Peculiarities of the course and management of Ukrainians with post-traumatic stress disorder in the context of the Ukrainian-Russian war

Peculiarities of the course and management of Ukrainians with post-traumatic stress disorder in the context of the Ukrainian-Russian war | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Peculiarities of the course and management of Ukrainians with post-traumatic stress disorder in the context of the Ukrainian-Russian war Liudmyla Kiro, Alina Urbanovych, Maksym Zak This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4691182/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 29 Oct, 2024 Read the published version in BMC Psychology → Version 1 posted 4 You are reading this latest preprint version Abstract Background The amount of Ukrainians with PTSD has been steadily increasing since December 2022. According to the National Health Service, amount of Ukrainians with posttraumatic-stress disorder (PTSD) in 2021 were 3,167 patients; 2022 — 7,051 patients; 2023 — 12.494 patients; 2024 (January-June) — 6,292, and for the forecasts of WHO, it will continue to increase rapidly. Methods The study involved 450 patients who sought psychological help at the University Clinic of Petro Mohyla Black Sea National University from January to June 2024. All patients were divided into 3 groups: 1st group — patients with PTSD (18–44 years); 2nd group — patients with PTSD (45–59 years), 3rd group — patients with PTSD (60–74 years). The examination of patients included clinical, psychological, questionnaire survey for CAPS-5 scale, SDS — 2000, and static methods. Results In 2nd group, mild and moderate course of PTSD among women were occurred in 2.0 (χ 2 = 0.86, p = 0.001) and 2.2 (χ 2 = 0.46, p = 0.023) times more often than in male. While severe and extreme course of PTSD in male of 2nd group were recorded in 1.6 (χ 2 = 0.16, p = 0.033) and 1.8 (χ 2 = 0.99, p = 0.006) times more often than in female patients. Conclusions Examination of patients found that, men have a greater resistance to the risk of developing a disorder in the long term in response to stressors than women, but when the disorder develops, men tend to have more severe manifestations. In women, in the long term after severe mental trauma, the risk of developing PTSD is higher, but the intensity of clinical and psychological manifestations of the disorder is less pronounced. Registration The study was carried out in accordance with the plan of research works at the Petro Mohyla Black Sea National University (Adress: 68 Desantnykiv St, 10, Mykolaiv, Ukraine, 54000) on the topic: “Clinical-pathogenetic justification of the system of primary and secondary prevention of the most socially significant chronic non-infectious diseases of internal organs”, state registration number 0120U101641. Date of registration: 17.03.2021 Duration of research: 03.2021-12.2024 Post-traumatic stress disorder Migration Refugees Cognitive-behaviour therapy Russian - Ukrainian war Background War is always a risk to health, particularly mental health. Post-traumatic stress disorder (PTSD) usually develops in 12–20% of people who have experienced or witnessed life-threatening events– themselves or loved ones [‎ 1 , ‎2 ]. Most often, they appear during the first three months after a traumatic event. According to expert estimates, PTSD is noted in 6–8% of the population in general [ ‎3 ]. At the same time, the frequency of detection of PTSD in certain population groups that have suffered severe psychological trauma is much higher. For example, combat veterans, emergency responders who have responded to natural disasters/terrorist attacks, displaced persons, and survivors of attacks may have a much higher risk of developing PTSD, reaching experts' assessments. According to the Ministry of Health of Ukraine, after the large–scale invasion of Russia in Ukraine, more than 50% of Ukrainians began to complain: hyperexcitement and irritability; memory problems; inability to control one's emotions; sleep disturbance - inability to fall asleep or wake up on time; headaches; obsessive thoughts and feelings of fear when having to remember a traumatic event [‎ 4 ]. The amount of PTSD patients has been steadily increasing since December 2022. According to the National Health Service, in 2021, 3,167 patients with this diagnosis were registered in the system. In the following years, the statistics look like this: 2022 — 7,051 patients; 2023 — 12,494 patients; As of June 6, 2024, the number has already reached 6,292, and according to the forecasts of the Ministry of Health of Ukraine, it will continue to increase rapidly [‎ 5 , ‎ 6 ]. The most frequent events that lead to the development of PTSD include: combat operations; physical abuse in childhood; sexual violence; physical attack (causing bodily harm); threat with a weapon; forced migration; accident) war-related disasters affecting mental health. hereditary factors, such as a family history of anxiety and depression; temperament; features of physiology (for example, the production of hormones in response to stress). Ukraine is in its third hour of war, and security risks continue to weigh on Ukrainians who live permanently in a state of forced search for a possible country for migration. A number of studies have shown that about 36% of refugees have post-traumatic syndrome. The Ukrainian refugee crisis is the biggest refugee crisis and the largest migration crisis in the world in the 21st century [‎ 7 , ‎ 8 ]. The ongoing large-scale refugee crisis in Europe, caused by the invasion of Russian troops into Ukraine as part of the Russian-Ukrainian war, which began on February 24, 2022 [ ‎9 , ‎ 10 ]. By March 20, 2022, more than ten million people left their homes in Ukraine — about a quarter of the country's entire population. Due to the restriction on leaving Ukraine for men of conscription age from 18 to 60 years old, 90% of Ukrainian refugees are women and children [‎ 11 ]. According to UNICEF, by March 24, 2022, more than half of all children in Ukraine (approximately 7.5 million) were forced to leave their homes, of which approximately 1.8 million became refugees in other countries [‎ 12 ]. Russia's invasion of Ukraine unleashed the largest refugee crisis in Europe since the Second World War and its aftermath, the first such crisis in Europe since the Yugoslav wars of the 1990s, and the largest migration crisis in the world in the 21st century, with the highest rate of flight refugees in the world. The main directions of refugee migration are neighboring countries to the west of Ukraine: Russia, Poland, Romania, Hungary, Moldova, Slovakia, the Czech Republic and Germany. At the same time, Poland accepted more refugees from Ukraine than all other neighboring countries combined (as of December 13, 2022 — more than 8.2 million). Some refugees then moved further west: to other European countries or outside the EU. Belarus and Russia accepted part of the immigrants (more than 2.9 million people) [‎ 13 , ‎ 14 , ‎ 15 ]. More than half of the world’s refugees are under the age of 18. Child refugees are at higher risk of developing PTSD and other mental health problems than adult refugees. This may be explained by their greater exposure to traumatic events, especially when the child is separated from their parents/caregivers. The severity of PTSD in their parents or caregivers also has some impact on the mental health of child refugees. Analysis of the results of epidemiological studies shows that susceptibility to PTSD correlates with certain mental disorders that either arise as a consequence of the trauma or are present from the start. These disorders include: anxiety neurosis; depression; suicidal ideation or attempts; drug, alcohol or drug addiction; psychosomatic disorders; cardiovascular diseases. Data indicate that 50–100% of patients suffering from PTSD have one of the listed comorbidities, and most often two or more [ ‎16 , ‎ 17 ]. In addition, a high rate of suicide or suicide attempts is especially problematic in patients with PTSD. The aim of this study was to determine the structure of PTSD depending on the gender and age characteristics of patients, social factors and methods of its correction in the conditions of war on the territory of Ukraine. Methods Dataset, study population The study involved 450 patients (224 (49.7%) men and 226 (50.3%) women) who sought psychological help at the University Clinic of Petro Mohyla Black Sea National University from January to June 2024. The patients' age ranged from 18 to 74 years, the average age was 46 ± 1.2 years. All patients were divided into 3 groups: 1st group - patients with PTSD (from 18 to 44 years, average age 31.0 ± 2.5 years); 2nd — patients with PTSD (from 45 to 59 years, average age 52.0 ± 3.5 years), 3rd group — patients with PTSD (from 60 to 74 years, average age 67.0 ± 2.8 years). The work used clinical, psychopathological, and statistical research methods. The sample included respondents with features meeting the diagnostic criteria for PTSD (DSM-V). The necessary condition for inclusion of respondents in the study was: patients were exposed to, participated in, witnessed or faced with a traumatic event (events) that included death or threat of death, or threat of serious injury, or threat to the physical integrity of others (or one's own); the individual's reaction included intense fear, helplessness or horror; or the presence of agitated or disorganized behaviour; the traumatic event is persistently repeated in the experience in one (or more) of the following ways: repetitive and intrusive reproduction of the event, corresponding images, thoughts and perceptions, causing severe emotional distress; recurrent distressing dreams about the event. Persistent avoidance of stimuli associated with the trauma; persistent symptoms of increasing arousal (which were not observed before the trauma). Defined by the presence of at least two of the following symptoms: difficulty falling asleep or poor sleep (early awakenings); irritability or angry outbursts; difficulty concentrating; increased alertness, hypervigilance, constant expectation of threat; exaggerated fear response. Duration of the disorder is more than 1 month. The disorder, according to patients, causes clinically significant severe emotional state or impairment in social, professional or other important areas of life. The criteria for exclusion from the sample were the presence of a verified endogenous disorder and organic brain damage of various etiology with manifestations of psychoorganic syndrome, lack of memories of trauma; history of psychosis; current alcohol or drug addiction; borderline personality disorder; acute suicidal risk. Definitions Evaluation of PTSD was determined using the following diagnostic scales: 1.Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), which assesses the frequency and severity of each of the PTSD symptoms listed in the DSM-V [‎ 18 ]. The scale results were interpreted as follows: 0) Absent: The respondent denied the problem or the respondent's report doesn't fit the DSM-5 symptom criterion. 1) Mild / subthreshold: The respondent described a problem that is consistent with the symptom criterion but isn't severe enough to be considered clinically significant. The problem doesn't satisfy the DSM-5 symptom criterion and thus doesn't count toward a PTSD diagnosis. 2) Moderate / threshold: The respondent described a clinically significant problem. The problem satisfies the DSM-5 symptom criterion and thus counts toward a PTSD diagnosis. The problem would be a target for intervention. This rating requires a minimum frequency of 2 x month or some of the time (20–30%) PLUS a minimum intensity of Clearly Present. 3) Severely / markedly elevated: The respondent described a problem that is above the threshold. The problem is difficult to manage and at times overwhelming, and would be a prominent target for intervention. This rating requires a minimum frequency of 2 x week or much of the time (50–60%) PLUS a minimum intensity of Pronounced. 4) Extreme/ incapacitating: The respondent described a dramatic symptom, far above threshold. The problem is pervasive, unmanageable, and overwhelming, and would be a high-priority target for intervention. 2. The Sheehan Disability Scale (SDS, 2000) assesses disability in four domains of home management, work responsibilities, close relationships and social life [‎ 19 ]. Statistic analysis Statistical processing of the research results was carried out by the methods of variation statistics implemented by the standard package of application programs SPSS 13.0 for Windows (USA). Quantitative indicators were checked for normality of data distribution using the Shapiro-Wilk test and are presented in the form (M ± m), where M is the mean value, m is the standard error. Qualitative data are presented in the form of absolute and relative frequencies. Differences between groups were evaluated using the Student's test for independent samples, between subgroups in the dynamics of treatment – using the Student's test for dependent samples. The Pirson (χ 2 ) test was used to compare discrete values. To determine the functional relationships between the parameters, Spearman's non-parametric correlation coefficients (r) were calculated. The strength of the connection was interpreted as follows: very weak – 0–0.3; weak – 0.3– 0.5; medium strength – 0.5–0.7; strong – 0.7– 0.9; very strong – 0.9 − 1.0.The results were considered statistically reliable with a probability of error of less than 5% (p < 0.05). Results During the study, it was recorded that mild and moderate PTSD in female patients of 2nd group occurred in 2.0 (χ 2 = 0.86, p = 0.001) and 2.2 (χ 2 = 0.46, p = 0.023) times more often than in male patients. While severe and Extreme PTSD in male patients of 2nd group were recorded in 1.6 (χ 2 = 0.16, p = 0.033) and 1.8 (χ 2 = 0.99, p = 0.006) times more often than in female patients (Table 1). Таble 1 Severity of post-traumatic stress disorders (PTSD) among Ukrainians during January-June 2024 Severity of PTSD Patients with a clinical diagnosis of PTSD, n = 450 1st group 2nd group 3rd group men, n = 75 women, n = 75 men, n = 75 women, n = 75 men, n = 74 women, n = 76 n(%) n(%) n(%) n(%) n(%) n(%) A mild PTSD 9(12.0%) 13(17.3%) 11(14.6%) 22(29.3%) 10(13.5%) 14(18.5%) Moderate PTSD 16(21.3%) 19(25.3%) 9(12.2%) 20(26.7%) 10(13.5%) 12(15.9%) Severe PTSD 32(42.7%) 27(36.0%) 30(40.1%) 19(25.3%) 29(39.1%) 25(32.8%) Extreme PTSD 18(24.0%) 16(21.4%) 25(33.4%) 14(18.7%) 25(33.9%) 25(32.8%) A detailed analysis of the PTSD structure revealed that in the age category from 18 to 44 years, the dysphoric type of PTSD was recorded in 16 (20.4%) men and 22 (29.3%) women; at the age from 60 to 74 – in 8 (10.2%) men and 12 (15.8%) women. In the middle age category among female patients of 2nd group aged, asthenic and somatophoric types of PTSD were recorded in 3.0 (χ 2 = 0.11, p = 0.022) and 2.1 (χ 2 = 0.06, p = 0.004) times more often than in men. While in men of 2nd groups: dysphoric and severe types of PTSD were recorded in 2.6 (χ 2 = 0.01, p = 0.012) and 2.1 times (χ 2 = 0.99, p = 0.003) more often than among women of the same age category (Table 2 ). Table 2 Types of PTSD among Ukrainians depending on the gender and age characteristics of patients Types of PTSD Patients with a clinical diagnosis of PTSD, n = 450 1st group 2nd group 3rd group men, n = 75 women, n = 75 men, n = 75 women, n = 75 men, n = 74 women, n = 76 n(%) n(%) n(%) n(%) n(%) n(%) Severe type of PTSD 26(34.6%) 19(25.3%) 29(+ 38.6%) 14(18.6%) 11(14.8%) 14(18.4%) Asthenic type of PTSD 15(20.5%) 27(36.0%) 10(13.4%) 30(+ 40.0%) 31(41.8%) 30(39.4%) Dysphoric type of PTSD 16(20.4%) 22(29.3%) 26(+ 34.6%) 10(13.4%) 8(10.2%) 12(15.8%) Somatoform type of PTSD 18(24.5%) 7(9.4%) 10(13.4%) 21(+ 28.0%) 24(33.2%) 20(26.4%) PTSD had a negative impact on all areas of life of the subjects and had its own characteristics depending on gender factors. Among the men in the 1st group: 27 (36.0%) men reported a decrease in work responsibilities; 28 (37.3%) – problems in communication with females; 11 (14.7%) individuals reported a decrease in social activity; 9 (12%) complained of the inability to manage the household. Among the female patients, the inability to manage the household was recorded in 20 (26.7%); problems in close relationships were noted by 22 (29.3%); decrease of work responsibilities – in 19 (25.3%); declining quality of social life – 14 (18.7%), (Table 1). Among the 2nd group: 30 (40.0%) men reported a decrease in work responsibilities; 14 (18.6%) – problems in communication with females; 20 (26.8%) individuals reported