Conflict exposure increases PTSD and suicide among young people in Ukraine

For more than a decade, Ukrainian children have grown up against a backdrop of constant war. According to researchers, its psychological consequences are now becoming clear. A comprehensive review of 37 studies shows that Ukrainian children and adolescents exposed to a decade of war suffer higher levels of post-traumatic stress disorder (PTSD), internalizing and externalizing symptoms, suicide, and self-harm.

An international research team led by the Child Psychiatry Research Center at the University of Turku, Finland, reviewed the available evidence on the mental health of Ukrainian children and adolescents. Their scoping review included findings from 37 studies published between 2020 and 2024, covering research conducted from the early years of the conflict through to an ongoing full-scale invasion.

Across all studies, children and young people aged 0–19 were found to experience a wide range of mental health problems, including post-traumatic stress disorder (PTSD), depression, anxiety, conduct problems, suicide and self-harm. Although prevalence rates varied, the overall conclusion was consistent: prolonged exposure to war is having serious psychological effects on Ukraine’s youth.

Most studies were cross-sectional and focused on children living in Ukraine, with fewer examining refugees or clinical populations. Differences in study design, assessment tools and timing made direct comparisons difficult, but many relied on young people’s own reports, which provide rare insights into their lived experiences.

Sanju Silval, lead author of the study, postdoctoral researcher, University of Turku

Silwal says several patterns emerged again and again.

“Girls were more likely than boys to report suicidal thoughts, suicide attempts, and self-harm, while boys showed higher levels of conduct disorders. Children living in areas most affected by the fighting faced higher risks of moderate to severe mental health symptoms, including suicide and self-harm. These risks were evident both during the early stages of the war and after the full-scale invasion, pointing to the cumulative effect of ongoing exposure.”

Displacement and family relationships shape children’s outcomes

Beyond normal exposure to conflict, certain experiences sharply increase the risk of mental health problems. Children who were forcibly displaced, exposed to violence, separated from parents, or who lost loved ones were particularly vulnerable. One-quarter to half of young people reported direct or indirect exposure to war-related events. About one-fifth had experienced displacement either within Ukraine or abroad.

“Where children end up matters,” says Silwal. “Forced transfer to another country was associated with a higher risk of mental health problems, while internal displacement was associated with greater resilience, possibly because children remained in familiar cultural and social environments.”

Family dynamics also played a decisive role.

Professor Andre Saurender of the University of Turku says, “Negative parenting practices or low parental involvement were associated with behavior problems and bullying, while supportive family environments provided some protection. Yet many children reported alienation from parents or family members, disrupting important sources of emotional security during periods of acute stress.”

“We conducted a time-trend study during the initial phase of the war and the full-scale invasion of Ukraine, which showed that adolescents exposed to both phases of the war experienced higher levels of psychological distress. More than 10 percent attempted suicide, compared to 4 percent of non-exposed peers. This clearly shows the devastating, cumulative effect of prolonged war on young brains”, continues Sorender.

Many of the studies in the review were rated low to moderate quality, underscoring how difficult it is to conduct rigorous, long-term research in active combat settings. Nevertheless, the inclusion of studies published in both English and Ukrainian provided important cultural and contextual insights.

“At a time when children around the world are increasingly affected by armed conflict, there is an urgent need to understand these experiences,” Saurender stressed.

Overall, the findings portray a generation that is growing up under extraordinary stress and highlight the urgent need for continued mental health support and stronger evidence to guide future interventions.