Parent-child mental health in Ukraine in relation to war trauma and drone attacks

We aimed to address the knowledge gap regarding mental health in Ukrainian children and parents one year after Russia's 2022 full-scale invasion including associations with exposure to drone attacks.

A cross-sectional, quota-sampled survey was conducted among parents of children aged 3-17 in Ukraine one year after the invasion (n = 858). Participants completed self-reported screening measures of the Pediatric Symptom Checklist-17, Child and Adolescent Trauma Screen-Caregiver, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, the International Trauma Questionnaire, and the University of California, Los Angeles (UCLA) 3-Item Loneliness Scale. We analyzed scores in relation to drone attack exposure using logistic regression.

Many children aged 3-6 years had scores suggestive of ADHD (24.2 %), conduct disorder (20.5 %), and anxiety/mood disorder (12.1 %). Results were similar among children aged 7-17 (anxiety/mood disorder: 24.1 %, conduct disorder: 14.5 %, and ADHD: 14 %). Of the 45.0 % of children aged 3-6 and 57.0 % aged 7-17 exposed to post-invasion trauma, 21.8 % and 17.6 % had clinically relevant levels of PTSD symptoms, respectively. Parental symptoms met screening criteria for depressive disorder in 46.7 % and for anxiety disorder in 24.2 %. All parents reported post-invasion trauma, with 24.5 % screening positive for PTSD. Child mental health disorder odds increased with parental PTSD (OR 1.85, 95 %CI 1.29-2.72) and symptoms meeting screening criteria for depressive disorder (OR 1.99, 95 %CI 1.15-2.56). The odds of children aged 7-17 having clinically relevant levels of PTSD symptoms increased with parental symptoms screening positive for depressive disorder (OR 6.0, 95 %CI 2.0-18.3), anxiety disorder (OR 3.48, 95 %CI 1.76-6.8), and PTSD (OR 3.23, 95 % 1.67-6.2). Parents had a higher prevalence of screening positive for PTSD in high-intensity drone attack regions (28.9 %) than low- and moderate-intensity regions (25.0 % and 20.5 %, respectively, p = 0.04).

The high prevalence of children and parents in Ukraine with symptoms screening positive for mental disorders indicates an urgent need for services for school-age children and parents in this war-affected region. High-intensity drone attacks increase the risk of parents screening positive for PTSD.