a decrease in social activity; 11 (14.6%) inability to do home management. Among female patients, inability to do housework was recorded in 19 (25.5%); problems in close relationships were noted by 23 (30.6%); decreased work responsibilities – in 11 (14.6%); declining quality of social life – 22 (29.3%), (Table 2 ). Among the 3rd group: 24 (32.4%) men noted a decrease in work responsibilities; 7 (9.5%) –the problems in communication with women; 36 (48.6%) individuals noted a decrease in social activity; 7 (9.5%) – inability to manage housework. Among female patients, inability to do housework was recorded in 25 (32.3%); problems with close relationships were noted by 15 (19.7%); decreased work responsibilities – in 9 (11.8%); declining quality of social life–27 (35.5%) (Table 3 ). Table 3 Distribution of patients with PTSD according to the Sheehan Disability Scale (SDS, 2000) Impact on social life Patients with a clinical diagnosis of PTSD, n = 450 1st group 2nd group 3rd group men, n = 75 women, n = 75 men, n = 75 women, n = 75 men, n = 74 women, n = 76 n(%) n(%) n(%) n(%) n(%) n(%) Home management 9(12.0%) 20(26.7%) 11(14.6%) 19(25.5%) 7(9.5%) 25(32.3%) Work responsibilities 27(36.0%) 19(25.3%) 30(40.0%) 11(14.6%) 24(32.4%) 9(11.8%) Close relationships 28(37.3%) 22(29.3%) 14(18.6%) 23(30.6%) 7(9.5%) 15(19.7%) Declining quality of social life 11(14.7%) 14(18.7%) 20(26.8%) 22(29.3%) 36(48.6%) 27(35.5%) Discussion The development of PTSD among Ukrainians is result of the body's response to trauma, and the activation of the stress reaction, including neurochemical and neuroendocrine processes. Adrenaline and norepinephrine play an important role, mobilizing the body to fight or avoid. During traumatic events, high levels of stress hormones reduce the activity of the hypothalamus, which can subsequently cause stress disorder. PTSD inevitably leads to biochemical changes in the brain. Patients have low cortisol levels and high catecholamine production. Also, people suffering from the disorder have chronically low serotonin levels, which causes appropriate behaviour: anxiety, increased irritability, aggression, outbursts of anger and suicidal thoughts. The scenario of the clinical picture of PTSD among Ukrainians, according to J. Wilson, is similar to that during the Vietnam War [‎ 20 , ‎ 21 ]. The famous American psychiatrist Abram Kardiner in 1941, while studying this problem, called the changes caused by stress during an armed conflict, chronic war neurosis [‎ 22 , ‎ 23 ]. That is why the symptoms of the disease have a similar clinical picture in our time and include complaints of patients about: excitability and irritability; fixation on the traumatic circumstances of past events; predisposition to aggression and inability to control it; escape from reality; acute reaction to sudden irritants. The prevalence of PTSD among the population depends on the frequency of traumatic events. Thus, we can talk about injuries typical for certain political regimes, geographic regions in which natural disasters occur especially often, etc. In the 90s, the incidence of PTSD increased significantly: if in the 80s they corresponded to 1–2%, then in recent studies published in the USA, 7.8%, and there are pronounced gender differences (10.4% for women, 5.0% for men) [ ‎24 , ‎ 25 , ‎26 ]. Examination of individuals from the risk group (for example, Vietnam veterans, and victims of volcanic eruptions or criminal violence) gave an obvious increase in the prevalence of the diagnosis from 3–58% [‎ 27 , ‎28 , ‎29 ]. The intensity of the psychotraumatic situation is a risk factor for the development of PTSD. Other risk factors are: low level of education, social status; psychiatric problems preceding the traumatic event; the presence of close relatives suffering from psychiatric disorders, chronic stress. It should be noted that quite often individuals with PTSD experience secondary traumatisation, which usually occurs as a result of negative reactions of other people, medical personnel and social workers to the problems faced by people who have experienced trauma. Negative reactions manifest themselves in denial of the very fact of trauma, the connection between trauma and the individual’s suffering, blaming and even vilifying victims, and refusal to provide assistance. In other cases, secondary traumatisation can occur as a result of overprotection of victims, around whom those around them create a “traumatic membrane” that isolates them from the outside world, removing them from the influence of the stressors of everyday life. Millions of people exposed to war-related stressors experience mental health disorders, including post-traumatic stress disorder. Certainly, pre-migration traumatic experiences, such as those directly related to war and conflict, are important predictors of negative mental health outcomes. At the same time, a range of migration-specific stressors play a very important role for refugees and asylum seekers. Among them, socio-economic factors (i.e. unemployment or underemployment, financial constraints/poverty, lack of secure housing), social and interpersonal factors (i.e. family separation, lack of family and friend support, change in previous social role, social isolation, discrimination, loss of social identity, lack of social support, gender role change), factors related to the asylum process and immigration policies (i.e. mandatory detention, long processing times, lack of access to legal services) are of paramount importance. The consequences of post-traumatic stress disorder depend on the type they belong to. The study identified four types of PTSD: severe; asthenic; dysphoric, somatoformat. The results of the study recorded that the severe form of PTSD was observed more often in men, and was accompanied by unreasonable anxiety, constant worries; patients have sleep disturbances, insomnia, nightmares at night, panic attacks.. The asthenic type was recorded more often in women and is accompanied by lethargy, bad mood, and indifference to everything that surrounds a person. The patient oppresses himself, because he believes that he cannot return to normal life. Apathy leads to the fact that a person begins to lose physical shape, it comes to the point that it is difficult for him to get out of bed. Patients prefer daytime sleep, quickly agree to treatment. Dysphoric type is a complex form, manifested by aggression, touchiness, anxiety, distrust of others. Such people like to conflict, are difficult to treat, in rare cases they voluntarily agree to treatment. The study registered that this type was more often recorded in men. The somatoform type, like the asthenic type, was recorded in female patients. And it was accompanied not only by a psychological disorder, but also by other symptoms, for example, patients complain of pain in the heart and abdomen, headaches. The difficulty of this type is that the symptoms do not appear immediately, they can make themselves known after six months from the incident. If desired, the patient can express a desire to see a doctor. These differences are probably due to biochemical and hormonal differences in patients of different sexes. In wartime conditions, general principles of PTSD therapy should include: the principle of normalization – the therapist explains to the patient that his symptoms are a reaction of the normal psyche to an abnormal situation; the principle of partnership and enhancing the dignity of the individual, which is especially important for victims of violence; the principle of individuality– taking into account the fact that the post-traumatic process is very complex, and there are no general principles of therapy suitable for all patients; an interdisciplinary approach with the use, if necessary, of medications, physical exercise and a healthy diet, reading inspiring literature, providing social assistance, etc. The therapeutic approach depends on the severity of PTSD: Uncomplicated PTSD. This type of PTSD responds well to pharmacotherapy targeting the symptoms of PTSD and many types of short-term trauma-focused psychotherapy. PTSD accompanied by comorbid disorders of a transient nature (addictions, anxiety disorder, depression), which is more common than the previous option. In some cases, comorbid disorders become a more important problem for the patient than PTSD. PTSD therapy should simultaneously address the comorbid disorder. “Post-traumatic personality disorder” (e.g., borderline personality disorder, somatophoric disorder, and dissociative disorder), which often results from prolonged psychological trauma in childhood (e.g., sexual abuse). This type of PTSD is often accompanied by behavioural problems (impulsivity, anger reaching rage, aggression and self-aggression, problems with sexual behaviour, eating disorders), emotional instability, emotional impoverishment, depression, panic disorders, cognitive problems (for example, amnesia or fragmentation of memories). Dissociation is often observed. This type of PTSD requires long-term therapy, including the development of emotion regulation skills and communication skills (especially in the area of ​​family relationships), treatment of addictions, and the development of skills necessary for employment. During therapy, it is necessary to create a sense of security in the patient before the therapist can move on to working on the trauma. The methods with the most evidence base for assessing the effectiveness of PTSD are recognized as trauma-focused cognitive behavioural therapy (TF-CBT), including its individual variants, such as cognitive psychotherapy, cognitive-process psychotherapy, cognitive psychotherapy, prolonged exposure CBT, narrative exposure psychotherapy, as well as eye movement desensitization and reprocessing of mental trauma (EMDR) [‎ 30 ]. TF-CBT consists of three main stages: stabilization, reprocessing (cognitive processing and narrative), integration and consolidation, with a total of 20 sessions of 15–18, evenly divided between 3 blocks. Among the targets of TF-CBT are affective/emotional, cognitive, behavioural, and biological. Cognitive psychotherapy is highly effective, lasting 15–20 sessions, which are held weekly individually and/or in a group to modify pessimistic and catastrophic assessments and memories associated with psychological trauma in order to overcome behavioural and cognitive patterns that support avoidance and interfere with normal daily functioning. The main goal of therapy is to modify pessimistic and catastrophic assessments and memories associated with psychological trauma in order to overcome behavioural and cognitive patterns that support avoidance and interfere with normal daily functioning. Under the guidance of a psychotherapist, the patient learns to identify internal and external stimuli, as well as specific triggers that support PTSD symptoms. In order to reduce the severity of intrusions, a thorough assessment of memories and integration of traumatic experience is carried out. Socratic dialogue is recommended for working with dysfunctional thoughts related to trauma appraisal and core beliefs that support feelings of constant threat. An additional target is dysfunctional cognitive and behavioural patterns that block adaptive coping strategies and recovery of consistent memories of the traumatic event, such as rumination, safety seeking, and thought suppression [‎ 31 , ‎ 32 ]. In the treatment of PTSD, the use of cognitive-process psychotherapy (12 sessions) has proven its effectiveness in overcoming avoidance associated with traumatic experience, its new conceptualization and teaching skills of problem-solving behaviour [‎ 33 ]. The method has proven its effectiveness in reducing PTSD symptoms in working with different types of traumatic impacts, including natural disasters, child abuse, participation in military operations, rape; the standard protocol includes 12 sessions. The main goal is to overcome avoidance associated with traumatic experience, its new conceptualization and teaching skills of problem-solving behaviour. For this purpose, psychoeducation is used, keeping a diary of automatic thoughts, identifying maladaptive thoughts that support PTSD symptoms, Socratic 21 dialogue, aimed at changing the attitude to the traumatic experience, for example, overcoming self-blame [ ‎34 , ‎35 ]. The final stage involves improving skills for assessing and correcting beliefs related to the traumatic event, and reinforcing adaptive cognitive strategies in relation to issues of safety, trust, power, control, respect and closeness, those areas that may have been affected by the traumatic experience, with the main goal being to improve the patient’s daily functioning and quality of life. The use of individual cognitive-behavioural psychotherapy with prolonged exposure has proven itself – 15–20 sessions to increase the tolerance of unpleasant stimuli associated with traumatic experience, teaching patients to gradually come into contact with feelings, memories and situations associated with trauma [ ‎36 ]. The main goal of this method is to increase the tolerance of unpleasant stimuli associated with traumatic experience, it is aimed at teaching patients to gradually come into contact with feelings, memories and situations associated with trauma. The main task is to teach that triggers and memories are safe and tolerable and should not be avoided. The duration of therapy is about 3 months with weekly sessions from 60 to 120 minutes, a total of 8 to 15 sessions are held, in some cases 15 to 20 are recommended. At the beginning of therapy, the psychotherapist describes the treatment plan and validates the patient's traumatic experience, then training in anxiety coping skills and breathing exercises is carried out. After this, the actual exposure is carried out; for its successful implementation, a therapeutic alliance and a safe atmosphere must be formed, where, under conditions of emotional support, a collision with very frightening stimuli is possible. The exposure can be carried out in the imagination, or as homework in vivo; at present, virtual reality (VR) programs are actively used for conducting the exposure. When conducting VR exposure, the duration of the session is 45–60 minutes, each scene is repeated until the level of distress is reduced by half compared to the first presentation. The next scene is used after the patient confirms his readiness; the goal of therapy is to make the discomfort bearable. The pace of psychotherapy is determined by the condition and individual characteristics of the patient. Individual narrative exposure therapy lasting from 4 to 10 sessions is also used to work through traumatic experiences [‎ 37 , ‎ 38 ]. The method is actively used to help refugees; the main task is to create a consistent life narrative, into the context of which the traumatic experience fits. Important in the behaviour of the psychotherapist are sympathetic understanding, active listening, unconditional positive acceptance and maintenance of the therapeutic alliance. Under the guidance of the psychotherapist, the patient creates his life narrative in chronological order, focusing mainly on the traumatic experience, but also including positive events. It is believed that this unites the context of cognitive, affective and sensory memories of the trauma. By creating a narrative, the patient forms a consistent, coherent biographical history from fragmentary memories. An important task of psychotherapy is to combine in the narrative the past with episodes of traumatisation, the present with traumatic memories of past events and the future, where the traumatic experience is defined as one of the life episodes. Patients with PTSD may be shown the use of biofeedback techniques – 10 sessions to reduce anxiety and tension, teach self-regulation skills and reduce the level of tension. In cases of prolonged or multiple traumatisations, individual dialectical behavioural therapy (DBT) is used to form an alternative assessment of the traumatic experience [‎ 39 , ‎ 40 ]. The name itself defines the main goal of the therapy - the formation of an alternative assessment of the traumatic experience, which is often clearly perceived by patients as unbearable and hopeless, the behavioural module is aimed at developing optimal behaviour patterns in the process of comparing various, sometimes contradictory options. The task of the psychotherapist in each individual case is to find the optimal balance between acceptance and change, for which the appropriate techniques are used, to solve individual problems; individual techniques of TF-CBT, compassion-focused psychotherapy, acceptance and responsibility