Analysis of the dynamics and trends in the mental health of Ukrainian youth under martial law

Abstract

The ongoing full-scale war in Ukraine subjects the civilian population’s psyche, particularly that of young people and university students, to extreme, unprecedented macrosocial duress. Chronic exposure to military danger, active combat conditions, missile strikes, and prolonged socio-economic instability triggers a significant increase in affective disorders, generalized anxiety, and post-traumatic stress disorder (PTSD). Understanding the long-term clinical and psychological dynamics of youth mental health, along with the precise impact of individual-demographic, gender, and behavioral factors, is critically important. Such comprehensive empirical data are essential for developing effective, targeted psychosocial support strategies and sustainable public health programs tailored to a society under severe stress. Purpose. The study aims to establish the baseline characteristics, identify the longitudinal dynamics, and determine the prominent trends in mental health changes among Ukrainian youth aged 17–24 under the conditions of prolonged martial law. Materials and Methods. A comprehensive two-stage monitoring study with a strict 1-year interval was conducted to assess the psycho-emotional state of young individuals (higher education students). The first stage assessed 316 respondents, and the second examined 308 participants. Standardized and validated psychodiagnostic instruments were utilized: the Beck Depression Inventory (BDI), the Generalized Anxiety Disorder Assessment (GAD-7), the Mood Disorder Questionnaire (MDQ), the PTSD Checklist for DSM-5 (PCL-5), and the Positive and Negative Syndrome Scale (PANSS). The comprehensive statistical analysis accounted for gender, self-reported physical activity levels, and migration status (remaining in a permanent residence, internal displacement, or relocation abroad). Results. At the second stage of monitoring, manifestations of anxiety were identified in 66.0% of respondents, depression in 40.6%, psychopathological syndromes (PANSS) in 22.0%, clinical signs of PTSD in 18.5%, and mood disorders in 15.0%. The annual dynamics revealed a clear cumulative effect of chronic wartime stress: generalized anxiety increased statistically significantly (from 56.6% to 65.9%, p < 0.05), and severe forms of clinical depression intensified (from 11.4% to 14.0%). Concurrently, signs of longterm psychological adaptation were observed: the prevalence of mood disorders decreased (from 25.3% to 15.0%, p < 0.05), as did PTSD symptoms (from 25.9% to 18.5%, p < 0.05) and PANSS syndromes (from 41.7% to 22.1, p < 0.001). Factor analysis indicated that women are significantly more vulnerable to stress chronification, demonstrating a prominent annual increase in mild anxiety (from 38.2% to 50.0%, p < 0.01). Sufficient physical activity proved to be a potent protective behavioral resource: physically active individuals experienced a substantial improvement in their affective sphere, with mood disorders decreasing from 22.1% to 10.8% (p < 0.01). The impact of migration status is highly ambivalent: staying permanently in Ukraine exacerbates generalized anxiety (p < 0.05), whereas temporary external migration abroad provides physical safety, reducing acute psychopathological syndromes (p < 0.05), yet simultaneously increases the risk of depressive states (rising from 10.5% to 17.95%) due to acculturation stress. Conclusions. Chronic wartime stress shapes a complex, multidirectional trajectory of changes in youth mental health, where phenomena of psycho-emotional exhaustion coexist with an adaptive plateau. These empirical findings practically substantiate the necessity of restructuring existing civilian medical support protocols and developing targeted public health programs. These programs should mandatorily incorporate behavioral activation through physical practices for all youth, focus on anxiety reduction in women, and support adaptation alongside the deconstruction of media trauma in external emigrants.