A Scoping Review of Mental Health and Psychological Impact of the Russo-Ukrainian War (2014– until present)

Nino Tabeshadze^*

https://orcid.org/0009-0005-3038-7247
Swedish Defence University
e-mail: nino.tabeshadze@fhs.se

Przegląd scopingowy dotyczący zdrowia psychicznego i psychologicznych skutków wojny rosyjsko-ukraińskiej (2014–2024)

Introduction

This scoping review aims to consolidate the existing evidence on the psychological and mental health impacts of the Russo-Ukrainian war. By mapping the multifaceted challenges and identifying evidence-based interventions, this review seeks to provide actionable insights for policymakers, mental health professionals, and humanitarian organisations. The findings will inform the development of targeted strategies to address the immediate and long-term mental health needs of those affected by this conflict.

Any war’s impact transcends immediate physical destruction, infiltrating the very fabric of societies by eroding social cohesion, trust, and community resilience. The degradation of mental health systems in conflict zones further exacerbates the situation, leaving affected populations without adequate support (Roberts et al., 2021). Despite these challenges, the resilience displayed by many individuals and communities highlights the potential for targeted interventions to foster recovery and stability (Masten, Narayan, 2012).

The conflict which is under scrutiny in this paper began in 2014 with Russia’s annexation of Crimea and escalated into a full-scale invasion in February 2022. This protracted timeline has allowed the psychological effects of war to permeate through generations, leaving a deep imprint on the collective mental health of Ukrainians (Tol et al., 2020). Vulnerable groups – including children exposed to violence, displaced families, and the elderly – are facing unique challenges. For instance, children often experience developmental disruptions and educational instability, while the elderly grapple with isolation and unmet health care needs (World Health Organization [WHO], 2022).

The ongoing Russo-Ukrainian war has profoundly disrupted the mental health landscape, exposing millions to severe psychological distress and long-term consequences. Civilians caught in the crossfire face daily stressors such as displacement, loss of loved ones, and the destruction of homes and communities (Morina et al., 2018). For military personnel, the psychological burden often includes moral injury, post-traumatic stress disorder (PTSD), and challenges in reintegration into civilian life (Kok et al., 2021). The war has intensified pre-existing mental health challenges and introduced systemic barriers that limit access to care, particularly for marginalised populations such as children, the elderly, and individuals with pre-existing mental health conditions (UNHCR, 2022).

Methods

This review synthesised findings from multiple studies, employing diverse methodologies such as network analyses, and cross-sectional surveys. Data sources included peer-reviewed journals, reports from international organisations, and national-level surveys conducted during the conflict. The scope encompassed key themes such as PTSD, complex PTSD (CPTSD), depression, anxiety, moral injury, and the psychosocial dynamics within families and communities. Studies were selected based on relevance, methodological rigour, and their focus on affected populations, including civilians, refugees, and students.

Research design

This scoping review aimed to map the psychological and mental health impacts of the Russo-Ukrainian war, identify vulnerable populations, and highlight effective interventions for addressing these challenges. To achieve this, a mixed-methods approach was used to consolidate evidence from various disciplines, providing a comprehensive understanding of the issue.

The review examined relevant literature, drawing on peer-reviewed journals, reports from international organisations such as the World Health Organization (WHO) and the United Nations High Commissioner for Refugees (UNHCR), and national surveys conducted in Ukraine and its neighbouring regions. This category included materials from Médecins Sans Frontières, UNICEF, and Mental Health Europe, and they described field-level psychological service gaps and strategies. Government sources comprised public health updates from the Ukrainian Ministry of Health and emergency bulletins from the Ministry of Reintegration. Press materials included verified reports from the BBC, The Guardian, and Al Jazeera that provided context for mental health disruptions in occupied territories and among refugees. These were accessed via official websites and cross-checked with international agency reports for verification. Selected sources are referenced throughout the text.

To focus the study, specific inclusion and exclusion criteria guided the selection of sources. Only studies addressing the psychological effects of the Russo-Ukrainian war – particularly those focusing on conditions such as post-traumatic stress disorder (PTSD), complex PTSD (CPTSD), depression, and anxiety – were included. These studies had to cover populations directly impacted by the war, including civilians, refugees, military personnel, and children. Research published in English from 2014 onwards was prioritised, reflecting the period of conflict and its intensification. Conversely, articles that lacked primary data, focused solely on physical health outcomes, or were published in languages other than English were excluded.

The data collection process employed a systematic search strategy. Academic databases such as PubMed, PsycINFO, and Scopus were explored using carefully selected keywords and Boolean operators. This search was complemented by title and abstract screening, followed by a full-text review to ensure alignment with the inclusion criteria.