psychotherapy can be additionally used. In the process of dialectical behavioural therapy of PTSD, mindfulness, training in distress tolerance and emotional regulation skills, increasing interpersonal effectiveness, exposure and response prevention, counter-behaviour, validation, and self-acceptance are used. Eye movement desensitization and reprocessing (EMDR) is a method of confronting traumatic experiences using targeted bilateral stimulation (through rhythmic 23 eye movements) with simultaneous imagery of the traumatic event. Eye movements and other forms of stimulation of dual focus of attention, in addition to eye movements, it is possible to use sound stimulation or tapping on various parts of the body, provides simultaneous desensitization and cognitive restructuring, as well as integration of traumatic memories and a decrease in the severity of PTSD symptoms. This is a method of individual psychotherapy lasting 6–12 sessions, which can be held sequentially every day. F. Shapiro – the author of the method is based on the fact that emotional trauma can disrupt the work of the information processing system, therefore it will be preserved in the form caused by the traumatic experience, and contributes to the formation of intrusive symptoms of post-traumatic syndrome. Eye movements (there may be other alternative stimuli) used in EMDR activate the information processing system and restore its balance. Psychotherapy consists of 8 consecutive phases: anamnesis; preparation; assessment; desensitization; installation; body scanning; completion; re-assessment. Treatment and rehabilitation of patients with PTSD should be comprehensive and carried out by a team of specialists: psychiatrist/psychotherapist, family doctor, internal medicine specialist, with the active participation of patient and his family. Conclusions The study recorded that with the beginning of military actions in the territory of Ukraine, the amount of patients with post-traumatic syndrome increased more than in 3 times, compared to the figures for pre-war years. The results of the reaserch found that in both men and women, the severity of clinical manifestations and psychological disorders increases as the severity of the disorder increases. During the examination of patients, differences in the clinical picture of the disorder in men and women were found. Thus, men have a greater resistance to the risk of developing a disorder in the long term in response to stressors than women, but when the disorder develops, men tend to have more severe manifestations. In women, in the long term after severe mental trauma, the risk of developing PTSD is higher, but the intensity of clinical and psychological manifestations of the disorder is less pronounced. The results obtained during the study will not only allow us to correctly select complex treatment for this category of patients and correct all levels of functioning of the traumatic personality, but will also contribute to the prevention of stress-associated somatised pathology of internal organs, reducing the risk of developing alcohol and drug addiction in people with PTSD. Abbreviations APA American Psychiatric Association ASD Acute Stress disorder CBT Cognitive-behavioural therapy CAPS Clinician-Administered Post-traumatic stress disorder Scale CVD Cardiovascular diseases DSM-5 Diagnostic and Statistical Manual of Mental Disorders ICD-10 International Classification of Diseases 10 revision MHU Ministry of Health of Ukraine PHQ-2 Patient Health Questionnaire PTSD Post-traumatic stress disorder WHO World Health Organization Declarations Acknowledgements The authors express great gratitude to the Editors of the journal for their support in the publication of this study. We would also like to thank the Rector of the Petro Mohyla Black Sea National University for his facilitation of this research. Authors’ contributions Liudmyla Kiro – A- Manuscript preparation, B- Study design, C-Data collection; D-Statistical analysis; Alina Urbanovych – E-Questionnaires and clinical examination of patients; Maksym Zak – H – Literature research. Funding The Authors received no financial support for the research. No funding. Data Availability All data generated or analysed during this study are included in this published article. Ethics approval and consent participate The study was conducted in accordance with the basic bioethical norms of the Helsinki Declaration of the World Medical Association “Ethical Principles of Medical Research Involving Humans as Research Subjects” (1964), with changes and additions to the General Declaration on Bioethics and Human Rights. United Nations (2005), Council of Europe Convention on Human Rights and Biomedicine (1997). All participants were informed about the goals, organization, methods of the study and signed an informed consent to participate in it. All measures are also taken to ensure patient anonymity. The study was approved by the Ethics Committee of the Petro Mohyla Black Sea National University; Registration card No. 0120U101641 (Address of the institution: Petro Mohyla Black Sea National University, 68 Desantnykiv str.10, Mykolaiv, 54003, Ukraine) Consent for publication Not applicable. Competing interests The authors declare no competing interest. Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. References Epstein A, Lim R, Johannigman J, Fox CJ, Inaba K, Vercruysse GA, Thomas RW, Martin MJ, Konstantyn G, Schwaitzberg SD, MD. FACS, MAMSE. Putting Medical Boots on the Ground: Lessons from the War in Ukraine and Applications for Future Conflict with Near-Peer Adversaries. J Am Coll Surg. 2023;237(2):364–73. https://doi.org/10.1097/xcs.0000000000000707 . Epub 2023 Apr 24. PMID: 37459197; PMCID: PMC10344429. https://pubmed.ncbi.nlm.nih.gov/37459197/ . Conversano C, Lensi E, Testi C, Gremigni P. II paziente ustionato: fattori associati all'insorgenza del disturbo post-traumatico da stress e indicazioni per l'intervento [The burn patient: factors associated with post-traumatic stress disorder and directions for intervention]. Riv Psichiatr 2010 Jul-Aug;45(4):221–33. Italian. PMID: 20942368. https://pubmed.ncbi.nlm.nih.gov/20942368/ . Merians AN, Spiller T, Harpaz-Rotem I, Krystal JH, Pietrzak RH. Post-traumatic Stress Disorder. Med Clin North Am. 2023;107(1):85–99. https://doi.org/10.1016/j.mcna . 2022.04.003 Epub 2022 Oct 28. PMID:. https://pubmed.ncbi.nlm.nih.gov/36402502/ . Maercker A, Cloitre M, Bachem R, Schlumpf YR, Khoury B, Hitchcock C, Bohus M. Complex post-traumatic stress disorder. Lancet. 2022;400(10345):60–72. https://doi:10.1016/S0140-6736(22)00821-2 . PMID: 35780794. https://pubmed.ncbi.nlm.nih.gov/35780794/ . Fratto CM. Trauma-Informed Care for Youth in Foster Care. Arch Psychiatr Nurs. 2016;30(3):439–46. 10.1016/j.apnu.2016.01.007 . Epub 2016 Jan 13. PMID:. https://pubmed.ncbi.nlm.nih.gov/27256954/ . Bürgin D, Anagnostopoulos D, Board, Policy Division of ESCAP, Vitiello B, Sukale T, Schmid M, Fegert JM. Impact of war and forced displacement on children's mental health-multilevel, needs-oriented, and trauma-informed approaches. Eur Child Adolesc Psychiatry. 2022;31(6):845–53. https://doi:10.1007/s00787-022-01974-z . PMID: 35286450; PMCID: PMC9209349. https://pubmed.ncbi.nlm.nih.gov/35286450/ . Park SC, Kim YK. Anxiety Disorders in the DSM-5: Changes, Controversies, and Future Directions. Adv Exp Med Biol. 2020;1191:187–196. https://doi:10.1007/978-981-32-9705-0_12 . PMID: 32002930. https://pubmed.ncbi.nlm.nih.gov/32002930/ . Stein DJ, Craske MG, Friedman MJ, Phillips KA. Meta-structure issues for the DSM-5: how do anxiety disorders, obsessive-compulsive and related disorders, post-traumatic disorders, and dissociative disorders fit together? Curr Psychiatry Rep. 2011;13(4):248–50. https://pubmed.ncbi.nlm.nih.gov/21603904/ . https://doi.org/10.1556%2F2006.2022.00033 PMID. Horsch A, Garthus-Niegel S, Ayers S, Chandra P, Hartmann K, Vaisbuch E, Lalor J. Childbirth-related posttraumatic stress disorder: definition, risk factors, pathophysiology, diagnosis, prevention, and treatment. Am J Obstet Gynecol. 2024;230(3S):S1116–27. https://doi:10.1016/j.ajog.2023.09.089 . Epub 2024 Jan 9. PMID: 38233316. https://pubmed.ncbi.nlm.nih.gov/38233316/ . Vargová L, Jozefiaková B, Lačný M, Adamkovič M. War-related stress scale. BMC Psychol. 2024;12(1):208. https://doi.org/10.1186/s40359-024-01687-9 . PMID: 38622687; PMCID: PMC11020644. https://pubmed.ncbi.nlm.nih.gov/38622687/ . Chudzicka-Czupała A, Hapon N, Chiang SK, Żywiołek-Szeja M, Karamushka L, Lee CT, Grabowski D, Paliga M, Rosenblat JD, Ho R, McIntyre RS, Chen YL. Depression, anxiety and post-traumatic stress during the 2022 Russo-Ukrainian war, a comparison between populations in Poland, Ukraine, and Taiwan. Sci Rep. 2023;13(1):3602. https://doi:10.1038/s41598-023-28729-3 . PMID: 36869035; PMCID: PMC9982762. https://pubmed.ncbi.nlm.nih.gov/36869035/ . Li DJ, Chudzicka-Czupała A, Paliga M, Hapon N, Karamushka L, Żywiołek-Szeja M, McIntyre RS, Chiang SK, Chen YL, Yen CF, Man RHC. Rumination about the Russo-Ukrainian War and its related factors among individuals in Poland and Ukraine. Kaohsiung J Med Sci. 2023;39(9):943–53. https://doi.org/10.1002/kjm2.12711 . Epub 2023 Jun 7. PMID: 37283450. https://pubmed.ncbi.nlm.nih.gov/37283450/ . Li DJ, Chudzicka-Czupała A, Paliga M, Hapon N, Karamushka L, Żywiołek-Szeja M, McIntyre RS, Chiang SK, Chen YL, Yen CF, Man RHC. Association Between the Time Spent on and Sources of the News of Russo-Ukrainian War and Psychological Distress Among Individuals in Poland and Ukraine: The Mediating Effect of Rumination. Psychol Res Behav Manag. 2024;17:1855–66. https://doi:10.2147/PRBM.S457046 . PMID: 38716257; PMCID: PMC11075697. https://pubmed.ncbi.nlm.nih.gov/38716257/ . Murthy RS, Lakshminarayana R. Mental health consequences of war: a brief review of research findings. World Psychiatry. 2006;5(1):25–30. PMID: 16757987; PMCID: PMC1472271. https://pubmed.ncbi.nlm.nih.gov/16757987/ . Stein BD, Tanielian TL. Building and translating evidence into smart policy: continuing research needs for informing post-war mental health policy. World Psychiatry. 2006;5(1):34–5. PMID: 16757991; PMCID: PMC1472274. https://pubmed.ncbi.nlm.nih.gov/16757991/ . Keynejad R, Semrau M, Toynbee M, Evans-Lacko S, Lund C, Gureje O, Ndyanabangi S, Courtin E, Abdulmalik JO, Alem A, Fekadu A, Thornicroft G, Hanlon C. Building the capacity of policy-makers and planners to strengthen mental health systems in low- and middle-income countries: a systematic review. BMC Health Serv Res. 2016;16(1):601. https://doi.org/10.1186%2Fs12913-016-1853-0. PMID: 27769270; PMCID: PMC5073499. https://pubmed.ncbi.nlm.nih.gov/27769270/ . Al Jowf GI, Ahmed ZT, Reijnders RA, de Nijs L, Eijssen LMT. To Predict, Prevent, and Manage Post-Traumatic Stress Disorder (PTSD): A Review of Pathophysiology, Treatment, and Biomarkers. Int J Mol Sci. 2023;24(6):5238. https://doi:10.3390/ijms24065238 . PMID: 36982313; PMCID: PMC10049301. https://pubmed.ncbi.nlm.nih.gov/36982313/ . Friedman MJ, Bernardy NC. Considering future pharmacotherapy for PTSD. Neurosci Lett. 2017;649:181–5. https://doi.org/10.1016/j.neulet.2016.11.048 . Epub 2016 Nov 24. PMID:. https://pubmed.ncbi.nlm.nih.gov/27890743/ . Stein DJ, Zungu-Dirwayi N, van Der Linden GJ, Seedat S. Pharmacotherapy for posttraumatic stress disorder. Cochrane Database Syst Rev. 2000;(4):CD002795. doi: 10.1002/14651858.CD002795. Update in: Cochrane Database Syst Rev. 2006;(1):CD002795. https://doi:10.1002/14651858. CD002795.pub2 . PMID: 11034765. https://pubmed.ncbi.nlm.nih.gov/11034765/ . Yadav G, Gunturu S, Trauma-Informed T. 2024 Jun 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 38861623. https://pubmed.ncbi.nlm.nih.gov/38861623/ . Harper GW, Neubauer LC. Teaching During a Pandemic: A Model for Trauma-Informed Education and Administration. Pedagogy Health Promot. 2021;7(1):14–24. https://doi.org/10.1177/2373379920965596 . Epub 2020 Oct 14. PMID: 33614921; PMCID: PMC7894645. https://pubmed.ncbi.nlm.nih.gov/33614921/ . Brown T, Berman S, McDaniel K, Radford C, Mehta P, Potter J, Hirsh DA. Trauma-Informed Medical Education (TIME): Advancing Curricular Content and Educational Context. Acad Med. 2021;96(5):661–667. https://doi.org/10.1097/acm.0000000000003587 PMID: 32675789. https://pubmed.ncbi.nlm.nih.gov/32675789/ . Truscott A, Hayes D, Bardsley T, Choksi D, Edbrooke-Childs J. Defining young people's mental health self-care: a systematic review and co-development approach. Eur Child Adolesc Psychiatry. 2023 Nov 10. https://doi:10.1007/s00787-023-02320-7 . Epub ahead of print. PMID: 37947894. https://pubmed.ncbi.nlm.nih.gov/37947894/ . Sabé M, Chen C, El-Hage W, Leroy A, Vaiva G, Monari S, Premand N, Bartolomei J, Caiolo S, Maercker A, Pietrzak RH, Cloître M, Kaiser S, Solmi M. Half a Century of Research on Posttraumatic Stress Disorder: A Scientometric Analysis. Curr Neuropharmacol. 2024;22(4):736–48. https://doi.org/10.3389/fneur.2024.1374443 . PMID: 37888890; PMCID: PMC10845098. https://pubmed.ncbi.nlm.nih.gov/37888890/ . Coventry PA, Meader N, Melton H, Temple M, Dale H, Wright K, Cloitre M, Karatzias T, Bisson J, Roberts NP, Brown JVE, Barbui C, Churchill R, Lovell K, McMillan D, Gilbody S. Psychological and pharmacological interventions for posttraumatic stress disorder and comorbid mental health problems following complex traumatic events: Systematic review and component network meta-analysis. PLoS Med. 2020;17(8):e1003262. https://doi:10.1371/journal.pmed.1003262 . PMID: 32813696; PMCID: PMC7446790. https://pubmed.ncbi.nlm.nih.gov/32813696/ . Melton H, Meader N, Dale H, Wright K, Jones-Diette J, Temple M, Shah I, Lovell K, McMillan D, Churchill R, Barbui C, Gilbody S, Coventry P. Interventions for adults with a history of complex traumatic events: the INCiTE mixed-methods systematic review. Health Technol Assess. 2020;24(43):1–312. https://awspntest.apa.org/doi/10.2174/1570159X22666230927143106 . PMID: 32924926; PMCID: PMC7520719. https://pubmed.ncbi.nlm.nih.gov/32924926/ . Purgato M, Gastaldon C, Papola D, van Ommeren M, Barbui C, Tol WA. Psychological therapies for the treatment of mental disorders in low- and middle-income countries affected by humanitarian crises. Cochrane Database Syst Rev. 2018;7(7):CD011849. https://doi:10.1002/14651858 . CD011849.pub2. PMID: 29975811; PMCID: PMC6513488. https://pubmed.ncbi.nlm.nih.gov/29975811/ . Lewis C, Roberts NP, Bethell A, Robertson L, Bisson JI. Internet-based cognitive and behavioural therapies for post-traumatic stress disorder (PTSD) in adults. Cochrane Database Syst Rev. 2018;12(12):CD011710. https://doi:10.1002/14651858 . https://pubmed.ncbi.nlm.nih.gov/30550643/ . PMCID: PMC6516951. Roberts NP, Kitchiner NJ, Kenardy J, Robertson L, Lewis C, Bisson JI. Multiple session early psychological interventions for the prevention of post-traumatic stress disorder. Cochrane Database Syst Rev. 2019;8(8):CD006869. https://doi:10.1002/14651858 . CD006869.pub3. PMID: 31425615; PMCID: PMC6699654. https://pubmed.ncbi.nlm.nih.gov/31425615/ . Feinstein D. Using energy psychology to remediate emotional wounds rooted in childhood trauma: preliminary clinical guidelines. Front Psychol. 2023;14:1277555. https:/. PMID: 37920741; PMCID: PMC10619750. https://pubmed.ncbi.nlm.nih.gov/37920741/ . Bach D, Groesbeck G, Stapleton P, Sims R, Blickheuser K, Church D. Clinical EFT (Emotional Freedom Techniques) Improves Multiple Physiological Markers of Health. J Evid Based Integr Med. 2019 Jan-Dec;24. https://doi:10.1177/2515690X18823691 . PMID: 30777453; PMCID: PMC6381429. https://pubmed.ncbi.nlm.nih.gov/30777453/ . :2515690X18823691. Church D, Stapleton P, Vasudevan A, O'Keefe T. Clinical EFT as an evidence-based practice for the treatment of psychological and physiological conditions: A systematic review. Front Psychol. 2022;13:951451. https://doi:10.3389/fpsyg.2022.951451 . PMID: 36438382; PMCID: PMC9692186. https://pubmed.ncbi.nlm.nih.gov/36438382/ . Bürgin D, Anagnostopoulos D, Board and Policy Division of ESCAP, Vitiello B, Sukale T, Schmid M, Fegert JM. Impact of war and forced displacement on children's mental health-multilevel, needs-oriented, and trauma-informed approaches. Eur Child Adolesc Psychiatry. 2022;31(6):845–53. https://doi.org/10.1007/s00787-022-01974-z . PMID: 35286450; PMCID: PMC9209349. https://pubmed.ncbi.nlm.nih.gov/35286450/ . Betancourt TS, Newnham EA, Layne CM, Kim S, Steinberg AM, Ellis H, Birman D. Trauma history and psychopathology in war-affected refugee children referred for trauma-related mental health services in the United States. J Trauma Stress. 