Prevalence and Correlates of Significant Posttraumatic Stress Disorder Symptoms in Children in Ukraine.

Objective: Childhood traumatic events are key risk factors for posttraumatic stress disorder (PTSD) and other psychiatric conditions. The war context of the Russian invasion of Ukraine has exposed Ukrainian children to direct and indirect war-related traumatic events and has significantly increased the mental health burden of Ukrainian youth. The objective of the present article is to report the prevalence and correlates of significant PTSD symptoms among children in a part of Ukraine that is not directly affected by the war. Method: This is a cross-sectional study conducted in Ternopil. All primary schools in Ternopil were contacted, and children and adolescents aged 7 to 17 years were included in the study if the legal guardian did not object to participation. The Child Revised Impact of Events Scale (CRIES-8) was completed by the youth, whereas demographic characteristics were collected from the youth, parents/legal guardians, and teachers. Results: A total of 4,753 children and adolescents from 26 schools, aged 7 to 17 years (mean age 11.03 ±1.70 years), 52.3% female, participated in this study. The prevalence of clinically significant PTSD symptoms, defined as CRIES-8 scores of 17 or above, was 40.3% in the overall sample. Female participants had significantly higher intrusion, avoidance, and total CRIES-8 scores ( Conclusion: The study shows a high prevalence of significant PTSD symptoms even among Ukrainian children and adolescents living in areas far from active conflict zones, suggesting an urgent need for solutions to protect and improve the mental health of youth in war-affected countries. Clinical guidance: • Clinicians should consider screening children from war-affected countries for trauma-related symptoms, even if they live far from active conflict zones, as significant stress may be present without direct exposure.• Younger children may require special attention, as early school-age youth appear to be particularly vulnerable to war-related stress and may exhibit PTSD symptoms differently than adolescents.• Girls may require more targeted monitoring and early intervention, given the consistently higher levels of trauma-related symptoms in this group. Study registration information: Evaluation of the Teaching Recovery Techniques plus Parenting, a Cluster Randomised Controlled Trial in Ukrainian Schools in Ternopil (TRUST); https://doi.org/10.1186/ISRCTN15476405. Diversity & Inclusion Statement: We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. Diverse cell lines and/or genomic datasets were not available. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list.The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.