Research on depression, anxiety, post-traumatic stress and sleep disturbances among civilian and military populations during the war in Ukraine
DOI:
https://doi.org/10.14739/2310-1210.2026.2.347730Keywords:
depression, anxiety, post-traumatic stress disorder, sleep, sleep quality, civilians, military personnelAbstract
Aim. To determine the characteristics of depression, anxiety, post-traumatic stress disorder (PTSD), and sleep disturbances among civilian and military populations during the war in Ukraine.
Materials and methods. The study included 81 civilians (63 women and 18 men), predominantly residents of frontline regions, and 25 military personnel (all men). The survey was conducted in March 2025. The following standardized questionnaires were used: PHQ-9, GAD-7, PSQI, PC-PTSD-5.
Results. Median depression scores corresponded to a moderate level among civilians and a mild level among military personnel, while anxiety levels in both groups were within the mild range. The median PTSD screening score indicated the absence of clinically significant symptoms; however, the global sleep quality index in both groups fell within the range of poor sleep quality. No statistically significant differences were found between civilians and military personnel in levels of depression, anxiety, PTSD symptoms, or overall sleep quality. Among civilians, women and unmarried participants demonstrated higher levels of depression, anxiety, and PTSD symptoms. Analysis of sleep components revealed shorter sleep duration in military personnel, whereas civilians exhibited more pronounced daytime dysfunction. In civilians, clinically significant depression was associated with an increased risk of poor sleep quality (RR = 1.98; OR = 9.39; p < 0.01), and PTSD symptoms were associated with higher relative risk and odds of poor sleep (RR = 1.49; OR = 5.11; p < 0.05). No statistically significant predictors of poor sleep quality were identified among military personnel. Significant positive correlations between depression, anxiety, PTSD symptoms, and sleep quality were observed in both groups.
Conclusions. No statistically significant differences in depression, anxiety, PTSD symptoms, or sleep disturbances were identified between civilian and military populations during wartime. Social and demographic factors influenced psycho-emotional status only among civilians, with higher levels of depression, anxiety, and PTSD symptoms observed in women and unmarried individuals. Military personnel exhibited shorter sleep duration, whereas civilians demonstrated more pronounced daytime dysfunction. Depression and PTSD symptoms were the primary factors associated with poor sleep quality among civilians.
References
Charlson F, van Ommeren M, Flaxman A, Cornett J, Whiteford H, Saxena S. New WHO prevalence estimates of mental disorders in conflict settings: a systematic review and meta-analysis. Lancet. 2019;394(10194):240-8. doi: https://doi.org/10.1016/S0140-6736(19)30934-1
Yuan XL, Wang CY. Sleep deprivation-induced cognitive impairment: Unraveling the role of neuroinflammation. Exp Neurol. 2025;394:115419. doi: https://doi.org/10.1016/j.expneurol.2025.115419
Ma Y, Liang L, Zheng F, Shi L, Zhong B, Xie W. Association Between Sleep Duration and Cognitive Decline. JAMA Netw Open. 2020;3(9):e2013573. doi: https://doi.org/10.1001/jamanetworkopen.2020.13573
Moroziuk K. [Sleeping Disorders due to the Distress of War]. Psychosomatic Medicine and General Practice. 2023;8(2). Ukrainian. doi: https://doi.org/10.26766/pmgp.v8i2.428
Shevlin M, Hyland P, Karatzias T, Makhashvili N, Javakhishvili J, Roberts B. The Ukraine crisis: Mental health resources for clinicians and researchers. J Trauma Stress. 2022;35(3):775-7. doi: https://doi.org/10.1002/jts.22837