2012;25(6):682 – 90. https://doi.org/10.1002/jts.21749 PMID: 23225034. https://pubmed.ncbi.nlm.nih.gov/23225034/ . Xu W, Pavlova I, Chen X, Petrytsa P, Graf-Vlachy L, Zhang SX. Mental health symptoms and coping strategies among Ukrainians during the Russia-Ukraine war in March 2022. Int J Soc Psychiatry. 2023;69(4):957–966. https://doi.org/10.1177/00207640221143919 Epub 2023 Jan 4. PMID: 36598090. https://pubmed.ncbi.nlm.nih.gov/36598090/ . Zabłocka-Żytka L, Lavdas M. The stress of war. Recommendations for the protection of mental health and wellbeing for both Ukrainian refugees as well as Poles supporting them. Psychiatr Pol. 2023;57(4):729–746. English, Polish. https://doi.org/10.12740/PP/156157 Epub 2023 Aug 31. PMID: 38170647. https://pubmed.ncbi.nlm.nih.gov/38170647/ . Anjum G, Aziz M, Hamid HK. Life and mental health in limbo of the Ukraine war: How can helpers assist civilians, asylum seekers and refugees affected by the war? Front Psychol. 2023;14:1129299. https://doi:10.3389/fpsyg.2023.1129299 . PMID: 36874809; PMCID: PMC9983366. https://pubmed.ncbi.nlm.nih.gov/36874809/ . Hodes M. Thinking about young refugees' mental health following the Russian invasion of Ukraine in 2022. Clin Child Psychol Psychiatry. 2023;28(1):3–14. https://doi.org/10.1177/13591045221125639 Epub 2022 Sep 7. PMID: 36071016. https://pubmed.ncbi.nlm.nih.gov/36071016/ . Della Rocca B, Bello R, Carbone M, Pezzella P, Toni C, Sampogna G, Tarsitani L, Luciano M, Fiorillo A. Promoting mental health and preventing mental health problems in child and adolescent refugees and asylum seekers: A systematic review on psychosocial interventions. Int J Soc Psychiatry. 2024;70(4):653–66. https://. Epub 2023 Dec 9. PMID: 38069651. Uphoff E, Robertson L, Cabieses B, Villalón FJ, Purgato M, Churchill R, Barbui C. An overview of systematic reviews on mental health promotion, prevention, and treatment of common mental disorders for refugees, asylum seekers, and internally displaced persons. Cochrane Database Syst Rev. 2020;9(9):CD013458. https://doi:10.1002/14651858. CD013458.pub2. PMID: 32885850; PMCID: PMC8572368. https:// pubmed.ncbi.nlm.nih.gov/32885850/ . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 29 Oct, 2024 Read the published version in BMC Psychology → Version 1 posted Editorial decision: Revision requested 09 Jul, 2024 Editor assigned by journal 08 Jul, 2024 Submission checks completed at journal 08 Jul, 2024 First submitted to journal 05 Jul, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4691182","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":324786780,"identity":"1d4ee79a-edc2-44b0-9fbb-2c27a3bcef29","order_by":0,"name":"Liudmyla Kiro","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA2UlEQVRIiWNgGAWjYLCCBwY2DAbsDUCWgQWRWhIq0iQMeA6AtEgQq+XMYQkDiQQQkwgt5uxnDD8ktqXVmUs+v7rhR4EEA397dwJeLZY9OcYSiW02Epazc8pu9gAdJnHm7Aa8WgwO5G4AagH65XZO2g0eoBYDiVwCWs6/3fwjsQ3ol5tn0m7+IUrLjdxtEmDv32A/dps4W268/2YBDGTJDWdy2G7LGEjwEPbL+bTkGx8MbPgNjh9/dvPNHxs5/vZe/FqQAI8BmCRWOQiwPyBF9SgYBaNgFIwgAABfukyeyAXi8gAAAABJRU5ErkJggg==","orcid":"","institution":"Petro Mohyla Black Sea National University","correspondingAuthor":true,"prefix":"","firstName":"Liudmyla","middleName":"","lastName":"Kiro","suffix":""},{"id":324786781,"identity":"ba3e9ca9-6785-41e9-93b4-1dfe27408de7","order_by":1,"name":"Alina Urbanovych","email":"","orcid":"","institution":"Lviv Natinal Medical University","correspondingAuthor":false,"prefix":"","firstName":"Alina","middleName":"","lastName":"Urbanovych","suffix":""},{"id":324786784,"identity":"f48e886f-59bf-41e6-823e-b2d3e641e308","order_by":2,"name":"Maksym Zak","email":"","orcid":"","institution":"Petro Mohyla Black Sea National University","correspondingAuthor":false,"prefix":"","firstName":"Maksym","middleName":"","lastName":"Zak","suffix":""}],"badges":[],"createdAt":"2024-07-05 09:23:52","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4691182/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4691182/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s40359-024-02109-6","type":"published","date":"2024-10-29T16:13:07+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":68206901,"identity":"bd19bf61-de4c-4a7b-a8f4-6e95a30ce4eb","added_by":"auto","created_at":"2024-11-04 16:33:44","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":624459,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4691182/v1/e27045c4-7ea3-45c2-9a1a-e975446601fa.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Peculiarities of the course and management of Ukrainians with post-traumatic stress disorder in the context of the Ukrainian-Russian war","fulltext":[{"header":"Background","content":"\u003cp\u003eWar is always a risk to health, particularly mental health. Post-traumatic stress disorder (PTSD) usually develops in 12\u0026ndash;20% of people who have experienced or witnessed life-threatening events\u0026ndash; themselves or loved ones [\u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e1\u003c/span\u003e, \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026lrm;2\u003c/span\u003e]. Most often, they appear during the first three months after a traumatic event.\u003c/p\u003e \u003cp\u003eAccording to expert estimates, PTSD is noted in 6\u0026ndash;8% of the population in general [\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026lrm;3\u003c/span\u003e]. At the same time, the frequency of detection of PTSD in certain population groups that have suffered severe psychological trauma is much higher. For example, combat veterans, emergency responders who have responded to natural disasters/terrorist attacks, displaced persons, and survivors of attacks may have a much higher risk of developing PTSD, reaching experts' assessments.\u003c/p\u003e \u003cp\u003eAccording to the Ministry of Health of Ukraine, after the large\u0026ndash;scale invasion of Russia in Ukraine, more than 50% of Ukrainians began to complain: hyperexcitement and irritability; memory problems; inability to control one's emotions; sleep disturbance - inability to fall asleep or wake up on time; headaches; obsessive thoughts and feelings of fear when having to remember a traumatic event [\u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e4\u003c/span\u003e]. The amount of PTSD patients has been steadily increasing since December 2022. According to the National Health Service, in 2021, 3,167 patients with this diagnosis were registered in the system. In the following years, the statistics look like this: 2022 \u0026mdash; 7,051 patients; 2023 \u0026mdash; 12,494 patients; As of June 6, 2024, the number has already reached 6,292, and according to the forecasts of the Ministry of Health of Ukraine, it will continue to increase rapidly [\u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e5\u003c/span\u003e, \u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe most frequent events that lead to the development of PTSD include: combat operations; physical abuse in childhood; sexual violence; physical attack (causing bodily harm); threat with a weapon; forced migration; accident) war-related disasters affecting mental health. hereditary factors, such as a family history of anxiety and depression; temperament; features of physiology (for example, the production of hormones in response to stress).\u003c/p\u003e \u003cp\u003eUkraine is in its third hour of war, and security risks continue to weigh on Ukrainians who live permanently in a state of forced search for a possible country for migration. A number of studies have shown that about 36% of refugees have post-traumatic syndrome.\u003c/p\u003e \u003cp\u003eThe Ukrainian refugee crisis is the biggest refugee crisis and the largest migration crisis in the world in the 21st century [\u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e7\u003c/span\u003e, \u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e8\u003c/span\u003e]. The ongoing large-scale refugee crisis in Europe, caused by the invasion of Russian troops into Ukraine as part of the Russian-Ukrainian war, which began on February 24, 2022 [\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026lrm;9\u003c/span\u003e, \u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e10\u003c/span\u003e]. By March 20, 2022, more than ten million people left their homes in Ukraine \u0026mdash; about a quarter of the country's entire population. Due to the restriction on leaving Ukraine for men of conscription age from 18 to 60 years old, 90% of Ukrainian refugees are women and children [\u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e11\u003c/span\u003e]. According to UNICEF, by March 24, 2022, more than half of all children in Ukraine (approximately 7.5\u0026nbsp;million) were forced to leave their homes, of which approximately 1.8\u0026nbsp;million became refugees in other countries [\u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eRussia's invasion of Ukraine unleashed the largest refugee crisis in Europe since the Second World War and its aftermath, the first such crisis in Europe since the Yugoslav wars of the 1990s, and the largest migration crisis in the world in the 21st century, with the highest rate of flight refugees in the world.\u003c/p\u003e \u003cp\u003eThe main directions of refugee migration are neighboring countries to the west of Ukraine: Russia, Poland, Romania, Hungary, Moldova, Slovakia, the Czech Republic and Germany. At the same time, Poland accepted more refugees from Ukraine than all other neighboring countries combined (as of December 13, 2022 \u0026mdash; more than 8.2\u0026nbsp;million). Some refugees then moved further west: to other European countries or outside the EU. Belarus and Russia accepted part of the immigrants (more than 2.9\u0026nbsp;million people) [\u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e13\u003c/span\u003e, \u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e14\u003c/span\u003e, \u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMore than half of the world\u0026rsquo;s refugees are under the age of 18. Child refugees are at higher risk of developing PTSD and other mental health problems than adult refugees. This may be explained by their greater exposure to traumatic events, especially when the child is separated from their parents/caregivers. The severity of PTSD in their parents or caregivers also has some impact on the mental health of child refugees.\u003c/p\u003e \u003cp\u003eAnalysis of the results of epidemiological studies shows that susceptibility to PTSD correlates with certain mental disorders that either arise as a consequence of the trauma or are present from the start. These disorders include: anxiety neurosis; depression; suicidal ideation or attempts; drug, alcohol or drug addiction; psychosomatic disorders; cardiovascular diseases. Data indicate that 50\u0026ndash;100% of patients suffering from PTSD have one of the listed comorbidities, and most often two or more [\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026lrm;16\u003c/span\u003e, \u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e17\u003c/span\u003e]. In addition, a high rate of suicide or suicide attempts is especially problematic in patients with PTSD.\u003c/p\u003e \u003cp\u003eThe aim of this study was to determine the structure of PTSD depending on the gender and age characteristics of patients, social factors and methods of its correction in the conditions of war on the territory of Ukraine.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eDataset, study population\u003c/h2\u003e \u003cp\u003eThe study involved 450 patients (224 (49.7%) men and 226 (50.3%) women) who sought psychological help at the University Clinic of Petro Mohyla Black Sea National University from January to June 2024. The patients' age ranged from 18 to 74 years, the average age was 46\u0026thinsp;\u0026plusmn;\u0026thinsp;1.2 years. All patients were divided into 3 groups: 1st group - patients with PTSD (from 18 to 44 years, average age 31.0\u0026thinsp;\u0026plusmn;\u0026thinsp;2.5 years); 2nd \u0026mdash; patients with PTSD (from 45 to 59 years, average age 52.0\u0026thinsp;\u0026plusmn;\u0026thinsp;3.5 years), 3rd group \u0026mdash; patients with PTSD (from 60 to 74 years, average age 67.0\u0026thinsp;\u0026plusmn;\u0026thinsp;2.8 years).\u003c/p\u003e \u003cp\u003eThe work used clinical, psychopathological, and statistical research methods.\u003c/p\u003e \u003cp\u003eThe sample included respondents with features meeting the diagnostic criteria for PTSD (DSM-V). The necessary condition for inclusion of respondents in the study was: patients were exposed to, participated in, witnessed or faced with a traumatic event (events) that included death or threat of death, or threat of serious injury, or threat to the physical integrity of others (or one's own); the individual's reaction included intense fear, helplessness or horror; or the presence of agitated or disorganized behaviour; the traumatic event is persistently repeated in the experience in one (or more) of the following ways: repetitive and intrusive reproduction of the event, corresponding images, thoughts and perceptions, causing severe emotional distress; recurrent distressing dreams about the event. Persistent avoidance of stimuli associated with the trauma; persistent symptoms of increasing arousal (which were not observed before the trauma). Defined by the presence of at least two of the following symptoms: difficulty falling asleep or poor sleep (early awakenings); irritability or angry outbursts; difficulty concentrating; increased alertness, hypervigilance, constant expectation of threat; exaggerated fear response. Duration of the disorder is more than 1 month. The disorder, according to patients, causes clinically significant severe emotional state or impairment in social, professional or other important areas of life.\u003c/p\u003e \u003cp\u003eThe criteria for exclusion from the sample were the presence of a verified endogenous disorder and organic brain damage of various etiology with manifestations of psychoorganic syndrome, lack of memories of trauma; history of psychosis; current alcohol or drug addiction; borderline personality disorder; acute suicidal risk.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eDefinitions\u003c/h2\u003e \u003cp\u003eEvaluation of PTSD was determined using the following diagnostic scales:\u003c/p\u003e \u003cp\u003e1.Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), which assesses the frequency and severity of each of the PTSD symptoms listed in the DSM-V [\u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e18\u003c/span\u003e]. The scale results were interpreted as follows:\u003c/p\u003e \u003cp\u003e0) Absent: The respondent denied the problem or the respondent's report doesn't fit the DSM-5 symptom criterion.\u003c/p\u003e \u003cp\u003e1) Mild / subthreshold: The respondent described a problem that is consistent with the symptom criterion but isn't severe enough to be considered clinically significant. The problem doesn't satisfy the DSM-5 symptom criterion and thus doesn't count toward a PTSD diagnosis.\u003c/p\u003e \u003cp\u003e2) Moderate / threshold: The respondent described a clinically significant problem. The problem satisfies the DSM-5 symptom criterion and thus counts toward a PTSD diagnosis. The problem would be a target for intervention. This rating requires a minimum frequency of 2 x month or some of the time (20\u0026ndash;30%) PLUS a minimum intensity of Clearly Present.\u003c/p\u003e \u003cp\u003e3) Severely / markedly elevated: The respondent described a problem that is above the threshold. The problem is difficult to manage and at times overwhelming, and would be a prominent target for intervention. This rating requires a minimum frequency of 2 x week or much of the time (50\u0026ndash;60%) PLUS a minimum intensity of Pronounced.\u003c/p\u003e \u003cp\u003e4) Extreme/ incapacitating: The respondent described a dramatic symptom, far above threshold. The problem is pervasive, unmanageable, and overwhelming, and would be a high-priority target for intervention.