Data extraction focused on key variables such as the prevalence of mental health conditions, the demographic breakdowns of affected populations, systemic barriers to mental health care, and evidence-based interventions. Quantitative data, such as prevalence rates of PTSD or depression, was synthesised to identify patterns, while qualitative insights were used to explore systemic issues and lived experiences. Thematic analysis was employed to uncover recurring challenges and highlight areas where targeted interventions could have the greatest impact.

Ethically, this review did not require formal approval, since it relied solely on secondary data. However, great care was taken to ensure that all sources were credible and verified, respecting the integrity of the research process.

The goal of this research was to provide actionable insights for policymakers, mental health professionals, and humanitarian organisations. By consolidating the existing evidence, the review mapped the prevalence and demographic distribution of mental health disorders, identified systemic barriers, and proposed evidence-based strategies to address the immediate and long-term psychological needs of those affected by the Russo-Ukrainian war.

Findings

Discussion

Prevalence and risk factors. The elevated prevalence of PTSD and CPTSD among Ukrainian civilians and military personnel highlights the devastating impact of continuous exposure to war-related stressors. Levin and colleagues (2024) demonstrated how emotional dysregulation and heightened threat perception serve as key components of CPTSD. These symptoms are particularly prevalent in environments marked by continuous traumatic stress, where individuals lack the opportunity for psychological recovery between traumatic events.

Chudzicka-Czupała and colleagues (2023) emphasised that Ukrainian populations exhibit the highest rates of depression and anxiety compared to their neighbouring countries, likely due to their proximity to the conflict and direct exposure to trauma. Psychological stress is not only a response to the physical dangers of war but also to secondary stressors such as financial instability, displacement, and the loss of loved ones. These stressors collectively create a cycle of chronic mental health challenges, necessitating sustained interventions.

Kang and colleagues (2023) also noted that disability severity exacerbates PTSD symptoms, with women being disproportionately affected. This finding aligns with global patterns showing gender-based vulnerabilities in mental health outcomes during conflicts. Women often bear the brunt of caregiving responsibilities, experience heightened emotional labour, and face increased risks of gender-based violence during conflicts, further compounding their mental health burden.

Recent studies also highlight the prevalence of acute stress disorder and prolonged grief disorder, which remain underrepresented in war-related mental health assessments. Kordel and colleagues (2024) found acute stress disorder to be widespread among refugees shortly after displacement, while Lushchak and colleagues (2024) revealed sustained PTSD and grief symptoms after a full year of conflict exposure. These findings support expanding psychological screening and interventions to encompass a broader range of trauma-induced conditions beyond traditional PTSD and depression.

Moral injury in service members. Moral injury, a psychological construct describing the emotional and cognitive distress arising from violations of deeply held moral beliefs, is particularly prevalent among Ukrainian service members. Timmer and colleagues (2023) found that guilt and emotional distress were common, complicating the reintegration process. The profound psychological wounds inflicted by witnessing or participating in morally-conflicting situations can erode trust in oneself and others, leading to isolation and an increased risk of depression and suicide.

Systemic barriers – including insufficient resources and a lack of culturally-adapted tools – exacerbate the issue, as highlighted by Tkach and Lunov (2022). Addressing moral injury requires specialised interventions focusing on ethical reconciliation and cognitive behavioural therapy to rebuild shattered belief systems. These approaches must be tailored to the unique cultural and situational contexts of Ukrainian service members, incorporating elements of national identity and collective resilience.

The role of families and communities. Family support emerges as a crucial factor in mitigating the psychological impact of war. Bukovska (2015) emphasised the importance of involving families in the reintegration process of demobilised service members. Families serve as both a buffer and a resource, providing emotional and practical support that can significantly reduce the psychological burden of transitioning back to civilian life.

Similarly, Rizzi and colleagues (2022) reported that displaced individuals with strong familial ties exhibited greater resilience against depression and anxiety. Educational programmes aimed at equipping families with the knowledge to recognise and address PTSD symptoms could significantly improve outcomes for affected individuals. Community-based interventions that foster social cohesion and collective healing are equally vital, as they address the broader social determinants of mental health.

Impact on children and adolescents. Children and adolescents represent one of the most vulnerable groups during armed conflicts. Osokina and colleagues (2022) revealed that exposure to daily stressors and family separation significantly increased the risk of PTSD, anxiety, and depression among Ukrainian youth. The developmental stage of children makes them particularly susceptible to the long-term effects of trauma, which can manifest as difficulties in emotional regulation, academic performance, and social interactions.