Wang S, Hicks MH, Barrett E, Martsenkovskyi D, Holovanova I, Marchak O, et al. Sleep Duration, Insomnia, and Associated Factors Among Ukrainians 1 Year After Russia's Full-Scale Invasion. Psychosom Med. 2024;86(8):690-9. doi: https://doi.org/10.1097/PSY.0000000000001337
Yasenok V, Baumer AM, Petrashenko V, Kaufmann M, Frei A, Rüegger S, et al. Mental health burden of persons living in Ukraine and Ukrainians displaced to Switzerland: the mental health assessment of the Ukrainian population (MAP) studies. BMJ Glob Health. 2025;10(8):e019557. doi: https://doi.org/10.1136/bmjgh-2025-019557
Saguin E, Feingold D, Sipahimalani G, Quiquempoix M, Roseau JB, Remadi M, et al. PTSD Symptom Severity Associated With Sleep Disturbances in Military Personnel: Evidence From a Prospective Controlled Study With Ecological Recordings. Depress Anxiety. 2025;2025:8011375. doi: https://doi.org/10.1155/da/8011375
Obuobi-Donkor G, Oluwasina F, Nkire N, Agyapong V. A Scoping Review on the Prevalence and Determinants of Post-Traumatic Stress Disorder among Military Personnel and Firefighters: Implications for Public Policy and Practice. Int J Environ Res Public Health. 2022;19(3):1565. doi: https://doi.org/10.3390/ijerph19031565
The Universal Declaration on Bioethics and Human Rights. Int Soc Sci J. 2005;57:745-53. doi: https://doi.org/10.1111/j.1468-2451.2005.00592.x
World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-4. doi: https://doi.org/10.1001/jama.2013.281053. PMID: 24141714.
Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-13. doi: https://doi.org/10.1046/j.1525-1497.2001.016009606.x
Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092-7. doi: https://doi.org/10.1001/archinte.166.10.1092
Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213. doi: https://doi.org/10.1016/0165-1781(89)90047-4
Prins A, Bovin MJ, Smolenski DJ, Marx BP, Kimerling R, Jenkins-Guarnieri MA, et al. The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5): Development and Evaluation Within a Veteran Primary Care Sample. J Gen Intern Med. 2016;31(10):1206-11. doi: https://doi.org/10.1007/s11606-016-3703-5
Torres D, Normando D. Biostatistics: essential concepts for the clinician. Dental Press J Orthod. 2021;26(1):e21spe1. doi: https://doi.org/10.1590/2177-6709.26.1.E21SPE1
Mukaka MM. Statistics corner: A guide to appropriate use of correlation coefficient in medical research. Malawi Med J. 2012;24(3):69-71.
Martsenkovskyi D, Shevlin M, Ben-Ezra M, Bondjers K, Fox R, Karatzias T, et al. Mental health in Ukraine in 2023. Eur Psychiatry. 2024;67(1):e27. doi: https://doi.org/10.1192/j.eurpsy.2024.12.
Trautmann S, Goodwin L, Höfler M, Jacobi F, Strehle J, Zimmermann P, et al. Prevalence and severity of mental disorders in military personnel: a standardised comparison with civilians. Epidemiol Psychiatr Sci. 2017;26(2):199-208. doi: https://doi.org/10.1017/S204579601600024X
Li L, Wu C, Gan Y, Qu X, Lu Z. Insomnia and the risk of depression: a meta-analysis of prospective cohort studies. BMC Psychiatry. 2016;16(1):375. doi: https://doi.org/10.1186/s12888-016-1075-3
Hertenstein E, Feige B, Gmeiner T, Kienzler C, Spiegelhalder K, Johann A, et al. Insomnia as a predictor of mental disorders: A systematic review and meta-analysis. Sleep Med Rev. 2019;43:96-105. doi: https://doi.org/10.1016/j.smrv.2018.10.006
Alfadul E, Alrawa S, Hemmeda L, Adam A, Mohamed Salih Mohamed Nour S, Ebrahim Hamed Saeed N, et al. Effect of military conflict on mental health: a cross-sectional study among the medical students at Khartoum governmental universities, Sudan, 2023. BMJ Open. 2025;15(3):e086495. doi: https://doi.org/10.1136/bmjopen-2024-086495
Downloads
Additional Files
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 V. V. Ogorenko, V. O. Kokashynskyi, Yu. D. Zeltser
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. 