\u003c/p\u003e \u003cp\u003e2. The Sheehan Disability Scale (SDS, 2000) assesses disability in four domains of home management, work responsibilities, close relationships and social life [\u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e19\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStatistic analysis\u003c/h2\u003e \u003cp\u003eStatistical processing of the research results was carried out by the methods of variation statistics implemented by the standard package of application programs SPSS 13.0 for Windows (USA). Quantitative indicators were checked for normality of data distribution using the Shapiro-Wilk test and are presented in the form (M\u0026thinsp;\u0026plusmn;\u0026thinsp;m), where M is the mean value, m is the standard error. Qualitative data are presented in the form of absolute and relative frequencies. Differences between groups were evaluated using the Student's test for independent samples, between subgroups in the dynamics of treatment \u0026ndash; using the Student's test for dependent samples. The Pirson (χ\u003csup\u003e2\u003c/sup\u003e) test was used to compare discrete values. To determine the functional relationships between the parameters, Spearman's non-parametric correlation coefficients (r) were calculated. The strength of the connection was interpreted as follows: very weak \u0026ndash; 0\u0026ndash;0.3; weak \u0026ndash; 0.3\u0026ndash; 0.5; medium strength \u0026ndash; 0.5\u0026ndash;0.7; strong \u0026ndash; 0.7\u0026ndash; 0.9; very strong \u0026ndash; 0.9 \u0026minus;\u0026thinsp;1.0.The results were considered statistically reliable with a probability of error of less than 5% (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eDuring the study, it was recorded that mild and moderate PTSD in female patients of 2nd group occurred in 2.0 (χ\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.86, p\u0026thinsp;=\u0026thinsp;0.001) and 2.2 (χ\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.46, p\u0026thinsp;=\u0026thinsp;0.023) times more often than in male patients. While severe and Extreme PTSD in male patients of 2nd group were recorded in 1.6 (χ\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.16, p\u0026thinsp;=\u0026thinsp;0.033) and 1.8 (χ\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.99, p\u0026thinsp;=\u0026thinsp;0.006) times more often than in female patients (Table\u0026nbsp;1).\u003c/p\u003e \u003cp\u003e \u003cb\u003eТаble 1\u003c/b\u003e Severity of post-traumatic stress disorders (PTSD) among Ukrainians during January-June 2024\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eSeverity of PTSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e \u003cp\u003ePatients with a clinical diagnosis of PTSD, n\u0026thinsp;=\u0026thinsp;450\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1st group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e2nd group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e3rd group\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003emen,\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;75\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ewomen,\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;75\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003emen,\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;75\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ewomen,\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;75\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003emen,\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;74\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ewomen,\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;76\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003en(%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003en(%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003en(%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003en(%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003en(%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003en(%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA mild PTSD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9(12.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13(17.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11(14.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e22(29.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e10(13.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e14(18.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerate PTSD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16(21.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19(25.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9(12.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e20(26.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e10(13.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e12(15.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSevere PTSD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e32(42.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27(36.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30(40.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e19(25.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e29(39.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e25(32.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExtreme PTSD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18(24.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16(21.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25(33.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14(18.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e25(33.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e25(32.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eA detailed analysis of the PTSD structure revealed that in the age category from 18 to 44 years, the dysphoric type of PTSD was recorded in 16 (20.4%) men and 22 (29.3%) women; at the age from 60 to 74 \u0026ndash; in 8 (10.2%) men and 12 (15.8%) women. In the middle age category among female patients of 2nd group aged, asthenic and somatophoric types of PTSD were recorded in 3.0 (χ\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.11, p\u0026thinsp;=\u0026thinsp;0.022) and 2.1 (χ\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.06, p\u0026thinsp;=\u0026thinsp;0.004) times more often than in men. While in men of 2nd groups: dysphoric and severe types of PTSD were recorded in 2.6 (χ\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.01, p\u0026thinsp;=\u0026thinsp;0.012) and 2.1 times (χ\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.99, p\u0026thinsp;=\u0026thinsp;0.003) more often than among women of the same age category (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eTypes of PTSD among Ukrainians depending on the gender and age characteristics of patients\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eTypes of PTSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e \u003cp\u003ePatients with a clinical diagnosis of PTSD, n\u0026thinsp;=\u0026thinsp;450\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1st group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e2nd group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e3rd group\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003emen,\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;75\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ewomen,\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;75\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003emen,\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;75\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ewomen,\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;75\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003emen,\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;74\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ewomen,\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;76\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003en(%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003en(%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003en(%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003en(%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003en(%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003en(%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSevere type of PTSD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26(34.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19(25.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29(+\u0026thinsp;38.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14(18.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e11(14.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e14(18.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAsthenic type of PTSD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15(20.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27(36.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10(13.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e30(+\u0026thinsp;40.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e31(41.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e30(39.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDysphoric type of PTSD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16(20.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22(29.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26(+\u0026thinsp;34.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10(13.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e8(10.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e12(15.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSomatoform type of PTSD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18(24.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7(9.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10(13.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e21(+\u0026thinsp;28.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e24(33.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e20(26.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003ePTSD had a negative impact on all areas of life of the subjects and had its own characteristics depending on gender factors. Among the men in the 1st group: 27 (36.0%) men reported a decrease in work responsibilities; 28 (37.3%) \u0026ndash; problems in communication with females; 11 (14.7%) individuals reported a decrease in social activity; 9 (12%) complained of the inability to manage the household. Among the female patients, the inability to manage the household was recorded in 20 (26.7%); problems in close relationships were noted by 22 (29.3%); decrease of work responsibilities \u0026ndash; in 19 (25.3%); declining quality of social life \u0026ndash; 14 (18.7%), (Table\u0026nbsp;1).\u003c/p\u003e \u003cp\u003eAmong the 2nd group: 30 (40.0%) men reported a decrease in work responsibilities; 14 (18.6%) \u0026ndash; problems in communication with females; 20 (26.8%) individuals reported a decrease in social activity; 11 (14.6%) inability to do home management. Among female patients, inability to do housework was recorded in 19 (25.5%); problems in close relationships were noted by 23 (30.6%); decreased work responsibilities \u0026ndash; in 11 (14.6%); declining quality of social life \u0026ndash; 22 (29.3%), (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAmong the 3rd group: 24 (32.4%) men noted a decrease in work responsibilities; 7 (9.5%) \u0026ndash;the problems in communication with women; 36 (48.6%) individuals noted a decrease in social activity; 7 (9.5%) \u0026ndash; inability to manage housework. Among female patients, inability to do housework was recorded in 25 (32.3%); problems with close relationships were noted by 15 (19.7%); decreased work responsibilities \u0026ndash; in 9 (11.8%); declining quality of social life\u0026ndash;27 (35.5%) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDistribution of patients with PTSD according to the Sheehan Disability Scale (SDS, 2000)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eImpact on social life\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e \u003cp\u003ePatients with a clinical diagnosis of PTSD, n\u0026thinsp;=\u0026thinsp;450\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1st group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e2nd group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e3rd group\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003emen,\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;75\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ewomen,\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;75\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003emen,\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;75\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ewomen,\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;75\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003emen,\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;74\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ewomen,\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;76\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003en(%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003en(%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003en(%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003en(%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003en(%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003en(%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHome management\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9(12.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20(26.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11(14.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e19(25.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e7(9.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e25(32.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWork responsibilities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e27(36.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19(25.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30(40.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11(14.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e24(32.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e9(11.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClose relationships\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28(37.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22(29.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14(18.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e23(30.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e7(9.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e15(19.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDeclining quality of social life\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11(14.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14(18.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20(26.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e22(29.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e36(48.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e27(35.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe development of PTSD among Ukrainians is result of the body's response to trauma, and the activation of the stress reaction, including neurochemical and neuroendocrine processes. Adrenaline and norepinephrine play an important role, mobilizing the body to fight or avoid. During traumatic events, high levels of stress hormones reduce the activity of the hypothalamus, which can subsequently cause stress disorder. PTSD inevitably leads to biochemical changes in the brain. Patients have low cortisol levels and high catecholamine production. Also, people suffering from the disorder have chronically low serotonin levels, which causes appropriate behaviour: anxiety, increased irritability, aggression, outbursts of anger and suicidal thoughts. The scenario of the clinical picture of PTSD among Ukrainians, according to J. Wilson, is similar to that during the Vietnam War [\u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e20\u003c/span\u003e, \u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe famous American psychiatrist Abram Kardiner in 1941, while studying this problem, called the changes caused by stress during an armed conflict, chronic war neurosis [\u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e22\u003c/span\u003e, \u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e23\u003c/span\u003e]. That is why the symptoms of the disease have a similar clinical picture in our time and include complaints of patients about: excitability and irritability; fixation on the traumatic circumstances of past events; predisposition to aggression and inability to control it; escape from reality; acute reaction to sudden irritants.