ICD-11 PTSD and Complex PTSD Among Internally Displaced Civilian Outpatients in Ukraine During Wartime

Since the 2022 full-scale invasion of Ukraine, civilians have experienced substantial war-related trauma, yet little is known about the prevalence and risk factors of ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD) among internally displaced persons (IDPs) actively seeking medical or psychological care.

To examine the prevalence of PTSD and CPTSD in a clinical sample of Ukrainian IDPs, compare diagnostic rates between psychological and medical treatment-seekers, and identify sociodemographic and war-related predictors of diagnostic outcomes.

A total of 224 adult IDPs attending an outpatient clinic in Chernivtsi oblast completed the International Trauma Questionnaire. Descriptive statistics, bivariate analyses, and multinomial logistic regression models were used to assess prevalence and identify predictors of PTSD and CPTSD.

In the full sample, 24.5% met criteria for ICD-11 PTSD and 7.6% for CPTSD. Among psychological treatment-seekers, prevalence was higher (PTSD: 28.3%; CPTSD: 9.0%) compared to those seeking exclusively medical care (PTSD: 13.8%; CPTSD: 3.4%). Losing someone close due to the war significantly predicted both PTSD and CPTSD in the final multivariable model, while male gender independently predicted CPTSD.

PTSD rates in this sample were broadly comparable to global estimates for conflict-affected populations, whereas CPTSD prevalence appeared lower than that reported in other Ukrainian samples. Relocation to safer areas within one's own country-without the additional stressors associated with forced international migration-together with the relatively older age of the sample, may have contributed to a reduced CPTSD risk. Sociocultural expectations surrounding masculine roles during wartime might also play a role in male vulnerability to CPTSD, though further evidence is needed. Individuals bereaved by the war may represent a subgroup at heightened risk, highlighting the potential value of targeted psychosocial support. Longitudinal, multi-site studies with diverse samples are needed to clarify symptom trajectories and contextual risk factors in displaced civilians.