War in Ukraine impacts patients with mental disorders

Aarhus University

Danish patients with mental disorders seem to have experienced a worsening of symptoms in connection with the invasion of Ukraine. This is shown by a new study from Aarhus University and Aarhus University Hospital – Psychiatry.

War on European soil is a rare event, and for many, 24 February 2022 will therefore be remembered as an unusually dark day in history. This was the day when Russian troops began the invasion of neighbouring Ukraine. Since then, the hostilities have caused tens of thousands of deaths and driven more than ten million Ukrainians from their homes.

War has serious psychological consequences for the people who are directly involved. A new study now suggests that Danish patients with mental disorders are also affected by the ongoing situation in Ukraine.

Analysis of more than 500,000 clinical notes from medical records

In the research project, Søren Dinesen Østergaard, Christopher Rohde and Oskar Hougaard Jefsen have analysed more than 500,000 clinical notes from medical records from the psychiatric hospitals in the Central Denmark Region for the period from 1 January to 8 March 2022. Via an electronic search, the researchers identified the subset of the clinical notes that contained the word ‘Ukraine’.

“The results of the study confirmed our hypothesis, as we saw a sharp increase in the number of clinical notes that referred to Ukraine immediately after the invasion. 62 per cent of these notes described patients who experienced a worsening of anxiety, post-traumatic stress, delusions or hallucinations, which appear to be related to the war,” says Søren Dinesen Østergaard, who is professor at the Department of Clinical Medicine at Aarhus University and the Department of Affective Disorders at Aarhus University Hospital – Psychiatry.

Søren Dinesen Østergaard does, however, point out that it is difficult to document a causal relationship between the war in Ukraine and the patients’ symptom levels.

“For obvious reasons, we can’t conduct a randomised controlled study of the effect of war on humans, and based on the results of our study, we cannot be absolutely certain that the war really has affected our patients. The hypothesis is, however, quite plausible, and the clear temporal association between the invasion and the increase in the clinical notes describing symptom deterioration, suggests that we have identified a real effect,” he explains.

In accordance with previous studies of terrorism

Søren Dinesen Østergaard has previously been involved in research projects that have examined the effect of terrorist attacks outside Denmark on the psychological well-being of the general Danish population. The results from these studies are in line with those from the new study focusing on Ukraine.

“In our prior studies, we documented an increase in the number of contacts to psychiatric hospitals in Denmark due to stress- and adjustment disorders in the period following the 9/11 terrorist attacks in the United States, as well as after Breivik’s attacks in Oslo and at Uttøya,” he says and continues:

“I think that the same mechanisms are at play in the current situation. It therefore appears that war and terrorism have negative psychological consequences far beyond the borders of the countries that are directly affected,” says Søren Dinesen Østergaard.

What are the consequences?

According to the researcher, we can learn a number of things from the study.

“The study’s results suggest that the war in Ukraine probably has secondary effects that require attention. Specifically, in the psychiatric services, we must be aware of the possibility that some of our patients may be very negatively affected by the situation. Many of our patients were already under substantial pressure prior to the war due to the COVID-19 pandemic and may therefore be extra sensitive at the moment,” says Søren Dinesen Østergaard, who ends by putting the research findings into perspective:

“It’s important to keep in mind that the negative psychological impact we experience in Denmark is nothing compared to what the Ukrainian population is experiencing – including the Ukrainians who have fled the war.”

The research results – more information:

Type of study: The research project is based on an analysis of a total of 567,647 clinical notes from the psychiatric hospitals in the Central Denmark Region for the period from 1 January to 8 March 2022 . Via an electronic search, the researchers identified the subset of clinical notes that contained the word ‘Ukraine’.

Funding: The study is supported by Aarhus University Hospital – Psychiatry and the Department of Clinical Medicine, Aarhus University.

Conflicts of interest: Søren Dinesen Østergaard received the 2020 Lundbeck Foundation Young Investigator Prize. Furthermore, he owns units of mutual funds with stock tickers DKIGI and WEKAFKI, as well as units of exchange-traded funds with stock tickers TRET and EUNL. Christopher Rohde received the 2020 Lundbeck Foundation Talent Prize.

Read the published article here: https://onlinelibrary.wiley.com/doi/full/10.1111/acps.13440

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