\u003c/p\u003e \u003cp\u003eThe prevalence of PTSD among the population depends on the frequency of traumatic events. Thus, we can talk about injuries typical for certain political regimes, geographic regions in which natural disasters occur especially often, etc. In the 90s, the incidence of PTSD increased significantly: if in the 80s they corresponded to 1\u0026ndash;2%, then in recent studies published in the USA, 7.8%, and there are pronounced gender differences (10.4% for women, 5.0% for men) [\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026lrm;24\u003c/span\u003e, \u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e25\u003c/span\u003e, \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026lrm;26\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eExamination of individuals from the risk group (for example, Vietnam veterans, and victims of volcanic eruptions or criminal violence) gave an obvious increase in the prevalence of the diagnosis from 3\u0026ndash;58% [\u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e27\u003c/span\u003e, \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026lrm;28\u003c/span\u003e, \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026lrm;29\u003c/span\u003e]. The intensity of the psychotraumatic situation is a risk factor for the development of PTSD. Other risk factors are: low level of education, social status; psychiatric problems preceding the traumatic event; the presence of close relatives suffering from psychiatric disorders, chronic stress. It should be noted that quite often individuals with PTSD experience secondary traumatisation, which usually occurs as a result of negative reactions of other people, medical personnel and social workers to the problems faced by people who have experienced trauma. Negative reactions manifest themselves in denial of the very fact of trauma, the connection between trauma and the individual\u0026rsquo;s suffering, blaming and even vilifying victims, and refusal to provide assistance. In other cases, secondary traumatisation can occur as a result of overprotection of victims, around whom those around them create a \u0026ldquo;traumatic membrane\u0026rdquo; that isolates them from the outside world, removing them from the influence of the stressors of everyday life.\u003c/p\u003e \u003cp\u003eMillions of people exposed to war-related stressors experience mental health disorders, including post-traumatic stress disorder. Certainly, pre-migration traumatic experiences, such as those directly related to war and conflict, are important predictors of negative mental health outcomes. At the same time, a range of migration-specific stressors play a very important role for refugees and asylum seekers. Among them, socio-economic factors (i.e. unemployment or underemployment, financial constraints/poverty, lack of secure housing), social and interpersonal factors (i.e. family separation, lack of family and friend support, change in previous social role, social isolation, discrimination, loss of social identity, lack of social support, gender role change), factors related to the asylum process and immigration policies (i.e. mandatory detention, long processing times, lack of access to legal services) are of paramount importance. The consequences of post-traumatic stress disorder depend on the type they belong to. The study identified four types of PTSD: severe; asthenic; dysphoric, somatoformat.\u003c/p\u003e \u003cp\u003eThe results of the study recorded that the severe form of PTSD was observed more often in men, and was accompanied by unreasonable anxiety, constant worries; patients have sleep disturbances, insomnia, nightmares at night, panic attacks..\u003c/p\u003e \u003cp\u003eThe asthenic type was recorded more often in women and is accompanied by lethargy, bad mood, and indifference to everything that surrounds a person. The patient oppresses himself, because he believes that he cannot return to normal life. Apathy leads to the fact that a person begins to lose physical shape, it comes to the point that it is difficult for him to get out of bed. Patients prefer daytime sleep, quickly agree to treatment.\u003c/p\u003e \u003cp\u003eDysphoric type is a complex form, manifested by aggression, touchiness, anxiety, distrust of others. Such people like to conflict, are difficult to treat, in rare cases they voluntarily agree to treatment. The study registered that this type was more often recorded in men.\u003c/p\u003e \u003cp\u003eThe somatoform type, like the asthenic type, was recorded in female patients. And it was accompanied not only by a psychological disorder, but also by other symptoms, for example, patients complain of pain in the heart and abdomen, headaches. The difficulty of this type is that the symptoms do not appear immediately, they can make themselves known after six months from the incident. If desired, the patient can express a desire to see a doctor. These differences are probably due to biochemical and hormonal differences in patients of different sexes.\u003c/p\u003e \u003cp\u003eIn wartime conditions, general principles of PTSD therapy should include: the principle of normalization \u0026ndash; the therapist explains to the patient that his symptoms are a reaction of the normal psyche to an abnormal situation; the principle of partnership and enhancing the dignity of the individual, which is especially important for victims of violence; the principle of individuality\u0026ndash; taking into account the fact that the post-traumatic process is very complex, and there are no general principles of therapy suitable for all patients; an interdisciplinary approach with the use, if necessary, of medications, physical exercise and a healthy diet, reading inspiring literature, providing social assistance, etc.\u003c/p\u003e \u003cp\u003eThe therapeutic approach depends on the severity of PTSD:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eUncomplicated PTSD. This type of PTSD responds well to pharmacotherapy targeting the symptoms of PTSD and many types of short-term trauma-focused psychotherapy.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003ePTSD accompanied by comorbid disorders of a transient nature (addictions, anxiety disorder, depression), which is more common than the previous option. In some cases, comorbid disorders become a more important problem for the patient than PTSD. PTSD therapy should simultaneously address the comorbid disorder.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e\u0026ldquo;Post-traumatic personality disorder\u0026rdquo; (e.g., borderline personality disorder, somatophoric disorder, and dissociative disorder), which often results from prolonged psychological trauma in childhood (e.g., sexual abuse). This type of PTSD is often accompanied by behavioural problems (impulsivity, anger reaching rage, aggression and self-aggression, problems with sexual behaviour, eating disorders), emotional instability, emotional impoverishment, depression, panic disorders, cognitive problems (for example, amnesia or fragmentation of memories). Dissociation is often observed. This type of PTSD requires long-term therapy, including the development of emotion regulation skills and communication skills (especially in the area of ​​family relationships), treatment of addictions, and the development of skills necessary for employment. During therapy, it is necessary to create a sense of security in the patient before the therapist can move on to working on the trauma.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003eThe methods with the most evidence base for assessing the effectiveness of PTSD are recognized as trauma-focused cognitive behavioural therapy (TF-CBT), including its individual variants, such as cognitive psychotherapy, cognitive-process psychotherapy, cognitive psychotherapy, prolonged exposure CBT, narrative exposure psychotherapy, as well as eye movement desensitization and reprocessing of mental trauma (EMDR) [\u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e30\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTF-CBT consists of three main stages: stabilization, reprocessing (cognitive processing and narrative), integration and consolidation, with a total of 20 sessions of 15\u0026ndash;18, evenly divided between 3 blocks. Among the targets of TF-CBT are affective/emotional, cognitive, behavioural, and biological. Cognitive psychotherapy is highly effective, lasting 15\u0026ndash;20 sessions, which are held weekly individually and/or in a group to modify pessimistic and catastrophic assessments and memories associated with psychological trauma in order to overcome behavioural and cognitive patterns that support avoidance and interfere with normal daily functioning. The main goal of therapy is to modify pessimistic and catastrophic assessments and memories associated with psychological trauma in order to overcome behavioural and cognitive patterns that support avoidance and interfere with normal daily functioning. Under the guidance of a psychotherapist, the patient learns to identify internal and external stimuli, as well as specific triggers that support PTSD symptoms. In order to reduce the severity of intrusions, a thorough assessment of memories and integration of traumatic experience is carried out. Socratic dialogue is recommended for working with dysfunctional thoughts related to trauma appraisal and core beliefs that support feelings of constant threat. An additional target is dysfunctional cognitive and behavioural patterns that block adaptive coping strategies and recovery of consistent memories of the traumatic event, such as rumination, safety seeking, and thought suppression [\u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e31\u003c/span\u003e, \u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e32\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn the treatment of PTSD, the use of cognitive-process psychotherapy (12 sessions) has proven its effectiveness in overcoming avoidance associated with traumatic experience, its new conceptualization and teaching skills of problem-solving behaviour [\u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e33\u003c/span\u003e]. The method has proven its effectiveness in reducing PTSD symptoms in working with different types of traumatic impacts, including natural disasters, child abuse, participation in military operations, rape; the standard protocol includes 12 sessions. The main goal is to overcome avoidance associated with traumatic experience, its new conceptualization and teaching skills of problem-solving behaviour. For this purpose, psychoeducation is used, keeping a diary of automatic thoughts, identifying maladaptive thoughts that support PTSD symptoms, Socratic 21 dialogue, aimed at changing the attitude to the traumatic experience, for example, overcoming self-blame [\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026lrm;34\u003c/span\u003e, \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026lrm;35\u003c/span\u003e]. The final stage involves improving skills for assessing and correcting beliefs related to the traumatic event, and reinforcing adaptive cognitive strategies in relation to issues of safety, trust, power, control, respect and closeness, those areas that may have been affected by the traumatic experience, with the main goal being to improve the patient\u0026rsquo;s daily functioning and quality of life.\u003c/p\u003e \u003cp\u003eThe use of individual cognitive-behavioural psychotherapy with prolonged exposure has proven itself \u0026ndash; 15\u0026ndash;20 sessions to increase the tolerance of unpleasant stimuli associated with traumatic experience, teaching patients to gradually come into contact with feelings, memories and situations associated with trauma [\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026lrm;36\u003c/span\u003e]. The main goal of this method is to increase the tolerance of unpleasant stimuli associated with traumatic experience, it is aimed at teaching patients to gradually come into contact with feelings, memories and situations associated with trauma. The main task is to teach that triggers and memories are safe and tolerable and should not be avoided. The duration of therapy is about 3 months with weekly sessions from 60 to 120 minutes, a total of 8 to 15 sessions are held, in some cases 15 to 20 are recommended. At the beginning of therapy, the psychotherapist describes the treatment plan and validates the patient's traumatic experience, then training in anxiety coping skills and breathing exercises is carried out. After this, the actual exposure is carried out; for its successful implementation, a therapeutic alliance and a safe atmosphere must be formed, where, under conditions of emotional support, a collision with very frightening stimuli is possible. The exposure can be carried out in the imagination, or as homework in vivo; at present, virtual reality (VR) programs are actively used for conducting the exposure. When conducting VR exposure, the duration of the session is 45\u0026ndash;60 minutes, each scene is repeated until the level of distress is reduced by half compared to the first presentation. The next scene is used after the patient confirms his readiness; the goal of therapy is to make the discomfort bearable. The pace of psychotherapy is determined by the condition and individual characteristics of the patient.\u003c/p\u003e \u003cp\u003eIndividual narrative exposure therapy lasting from 4 to 10 sessions is also used to work through traumatic experiences [\u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e37\u003c/span\u003e, \u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e38\u003c/span\u003e]. The method is actively used to help refugees; the main task is to create a consistent life narrative, into the context of which the traumatic experience fits. Important in the behaviour of the psychotherapist are sympathetic understanding, active listening, unconditional positive acceptance and maintenance of the therapeutic alliance. Under the guidance of the psychotherapist, the patient creates his life narrative in chronological order, focusing mainly on the traumatic experience, but also including positive events. It is believed that this unites the context of cognitive, affective and sensory memories of the trauma. By creating a narrative, the patient forms a consistent, coherent biographical history from fragmentary memories. An important task of psychotherapy is to combine in the narrative the past with episodes of traumatisation, the present with traumatic memories of past events and the future, where the traumatic experience is defined as one of the life episodes. Patients with PTSD may be shown the use of biofeedback techniques \u0026ndash; 10 sessions to reduce anxiety and tension, teach self-regulation skills and reduce the level of tension.\u003c/p\u003e \u003cp\u003eIn cases of prolonged or multiple traumatisations, individual dialectical behavioural therapy (DBT) is used to form an alternative assessment of the traumatic experience [\u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e39\u003c/span\u003e, \u0026lrm;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e40\u003c/span\u003e]. The name itself defines the main goal of the therapy - the formation of an alternative assessment of the traumatic experience, which is often clearly perceived by patients as unbearable and hopeless, the behavioural module is aimed at developing optimal behaviour patterns in the process of comparing various, sometimes contradictory options. The task of the psychotherapist in each individual case is to find the optimal balance between acceptance and change, for which the appropriate techniques are used, to solve individual problems; individual techniques of TF-CBT, compassion-focused psychotherapy, acceptance and responsibility psychotherapy can be additionally used.\u003c/p\u003e \u003cp\u003eIn the process of dialectical behavioural therapy of PTSD, mindfulness, training in distress tolerance and emotional regulation skills, increasing interpersonal effectiveness, exposure and response prevention, counter-behaviour, validation, and self-acceptance are used. Eye movement desensitization and reprocessing (EMDR) is a method of confronting traumatic experiences using targeted bilateral stimulation (through rhythmic 23 eye movements) with simultaneous imagery of the traumatic event. Eye movements and other forms of stimulation of dual focus of attention, in addition to eye movements, it is possible to use sound stimulation or tapping on various parts of the body, provides simultaneous desensitization and cognitive restructuring, as well as integration of traumatic memories and a decrease in the severity of PTSD symptoms. This is a method of individual psychotherapy lasting 6\u0026ndash;12 sessions, which can be held sequentially every day. F. Shapiro \u0026ndash; the author of the method is based on the fact that emotional trauma can disrupt the work of the information processing system, therefore it will be preserved in the form caused by the traumatic experience, and contributes to the formation of intrusive symptoms of post-traumatic syndrome. Eye movements (there may be other alternative stimuli) used in EMDR activate the information processing system and restore its balance. Psychotherapy consists of 8 consecutive phases: anamnesis; preparation; assessment; desensitization; installation; body scanning; completion; re-assessment.