worsening of the economic situation, and the risk of conflict escalation, including a nuclear threat. The results of the network analysis indicate that concern about escalation and fear of an economic crisis play a central role.

CONCLUSIONS

The scale attempts to encompass a wide spectrum of areas that are affected by war and its potential consequences on individuals who reside outside the conflict zone. Given the complexity of the issue, researchers are invited to modify the scale, tailoring it to specific cultural, geographical, and temporal contexts.

Integrative attitudes of Ukrainian war refugees in two neighboring European countries (Poland and Hungary) in connection with posttraumatic stress symptoms and social support

Since February 24th, 2022, millions of Ukrainians have sought refuge in other, mainly European countries. Hungary, after Poland, is the second largest host of Ukrainian refugees. Only a portion of them are asylum seekers (~11.0% in Poland and ~ 1.1% in Hungary). The aim of the study is to compare the integrative acculturation attitudes between the war refugees residing in the two European countries. The comparison takes into account both the suffering of posttraumatic stress symptoms and social support. It is the first comparative study of this kind pertaining to the Ukrainian refugees in European countries. The data were obtained by a survey method using the modified CAPI (Computer Assisted Personal Interview) technique. The data analyzed were collected between November 21st and December 20th, 2022 from 728 adult Ukrainian individuals who crossed the borders of Poland and Hungary after February 24th, 2022. The research results show that refugees in Poland perceive significantly more social support and show stronger integrative attitudes than refugees in Hungary. The two samples do not differ regarding the presence of posttraumatic stress. The integrative attitudes proved not to be linked to gender and age, but linked to the host country. Besides social support and the host country, posttraumatic stress also proved to be a significant predictor of integrative attitudes.

Examining terror management theory in Ukraine: impact of air-raid alarms and explosions on mental health, somatic symptoms, and well-being

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.

Is acne vulgaris exacerbated during the military conflict in Ukraine? A self-reported cross-sectional prospective study

Introduction

Acne is a common disease of the pilosebaceous unit. Acne has been reported to be exacerbated by many factors, including psychoemotional stress.

Aim

This study was conducted to assess the clinical severity of acne among acne patients seeking dermatological help in Ukraine during the stressful military conflict and to assess the influence of war on acne exacerbation.

Material and methods

The study group consisted of 143 consecutive acne patients with the mean age of 21.24 ±6.37 years. The severity of acne was measured with the Investigator's Global Assessment (IGA) for acne. The self-reported acne exacerbation was studied with a single question "Have you observed exacerbation of acne during the war?".

Results

Almost 45% of acne patients suffered from moderate to severe acne. The remaining ones had very mild and mild acne. The severity of acne did not differ between the sexes. More than half of patients (50.7%) reported that psychoemotional stress related to the ongoing military conflict exacerbated their acne lesions. No difference was noted in the flare of acne between female and males.

Conclusions

Psychoemotional stress related to war activities exacerbates acne in more than half of patients. A prospective, multicentre study with the assessment of stress and acne flares by physicians will be of help confirming current results.