Bürgin and colleagues (2022) advocated for trauma-informed, multilevel interventions tailored to the developmental needs of children. This includes creating safe spaces, ensuring access to education, and providing psychological first aid to foster resilience and emotional stability. Schools can play a pivotal role by integrating mental health education into their curricula and offering counselling services to students and their families.

Systemic challenges in mental health care. The fragmentation of Ukraine’s mental health services poses significant barriers to effective care delivery. Tkach and Lunov (2022) highlighted the lack of a unified national psychological service, with the existing systems being departmentalised and inadequately equipped to handle large-scale mental health crises. This necessitates comprehensive policy reforms to streamline mental health services, develop standardised diagnostic tools, and train professionals in trauma-informed care practices.

International collaboration can also play a critical role in addressing these systemic challenges. Partnerships with global health organisations can facilitate the exchange of knowledge, resources, and best practices, enabling Ukraine to build a more resilient mental health infrastructure.

Environmental and broader effects. Environmental destruction caused by the war has profound psychological consequences. Khrushch and colleagues (2023) documented high levels of PTSD, depression, and anxiety linked to noise and air pollution. The destruction of natural environments and infrastructure not only disrupts daily life but also contributes to a sense of loss and disorientation among the affected populations.

Addressing these issues requires integrating environmental rehabilitation into mental health strategies, ensuring that the affected populations have access to both psychological support and a safe, sustainable environment. Policies aimed at rebuilding infrastructure and restoring ecosystems should incorporate mental health considerations, recognising the interplay between physical and psychological well-being.

Refugee and displacement experiences. The psychological distress experienced by refugees and internally displaced persons (IDPs) underscores the importance of targeted interventions. Buchcik and colleagues (2023) found that female refugees reported higher levels of depression and anxiety compared to their male counterparts. Factors such as prolonged uncertainty, separation from family members, and difficulties in accessing basic services contribute to this heightened vulnerability.

Timmer and colleagues (2023) highlighted that daily stressors, financial instability, and discrimination significantly contributed to the mental health burden of IDPs. Integrating mental health support with socioeconomic interventions could alleviate these stressors and promote resilience. For example, providing access to education, employment opportunities, and legal assistance can empower displaced individuals to rebuild their lives and reduce the long-term psychological impact of displacement.

Based on the analysed articles, the following actions are recommended in order to support humanitarian actors and policymakers:

• implementing mobile mental health clinics in rural and conflict-affected regions to improve access;
• funding community-based resilience and family therapy programmes tailored to displaced populations;
• developing multilingual mental health toolkits for refugees, incorporating trauma-informed approaches;
• training local aid workers and educators in psychological first aid and PTSD screening;
• promoting international cooperation to support Ukraine’s mental health infrastructure development.

Limitations

While this scoping review offers valuable insights into the mental health and psychological impacts of the Russo-Ukrainian war, several limitations must be acknowledged.