\u003c/p\u003e \u003cp\u003eTreatment and rehabilitation of patients with PTSD should be comprehensive and carried out by a team of specialists: psychiatrist/psychotherapist, family doctor, internal medicine specialist, with the active participation of patient and his family.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe study recorded that with the beginning of military actions in the territory of Ukraine, the amount of patients with post-traumatic syndrome increased more than in 3 times, compared to the figures for pre-war years. The results of the reaserch found that in both men and women, the severity of clinical manifestations and psychological disorders increases as the severity of the disorder increases. During the examination of patients, differences in the clinical picture of the disorder in men and women were found. Thus, men have a greater resistance to the risk of developing a disorder in the long term in response to stressors than women, but when the disorder develops, men tend to have more severe manifestations. In women, in the long term after severe mental trauma, the risk of developing PTSD is higher, but the intensity of clinical and psychological manifestations of the disorder is less pronounced.\u003c/p\u003e \u003cp\u003eThe results obtained during the study will not only allow us to correctly select complex treatment for this category of patients and correct all levels of functioning of the traumatic personality, but will also contribute to the prevention of stress-associated somatised pathology of internal organs, reducing the risk of developing alcohol and drug addiction in people with PTSD.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAPA \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;American Psychiatric Association\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eASD \u0026nbsp; \u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;Acute Stress disorder\u003c/p\u003e\n\u003cp\u003eCBT \u0026nbsp; \u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;Cognitive-behavioural therapy\u003c/p\u003e\n\u003cp\u003eCAPS \u0026nbsp; \u0026nbsp; Clinician-Administered Post-traumatic stress disorder Scale\u003c/p\u003e\n\u003cp\u003eCVD \u0026nbsp; \u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;Cardiovascular diseases\u003c/p\u003e\n\u003cp\u003eDSM-5\u0026nbsp;\u0026nbsp; \u0026nbsp;Diagnostic and Statistical Manual of Mental Disorders\u003c/p\u003e\n\u003cp\u003eICD-10\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;International Classification of Diseases 10 revision\u003c/p\u003e\n\u003cp\u003eMHU \u0026nbsp;\u0026nbsp;\u0026nbsp; \u0026nbsp;Ministry of Health of Ukraine\u003c/p\u003e\n\u003cp\u003ePHQ-2\u0026nbsp;\u0026nbsp; \u0026nbsp;\u0026nbsp;Patient Health Questionnaire\u003c/p\u003e\n\u003cp\u003ePTSD \u0026nbsp;\u0026nbsp; \u0026nbsp;\u0026nbsp;\u0026nbsp;Post-traumatic stress disorder\u003c/p\u003e\n\u003cp\u003eWHO \u0026nbsp; \u0026nbsp; \u0026nbsp; World Health Organization\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors express great gratitude to the Editors of the journal for their support in the publication of this study. We would also like to thank the Rector of the Petro Mohyla Black Sea National University for his facilitation of this research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLiudmyla Kiro \u0026ndash; A- Manuscript preparation, B- Study design, C-Data collection; D-Statistical analysis; Alina Urbanovych \u0026ndash; E-Questionnaires and clinical examination of patients; Maksym Zak \u0026ndash; H \u0026ndash; Literature research.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Authors received no financial support for the research. No funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data generated or analysed during this study are included in this published article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted in accordance with the basic bioethical norms of the Helsinki Declaration of the World Medical Association \u0026ldquo;Ethical Principles \u0026nbsp;of Medical Research Involving Humans as Research Subjects\u0026rdquo; (1964), with changes and additions to the General Declaration on Bioethics and Human Rights. United Nations (2005), Council of Europe Convention on Human Rights and Biomedicine (1997). All participants were informed about the goals, organization, methods of the study and signed an informed consent to participate in it. All measures are also taken to ensure patient anonymity. The study was approved by the Ethics Committee of the Petro Mohyla Black Sea National University; Registration card No. 0120U101641 (Address of the institution: \u0026nbsp;Petro Mohyla Black Sea National University, 68 Desantnykiv str.10, Mykolaiv, 54003, Ukraine)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePublisher\u0026rsquo;s Note\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eEpstein A, Lim R, Johannigman J, Fox CJ, Inaba K, Vercruysse GA, Thomas RW, Martin MJ, Konstantyn G, Schwaitzberg SD, MD. FACS, MAMSE. Putting Medical Boots on the Ground: Lessons from the War in Ukraine and Applications for Future Conflict with Near-Peer Adversaries. J Am Coll Surg. 2023;237(2):364\u0026ndash;73. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/xcs.0000000000000707\u003c/span\u003e\u003cspan address=\"10.1097/xcs.0000000000000707\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2023 Apr 24. PMID: 37459197; PMCID: PMC10344429. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/37459197/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/37459197/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eConversano C, Lensi E, Testi C, Gremigni P. II paziente ustionato: fattori associati all'insorgenza del disturbo post-traumatico da stress e indicazioni per l'intervento [The burn patient: factors associated with post-traumatic stress disorder and directions for intervention]. Riv Psichiatr 2010 Jul-Aug;45(4):221\u0026ndash;33. Italian. PMID: 20942368. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/20942368/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/20942368/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMerians AN, Spiller T, Harpaz-Rotem I, Krystal JH, Pietrzak RH. Post-traumatic Stress Disorder. Med Clin North Am. 2023;107(1):85\u0026ndash;99. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.mcna\u003c/span\u003e\u003cspan address=\"10.1016/j.mcna\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. 2022.04.003 Epub 2022 Oct 28. PMID:. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/36402502/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/36402502/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMaercker A, Cloitre M, Bachem R, Schlumpf YR, Khoury B, Hitchcock C, Bohus M. Complex post-traumatic stress disorder. Lancet. 2022;400(10345):60\u0026ndash;72. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1016/S0140-6736(22)00821-2\u003c/span\u003e\u003cspan address=\"https://doi:10.1016/S0140-6736(22)00821-2\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 35780794. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/35780794/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/35780794/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFratto CM. Trauma-Informed Care for Youth in Foster Care. Arch Psychiatr Nurs. 2016;30(3):439\u0026ndash;46. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.apnu.2016.01.007\u003c/span\u003e\u003cspan address=\"10.1016/j.apnu.2016.01.007\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2016 Jan 13. PMID:. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/27256954/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/27256954/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eB\u0026uuml;rgin D, Anagnostopoulos D, Board, Policy Division of ESCAP, Vitiello B, Sukale T, Schmid M, Fegert JM. Impact of war and forced displacement on children's mental health-multilevel, needs-oriented, and trauma-informed approaches. Eur Child Adolesc Psychiatry. 2022;31(6):845\u0026ndash;53. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1007/s00787-022-01974-z\u003c/span\u003e\u003cspan address=\"https://doi:10.1007/s00787-022-01974-z\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 35286450; PMCID: PMC9209349. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/35286450/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/35286450/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePark SC, Kim YK. Anxiety Disorders in the DSM-5: Changes, Controversies, and Future Directions. Adv Exp Med Biol. 2020;1191:187\u0026ndash;196. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1007/978-981-32-9705-0_12\u003c/span\u003e\u003cspan address=\"https://doi:10.1007/978-981-32-9705-0_12\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 32002930. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/32002930/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/32002930/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStein DJ, Craske MG, Friedman MJ, Phillips KA. Meta-structure issues for the DSM-5: how do anxiety disorders, obsessive-compulsive and related disorders, post-traumatic disorders, and dissociative disorders fit together? Curr Psychiatry Rep. 2011;13(4):248\u0026ndash;50. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/21603904/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/21603904/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. https://doi.org/10.1556%2F2006.2022.00033 PMID.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHorsch A, Garthus-Niegel S, Ayers S, Chandra P, Hartmann K, Vaisbuch E, Lalor J. Childbirth-related posttraumatic stress disorder: definition, risk factors, pathophysiology, diagnosis, prevention, and treatment. Am J Obstet Gynecol. 2024;230(3S):S1116\u0026ndash;27. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1016/j.ajog.2023.09.089\u003c/span\u003e\u003cspan address=\"https://doi:10.1016/j.ajog.2023.09.089\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2024 Jan 9. PMID: 38233316. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/38233316/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/38233316/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVargov\u0026aacute; L, Jozefiakov\u0026aacute; B, Lačn\u0026yacute; M, Adamkovič M. War-related stress scale. BMC Psychol. 2024;12(1):208. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s40359-024-01687-9\u003c/span\u003e\u003cspan address=\"10.1186/s40359-024-01687-9\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 38622687; PMCID: PMC11020644. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/38622687/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/38622687/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChudzicka-Czupała A, Hapon N, Chiang SK, Żywiołek-Szeja M, Karamushka L, Lee CT, Grabowski D, Paliga M, Rosenblat JD, Ho R, McIntyre RS, Chen YL. Depression, anxiety and post-traumatic stress during the 2022 Russo-Ukrainian war, a comparison between populations in Poland, Ukraine, and Taiwan. Sci Rep. 2023;13(1):3602. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1038/s41598-023-28729-3\u003c/span\u003e\u003cspan address=\"https://doi:10.1038/s41598-023-28729-3\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 36869035; PMCID: PMC9982762. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/36869035/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/36869035/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi DJ, Chudzicka-Czupała A, Paliga M, Hapon N, Karamushka L, Żywiołek-Szeja M, McIntyre RS, Chiang SK, Chen YL, Yen CF, Man RHC. Rumination about the Russo-Ukrainian War and its related factors among individuals in Poland and Ukraine. Kaohsiung J Med Sci. 2023;39(9):943\u0026ndash;53. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1002/kjm2.12711\u003c/span\u003e\u003cspan address=\"10.1002/kjm2.12711\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2023 Jun 7. PMID: 37283450. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/37283450/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/37283450/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi DJ, Chudzicka-Czupała A, Paliga M, Hapon N, Karamushka L, Żywiołek-Szeja M, McIntyre RS, Chiang SK, Chen YL, Yen CF, Man RHC. Association Between the Time Spent on and Sources of the News of Russo-Ukrainian War and Psychological Distress Among Individuals in Poland and Ukraine: The Mediating Effect of Rumination. Psychol Res Behav Manag. 2024;17:1855\u0026ndash;66. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.2147/PRBM.S457046\u003c/span\u003e\u003cspan address=\"https://doi:10.2147/PRBM.S457046\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 38716257; PMCID: PMC11075697. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/38716257/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/38716257/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMurthy RS, Lakshminarayana R. Mental health consequences of war: a brief review of research findings. World Psychiatry. 2006;5(1):25\u0026ndash;30. PMID: 16757987; PMCID: PMC1472271. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/16757987/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/16757987/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStein BD, Tanielian TL. Building and translating evidence into smart policy: continuing research needs for informing post-war mental health policy. World Psychiatry. 2006;5(1):34\u0026ndash;5. PMID: 16757991; PMCID: PMC1472274. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/16757991/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/16757991/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKeynejad R, Semrau M, Toynbee M, Evans-Lacko S, Lund C, Gureje O, Ndyanabangi S, Courtin E, Abdulmalik JO, Alem A, Fekadu A, Thornicroft G, Hanlon C. Building the capacity of policy-makers and planners to strengthen mental health systems in low- and middle-income countries: a systematic review. BMC Health Serv Res. 2016;16(1):601. https://doi.org/10.1186%2Fs12913-016-1853-0. PMID: 27769270; PMCID: PMC5073499. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/27769270/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/27769270/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAl Jowf GI, Ahmed ZT, Reijnders RA, de Nijs L, Eijssen LMT. To Predict, Prevent, and Manage Post-Traumatic Stress Disorder (PTSD): A Review of Pathophysiology, Treatment, and Biomarkers. Int J Mol Sci. 2023;24(6):5238. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.3390/ijms24065238\u003c/span\u003e\u003cspan address=\"https://doi:10.3390/ijms24065238\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 36982313; PMCID: PMC10049301. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/36982313/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/36982313/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFriedman MJ, Bernardy NC. Considering future pharmacotherapy for PTSD. Neurosci Lett. 2017;649:181\u0026ndash;5. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.neulet.2016.11.048\u003c/span\u003e\u003cspan address=\"10.1016/j.neulet.2016.11.048\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2016 Nov 24. PMID:. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/27890743/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/27890743/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStein DJ, Zungu-Dirwayi N, van Der Linden GJ, Seedat S. Pharmacotherapy for posttraumatic stress disorder. Cochrane Database Syst Rev. 2000;(4):CD002795. doi: 10.1002/14651858.CD002795. Update in: Cochrane Database Syst Rev. 2006;(1):CD002795. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1002/14651858. CD002795.pub2\u003c/span\u003e\u003cspan address=\"https://doi:10.1002/14651858. CD002795.pub2\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 11034765. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/11034765/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/11034765/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYadav G, Gunturu S, Trauma-Informed T. 2024 Jun 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan\u0026ndash;. PMID: 38861623. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/38861623/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/38861623/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHarper GW, Neubauer LC. Teaching During a Pandemic: A Model for Trauma-Informed Education and Administration. Pedagogy Health Promot. 