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Patterns of somatic distress among internally displaced persons in Ukraine: analysis of a cross-sectional survey

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Abstract

Purpose

There are often high rates of mental disorders in low- and middle-income countries during humanitarian crises, but the prevalence of somatic distress (SD) is underreported in the existing health service research. We aim to examine the patterns of SD among internally displaced persons (IDPs) in Ukraine, who were forcibly displaced due to the ongoing conflict in the country’s eastern region.

Methods

The study design was a cross-sectional survey of 2203 adult IDPs throughout Ukraine. The survey collected data on sociodemographic characteristics, traumatic life events (Life Events Checklist), utilisation of mental health care services, and self-reported outcomes of SD (Patient Health Questionnaire 15), anxiety (Generalised Anxiety Disorder 7), depression (Patient Health Questionnaire 9), and post-traumatic stress (PTSD Checklist). Descriptive and multivariate regression analyses were used.

Results

Over half of respondents (n = 1142, 55%) were identified as being at risk of SD (PHQ-15 score ≥ 6), and the prevalence of moderate (n = 377, 18%) and high severity SD risk (n = 275, 13%) was substantial. There were significant associations (p < 0.05) between SD and age, female gender, economic status, self-reported depression and post-traumatic stress, and multiple trauma exposures. Being at risk of SD was also significantly associated with increased functional disability. Use of mental health care services was low across this population and only high SD risk seemed to be a reliable predictor of care-seeking behaviour.

Conclusions

There is a significant risk of SD among IDPs in Ukraine. Our results illustrate the need for targeted health service research and regional programs to ensure that mental health needs are appropriately met.

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Abbreviations

IDP:

Internally displaced person

PTSD:

Post-traumatic stress disorder

MHPSS:

Mental health and psychosocial support

SD:

Somatic distress

PHQ-15:

Patient Health Questionnaire 15

GAD-7:

Generalised Anxiety Disorder 7

PHQ-9:

Patient Health Questionnaire 9

PTSS:

Post-traumatic stress symptoms

PCL-5:

Post-traumatic stress disorder checklist for DSM-5

WHODAS 2.0:

World Health Organization disability assessment schedule, version 2

LEC-5:

Life events checklist

KIIS:

Kiev International Institute of Sociology

OR:

Odds ratio

CI:

Confidence interval

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Acknowledgements

We would like to thank the respondents participating in this study and the staff assisting with data collection for their contributions. This work was supported by a grant from the European Union’s Instrument contributing to Stability and Peace (IcSP) under a project entitled “Psychosocial needs for peace: trauma rehabilitation and civic activism in Ukraine”. The project was implemented by International Alert UK.

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The funder did not play a role in data collection, analysis, or interpretation.

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Authors and Affiliations

  1. Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK

    Anson Cheung & Bayard Roberts

  2. Ilia State University, Tbilisi, Georgia

    Nino Makhashvili & Jana Javakhishvili

  3. Global Initiative on Psychiatry, Tbilisi, Georgia

    Nino Makhashvili & Jana Javakhishvili

  4. Shayk National Medical Academy, Kiev, Ukraine

    Andrey Karachevsky

  5. Kiev International Institute of Sociology, Kiev, Ukraine

    Natalia Kharchenko & Marina Shpiker

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  1. Anson Cheung
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  2. Nino Makhashvili
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Correspondence to Bayard Roberts.

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All aspects of this study comply with institutional and national guidelines on research and human experimentation, in addition to the most recent revision of the Declaration of Helsinki.

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Cheung, A., Makhashvili, N., Javakhishvili, J. et al. Patterns of somatic distress among internally displaced persons in Ukraine: analysis of a cross-sectional survey. Soc Psychiatry Psychiatr Epidemiol 54, 1265–1274 (2019). https://doi.org/10.1007/s00127-019-01652-7

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