1. The evolving nature of the conflict – the ongoing nature of the conflict, particularly the escalation of the war in 2022, poses a challenge in capturing the most up-to-date data on the psychological impact. The continued intensity of the war means that new studies and data on the mental health outcomes of the affected populations are still emerging, and some of these may not be fully captured in this review. The rapidly changing context may also influence the consistency and generalisability of the findings over time.
2. Reporting bias – studies conducted in conflict zones are prone to various forms of reporting bias. These include the underreporting of mental health issues due to stigma or a fear of retribution, as well as the over-reporting of certain conditions that may be influenced by the researcher’s or participant’s perspectives. Additionally, mental health data from individuals living under extreme stress or in displacement may be inconsistent due to a lack of standardised diagnostic tools or reliable reporting mechanisms.
3. Language and access barriers – many studies relevant to the conflict and its psychological impacts may have been published in languages other than English, limiting the scope of this review. Furthermore, access to certain studies and data – particularly from conflict zones or politically-sensitive areas – may have been restricted, making it difficult to obtain a comprehensive dataset. As a result, some critical perspectives or findings from Ukrainian researchers or local health organisations may not be included.
4. The lack of longitudinal data – while the review identifies immediate psychological effects, long-term mental health outcomes of those affected by the Russo-Ukrainian war are less well-understood. Given that many of the available studies have been cross-sectional or have covered relatively short periods, there is insufficient longitudinal data to assess the full range of mental health consequences, including delayed effects or the evolution of conditions such as PTSD over time.
5. Variability in methodologies – the studies included in this review employ a wide range of methodologies, such as network analyses, and surveys. This diversity in approaches can lead to variability in how mental health outcomes are measured and reported, limiting the ability to draw definitive conclusions across all studies. In particular, differences in sample sizes, measurement tools, and population characteristics may result in inconsistencies in findings.
6. Focus on specific populations – while the review includes a broad range of populations, certain groups – such as combatants from both sides of the conflict, internally displaced persons (IDPs) living in non-urban areas, and individuals who have been exposed to multiple waves of violence over time – may not be adequately represented in the available studies. This could lead to an incomplete understanding of the full breadth of the psychological impact of the war across all demographic groups.
7. Resource constraints – the limited availability of resources in conflict zones has significantly hindered the ability of researchers to conduct extensive mental health assessments. As a result, many studies may rely on self-reported data, which can be unreliable in such high-stress environments. In addition, the disruption of health services in war-torn regions may have skewed the data, as access to care was frequently unavailable or limited for large segments of the population.
8. The generalisability of the findings – the findings of this review may not be fully applicable to other conflict settings due to the unique geopolitical, cultural, and social dynamics of the Russo-Ukrainian war. Although certain psychological impacts, such as PTSD and depression, are common in war zones, the specific nature of the conflict – including the prolonged exposure to violence, environmental destruction, and forced displacement – may lead to outcomes that differ from those observed in other international crises.
9. The lack of comparative studies – the review highlights the mental health challenges faced by Ukrainian populations, but it lacks in-depth comparative analysis between different groups, such as civilians versus military personnel, or Ukrainians versus displaced refugees. Comparative studies could provide a deeper understanding of how these populations experience and cope with psychological trauma, thus informing more tailored interventions.
10. Ethical considerations – given that this review is based on secondary data, ethical concerns related to participant confidentiality, informed consent, and the potential re-traumatisation of individuals in the studies are not directly addressed here. Although care was taken to use credible and verified sources, the potential for ethical challenges in the original studies may affect the integrity of the findings.

These limitations emphasise the need for continued research into the mental health impacts of the Russo-Ukrainian war, particularly studies that address these gaps and explore the long-term psychological outcomes of conflict on all affected populations. Future research should also aim to incorporate more standardised methodologies, longitudinal data, and a broader array of perspectives to better inform policy and interventions in war-torn regions.

Conclusion

The mental health impact of the Russo-Ukrainian war is both widespread and deeply entrenched, leaving millions of civilians, military personnel, and displaced individuals struggling with profound psychological distress. As this scoping review reveals, the war’s ongoing nature has compounded pre-existing mental health challenges and introduced new systemic barriers that hinder effective care, especially for the most vulnerable populations, including children, the elderly, and those with pre-existing conditions. Civilians and military personnel are bearing the brunt of severe psychological consequences, with high rates of PTSD, complex PTSD, depression, and anxiety being reported across affected regions. Notably, the most marginalised groups – such as refugees and internally displaced persons (IDPs) – face amplified psychological challenges due to displacement, family separation, and limited access to support.

The findings highlight the urgent need for targeted interventions that can address both the immediate and long-term psychological needs of those affected by the conflict. There is a clear need for mental health systems to be strengthened, particularly in regions affected by wars, where the fragmentation of services and lack of standardised care significantly impede effective support. Tailored interventions, including trauma-informed care and psychosocial support, must be incorporated into the recovery process, alongside rebuilding social infrastructure and community resilience. The involvement of families and communities emerges as a central factor in fostering resilience, with support systems playing a pivotal role in reintegration and recovery.

The mental health consequences of the Russo-Ukrainian war also underscore the importance of a multi-faceted, international response that integrates environmental rehabilitation, policy reforms, and cross-sectoral collaboration. Addressing systemic barriers and strengthening mental health services must be prioritised in the coming years, ensuring that mental health interventions are accessible, culturally appropriate, and capable of supporting individuals across all stages of recovery. Furthermore, interventions that address gender-specific vulnerabilities, particularly for women and children, are essential, as these groups are disproportionately affected by the psychological trauma of war.

Ultimately, the resilience demonstrated by individuals and communities, even in the face of immense hardship, provides hope for recovery. However, this resilience must be supported through sustained, evidence-based interventions that recognise the complex interplay of social, psychological, and environmental factors in the healing process. Policymakers, mental health professionals, and humanitarian organisations must work together to address the enduring psychological wounds of the Russo-Ukrainian war, with a focus on long-term strategies that ensure the well-being of all affected individuals and facilitate their recovery in the years to come. Only through comprehensive and coordinated efforts can the full psychological impact of the conflict be addressed, ensuring that mental health remains a priority for Ukraine’s recovery and future stability.