2021;7(1):14\u0026ndash;24. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1177/2373379920965596\u003c/span\u003e\u003cspan address=\"10.1177/2373379920965596\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2020 Oct 14. PMID: 33614921; PMCID: PMC7894645. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/33614921/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/33614921/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBrown T, Berman S, McDaniel K, Radford C, Mehta P, Potter J, Hirsh DA. Trauma-Informed Medical Education (TIME): Advancing Curricular Content and Educational Context. Acad Med. 2021;96(5):661\u0026ndash;667. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/acm.0000000000003587\u003c/span\u003e\u003cspan address=\"10.1097/acm.0000000000003587\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e PMID: 32675789. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/32675789/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/32675789/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTruscott A, Hayes D, Bardsley T, Choksi D, Edbrooke-Childs J. Defining young people's mental health self-care: a systematic review and co-development approach. Eur Child Adolesc Psychiatry. 2023 Nov 10. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1007/s00787-023-02320-7\u003c/span\u003e\u003cspan address=\"https://doi:10.1007/s00787-023-02320-7\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub ahead of print. PMID: 37947894. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/37947894/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/37947894/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSab\u0026eacute; M, Chen C, El-Hage W, Leroy A, Vaiva G, Monari S, Premand N, Bartolomei J, Caiolo S, Maercker A, Pietrzak RH, Clo\u0026icirc;tre M, Kaiser S, Solmi M. Half a Century of Research on Posttraumatic Stress Disorder: A Scientometric Analysis. Curr Neuropharmacol. 2024;22(4):736\u0026ndash;48. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3389/fneur.2024.1374443\u003c/span\u003e\u003cspan address=\"10.3389/fneur.2024.1374443\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 37888890; PMCID: PMC10845098. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/37888890/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/37888890/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCoventry PA, Meader N, Melton H, Temple M, Dale H, Wright K, Cloitre M, Karatzias T, Bisson J, Roberts NP, Brown JVE, Barbui C, Churchill R, Lovell K, McMillan D, Gilbody S. Psychological and pharmacological interventions for posttraumatic stress disorder and comorbid mental health problems following complex traumatic events: Systematic review and component network meta-analysis. PLoS Med. 2020;17(8):e1003262. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1371/journal.pmed.1003262\u003c/span\u003e\u003cspan address=\"https://doi:10.1371/journal.pmed.1003262\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 32813696; PMCID: PMC7446790. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/32813696/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/32813696/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMelton H, Meader N, Dale H, Wright K, Jones-Diette J, Temple M, Shah I, Lovell K, McMillan D, Churchill R, Barbui C, Gilbody S, Coventry P. Interventions for adults with a history of complex traumatic events: the INCiTE mixed-methods systematic review. Health Technol Assess. 2020;24(43):1\u0026ndash;312. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://awspntest.apa.org/doi/10.2174/1570159X22666230927143106\u003c/span\u003e\u003cspan address=\"https://awspntest.apa.doi/10.2174/1570159X22666230927143106\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 32924926; PMCID: PMC7520719. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/32924926/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/32924926/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePurgato M, Gastaldon C, Papola D, van Ommeren M, Barbui C, Tol WA. Psychological therapies for the treatment of mental disorders in low- and middle-income countries affected by humanitarian crises. Cochrane Database Syst Rev. 2018;7(7):CD011849. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1002/14651858\u003c/span\u003e\u003cspan address=\"https://doi:10.1002/14651858\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. CD011849.pub2. PMID: 29975811; PMCID: PMC6513488. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/29975811/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/29975811/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLewis C, Roberts NP, Bethell A, Robertson L, Bisson JI. Internet-based cognitive and behavioural therapies for post-traumatic stress disorder (PTSD) in adults. Cochrane Database Syst Rev. 2018;12(12):CD011710. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1002/14651858\u003c/span\u003e\u003cspan address=\"https://doi:10.1002/14651858\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/30550643/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/30550643/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMCID: PMC6516951.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRoberts NP, Kitchiner NJ, Kenardy J, Robertson L, Lewis C, Bisson JI. Multiple session early psychological interventions for the prevention of post-traumatic stress disorder. Cochrane Database Syst Rev. 2019;8(8):CD006869. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1002/14651858\u003c/span\u003e\u003cspan address=\"https://doi:10.1002/14651858\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. CD006869.pub3. PMID: 31425615; PMCID: PMC6699654. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/31425615/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/31425615/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFeinstein D. Using energy psychology to remediate emotional wounds rooted in childhood trauma: preliminary clinical guidelines. Front Psychol. 2023;14:1277555. https:/. PMID: 37920741; PMCID: PMC10619750. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/37920741/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/37920741/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBach D, Groesbeck G, Stapleton P, Sims R, Blickheuser K, Church D. Clinical EFT (Emotional Freedom Techniques) Improves Multiple Physiological Markers of Health. J Evid Based Integr Med. 2019 Jan-Dec;24. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1177/2515690X18823691\u003c/span\u003e\u003cspan address=\"https://doi:10.1177/2515690X18823691\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 30777453; PMCID: PMC6381429. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/30777453/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/30777453/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. :2515690X18823691.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChurch D, Stapleton P, Vasudevan A, O'Keefe T. Clinical EFT as an evidence-based practice for the treatment of psychological and physiological conditions: A systematic review. Front Psychol. 2022;13:951451. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.3389/fpsyg.2022.951451\u003c/span\u003e\u003cspan address=\"https://doi:10.3389/fpsyg.2022.951451\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 36438382; PMCID: PMC9692186. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/36438382/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/36438382/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eB\u0026uuml;rgin D, Anagnostopoulos D, Board and Policy Division of ESCAP, Vitiello B, Sukale T, Schmid M, Fegert JM. Impact of war and forced displacement on children's mental health-multilevel, needs-oriented, and trauma-informed approaches. Eur Child Adolesc Psychiatry. 2022;31(6):845\u0026ndash;53. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s00787-022-01974-z\u003c/span\u003e\u003cspan address=\"10.1007/s00787-022-01974-z\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 35286450; PMCID: PMC9209349. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/35286450/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/35286450/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBetancourt TS, Newnham EA, Layne CM, Kim S, Steinberg AM, Ellis H, Birman D. Trauma history and psychopathology in war-affected refugee children referred for trauma-related mental health services in the United States. J Trauma Stress. 2012;25(6):682\u0026thinsp;\u0026ndash;\u0026thinsp;90. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1002/jts.21749\u003c/span\u003e\u003cspan address=\"10.1002/jts.21749\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e PMID: 23225034. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/23225034/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/23225034/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eXu W, Pavlova I, Chen X, Petrytsa P, Graf-Vlachy L, Zhang SX. Mental health symptoms and coping strategies among Ukrainians during the Russia-Ukraine war in March 2022. Int J Soc Psychiatry. 2023;69(4):957\u0026ndash;966. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1177/00207640221143919\u003c/span\u003e\u003cspan address=\"10.1177/00207640221143919\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e Epub 2023 Jan 4. PMID: 36598090. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/36598090/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/36598090/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZabłocka-Żytka L, Lavdas M. The stress of war. Recommendations for the protection of mental health and wellbeing for both Ukrainian refugees as well as Poles supporting them. Psychiatr Pol. 2023;57(4):729\u0026ndash;746. English, Polish. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.12740/PP/156157\u003c/span\u003e\u003cspan address=\"10.12740/PP/156157\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e Epub 2023 Aug 31. PMID: 38170647. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/38170647/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/38170647/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAnjum G, Aziz M, Hamid HK. Life and mental health in limbo of the Ukraine war: How can helpers assist civilians, asylum seekers and refugees affected by the war? Front Psychol. 2023;14:1129299. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.3389/fpsyg.2023.1129299\u003c/span\u003e\u003cspan address=\"https://doi:10.3389/fpsyg.2023.1129299\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 36874809; PMCID: PMC9983366. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/36874809/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/36874809/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHodes M. Thinking about young refugees' mental health following the Russian invasion of Ukraine in 2022. Clin Child Psychol Psychiatry. 2023;28(1):3\u0026ndash;14. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1177/13591045221125639\u003c/span\u003e\u003cspan address=\"10.1177/13591045221125639\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e Epub 2022 Sep 7. PMID: 36071016. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/36071016/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/36071016/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDella Rocca B, Bello R, Carbone M, Pezzella P, Toni C, Sampogna G, Tarsitani L, Luciano M, Fiorillo A. Promoting mental health and preventing mental health problems in child and adolescent refugees and asylum seekers: A systematic review on psychosocial interventions. Int J Soc Psychiatry. 2024;70(4):653\u0026ndash;66. https://. Epub 2023 Dec 9. PMID: 38069651.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUphoff E, Robertson L, Cabieses B, Villal\u0026oacute;n FJ, Purgato M, Churchill R, Barbui C. An overview of systematic reviews on mental health promotion, prevention, and treatment of common mental disorders for refugees, asylum seekers, and internally displaced persons. Cochrane Database Syst Rev. 2020;9(9):CD013458.\u003c/span\u003e \u003cspan\u003ehttps://doi:10.1002/14651858.\u003c/span\u003e \u003cspan\u003eCD013458.pub2. PMID: 32885850; PMCID: PMC8572368.\u003c/span\u003e \u003cspan\u003ehttps://\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003epubmed.ncbi.nlm.nih.gov/32885850/\u003c/span\u003e\u003cspan address=\"http://pubmed.ncbi.nlm.nih.gov/32885850/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Post-traumatic stress disorder, Migration, Refugees, Cognitive-behaviour therapy, Russian - Ukrainian war","lastPublishedDoi":"10.21203/rs.3.rs-4691182/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4691182/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe amount of Ukrainians with PTSD has been steadily increasing since December 2022. According to the National Health Service, amount of Ukrainians with posttraumatic-stress disorder (PTSD) in 2021 were 3,167 patients; 2022 — 7,051 patients; 2023 — 12.494 patients; 2024 (January-June) — 6,292, and for the forecasts of WHO, it will continue to increase rapidly.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study involved 450 patients who sought psychological help at the University Clinic of Petro Mohyla Black Sea National University from January to June 2024. All patients were divided into 3 groups: 1st group — patients with PTSD (18–44 years); 2nd group — patients with PTSD (45–59 years), 3rd group — patients with PTSD (60–74 years). The examination of patients included clinical, psychological, questionnaire survey for CAPS-5 scale, SDS — 2000, and static methods.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn 2nd group, mild and moderate course of PTSD among women were occurred in 2.0 (χ\u003csup\u003e2\u003c/sup\u003e = 0.86, p = 0.001) and 2.2 (χ\u003csup\u003e2\u003c/sup\u003e = 0.46, p = 0.023) times more often than in male. While severe and extreme course of PTSD in male of 2nd group were recorded in 1.6 (χ\u003csup\u003e2\u003c/sup\u003e = 0.16, p = 0.033) and 1.8 (χ\u003csup\u003e2\u003c/sup\u003e = 0.99, p = 0.006) times more often than in female patients.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eExamination of patients found that, men have a greater resistance to the risk of developing a disorder in the long term in response to stressors than women, but when the disorder develops, men tend to have more severe manifestations. In women, in the long term after severe mental trauma, the risk of developing PTSD is higher, but the intensity of clinical and psychological manifestations of the disorder is less pronounced.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRegistration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was carried out in accordance with the plan of research works at the Petro Mohyla Black Sea National University (Adress: 68 Desantnykiv St, 10, Mykolaiv, Ukraine, 54000) on the topic: “Clinical-pathogenetic justification of the system of primary and secondary prevention of the most socially significant chronic non-infectious diseases of internal organs”, state registration number 0120U101641.\u003c/p\u003e\n\u003cp\u003eDate of registration: 17.03.2021\u003c/p\u003e\n\u003cp\u003eDuration of research: 03.2021-12.2024\u003c/p\u003e","manuscriptTitle":"Peculiarities of the course and management of Ukrainians with post-traumatic stress disorder in the context of the Ukrainian-Russian war","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-31 09:58:28","doi":"10.21203/rs.3.rs-4691182/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-07-09T14:55:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-07-08T06:31:37+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-07-08T06:29:29+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Psychology","date":"2024-07-05T09:22:40+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"bf8de017-4c85-4c32-b070-120f253ba369","owner":[],"postedDate":"July 31st, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-11-04T16:23:28+00:00","versionOfRecord":{"articleIdentity":"rs-4691182","link":"https://doi.org/10.1186/s40359-024-02109-6","journal":{"identity":"bmc-psychology","isVorOnly":false,"title":"BMC Psychology"},"publishedOn":"2024-10-29 16:13:07","publishedOnDateReadable":"October 29th, 2024"},"versionCreatedAt":"2024-07-31 09:58:28","video":"","vorDoi":"10.1186/s40359-024-02109-6","vorDoiUrl":"https://doi.org/10.1186/s40359-024-02109-6","workflowStages":[]},"version":"v1","identity":"rs-4691182","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4691182","identity":"rs-4691182","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}