Depression, anxiety and post-traumatic stress during the Russo- Ukrainian war in 2022: A Comparison of the Populations in Poland, Ukraine and Taiwan

Abstract Background Ukraine has been embroiled in an increasingly war since February 2022. In addition to Ukrainians, the Russo-Ukraine war has affected Poles due to the refugee crisis and the Taiwanese, who are facing a potential crisis with China. We examined the mental health status and associated factors in Ukraine, Poland and Taiwan. The data will be used for future reference as the war is still ongoing. Methods From March 8 to April 26, 2022, we conducted an online survey using snowball sampling techniques in Ukraine, Poland and Taiwan. Depression, anxiety and stress were measured using the Depression, Anxiety and Stress (DASS)-21 item scale; post-traumatic stress symptoms by the Impact of Event Scale-Revised (IES-R) and coping strategies by the Coping Orientation to Problems Experienced Inventory (Brief-COPE). We used univariate and multivariate linear regression to identify factors associated with DASS-21 and IES-R scores. Results There were 1625 participants (Poland: 1053; Ukraine: 385; Taiwan: 188) in this study. Ukrainian participants reported significantly higher DASS-21 (p < 0.001) and IES-R (p < 0.01) scores than Poles and Taiwanese. Although Taiwanese participants were not directly involved in the war, their mean IES-R scores (40.37 ± 16.86) were only slightly lower than Ukrainian participants (41.36 ± 14.94), and Taiwanese were associated with higher IES-R scores (p = 0.029) after adjustment of other variables. Taiwanese reported significantly higher avoidance score (1.60 ± 0.47) than the Polish (0.87 ± 0.53) and Ukrainian (0.91 ± 0.5) participants (p < 0.001). More than half of the Taiwanese (54.3%) and Polish (80.3%) participants were distressed by the war scenes in the media. More than half (52.5%) of the Ukrainian participants would not seek psychological help despite a significantly higher prevalence of psychological distress. Multivariate linear regression analyses found that female gender, Ukrainian citizenship, self-rating health status, past psychiatric history and avoidance coping were significantly associated with higher DASS-21 and IES-R scores after adjustment of other variables (p < 0.05). Conclusion We have identified mental health sequelae in Ukrainian, Poles and Taiwanese with the ongoing Russo-Ukraine war. Risk factors associated with developing depression, anxiety, stress and post-traumatic stress symptoms include female gender, self-rating health status, past psychiatric history and avoidance coping. Early resolution of the conflict, online mental health interventions, delivery of psychotropic medications and distraction techniques may help to improve the mental health of people who stay inside and outside Ukraine.