The Role of Comorbidity in Understanding Traumatic Sequelae Among Ukrainian War Refugees

Limited research exists regarding the impact of the Ukrainian War on mental distress among refugees or the presentation of post-traumatic stress disorder (PTSD) as a co-morbidity. This study analyzes the mental distress experienced by displaced Ukrainian refugees, including exposure to war-related trauma, PTSD, psychological distress based on socio-demographic factors, prevalence of concurrent mental illnesses, and associated risk factors. Ukrainian refugees in Israel were included in the study shortly after their arrival. Participants completed questionnaires on socio-demographic information, exposure to war-related events, presence of PTSD, depression, anxiety, and current life satisfaction. The 128 participants reported an average of 6.4 traumatic events (SD = 2.97). Among them, 69.5% (n = 89) met the criteria for probable PTSD, 36.7% (N = 47) for depression, and 53.1% (N = 68) for anxiety. The "comorbidity" cohort, consisting of refugees with PTSD and depression/anxiety or both, included 65 participants (53.3%), the "only PTSD" group was 24 participants (19.7%), and 33 (27%) had "no probability". Women and those who had left family members behind were 2.9 and 3.2 times more likely to experience comorbidity, respectively. Refugees with comorbidity reported higher distress and functional impairments compared to the "only PTSD" group, and lower life satisfaction than those with "no probability". This study highlights the significant traumatology experienced by Ukrainian refugees, with attention to the unique impact of comorbidity on functional and subjective well-being among refugees. Therefore, a comprehensive approach is necessary to appropriately diagnose and support refugees, considering the interconnected impact of PTSD, anxiety, and depression.