How war shapes daily physical health - A unique pre-post dataset

Despite the established link between trauma and physical health, no prior study has prospectively tracked changes in physical health before and during wartime in civilians, who are often overlooked in war-related trauma research.

This study addresses this gap by assessing 74 civilian participants across two pre-war baseline periods and wartime, tracking physical symptoms and war-related psychological distress. To examine whether physical symptom burden changed during the war compared to two assessments pre-war, we performed paired t-tests. To examine whether war-related psychological distress predicted wartime physical symptoms beyond pre-war physical symptom levels, we conducted hierarchical regression analyses.

Physical symptom burden significantly increased from pre-war to wartime (baseline 1 vs. wartime; p = .008, Cohen's d = 0.29, baseline 2 vs. wartime; p = .018, Cohen's d = 0.29), with no significant change between the two pre-war baselines (p = .353). The increased health burden was mainly due to the emergence of new symptoms rather than exacerbations of existing ones. During wartime, a significant proportion of participants exhibited elevated symptoms of depression (43.8%), anxiety (32.8%), and post-traumatic stress (32.8%). War-related psychological distress significantly predicted increased physical symptoms beyond baseline levels (β = 0.49, p < .001), explaining 18.2% of the variance.

This study, though modest in size, provides unique insights into how war-related trauma may impact civilians' everyday physical health, with potential implications for mechanisms and interventions to promote the long-term well-being of civilians in conflict zones.