Prolonged war linked to widespread PTSD and suicidal behavior in Ukrainian children

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

Across studies, children and young people aged 0–19 were found to experience a broad range of mental health problems, including post-traumatic stress disorder (PTSD), depression, anxiety, conduct problems, suicidality, and self-harm. Although prevalence rates varied, the overall conclusion was consistent: prolonged exposure to war is taking a serious psychological toll 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, offering rare insight into their lived experiences,” says the study’s lead author, Postdoctoral Researcher Sanju Silwal from the University of Turku.

Silwal notes that several patterns emerged repeatedly.

“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 regions most affected by fighting faced higher risks of moderate to severe mental health symptoms, including suicidality and self-harm. These risks were evident both during the early phase of the war and after the full-scale invasion, pointing to the cumulative impact of ongoing exposure.”

Displacement and family relationships shape children’s outcomes

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

“Where children ended up mattered,” notes Silwal. “Forced relocation to another country was linked to higher risks of mental health problems, while internal displacement was associated with greater resilience, possibly because children remained within familiar cultural and social environments.”

Family dynamics also played a decisive role.

“Negative parenting practices or low parental involvement were linked to conduct problems and bullying, while supportive family environments appeared to offer some protection. Yet many children reported separation from parents or family members, disrupting vital sources of emotional security during a period of intense stress,” says Professor Andre Sourander from the University of Turku.

“We conducted a time-trend study during the early phase of war and the full-scale invasion of Ukraine, which revealed that adolescents exposed to both phases of war experience higher levels of psychological distress. More than 10% attempted suicide compared to 4% of non-exposed peers. This starkly illustrates the devastating, cumulative impact of prolonged war on young minds,” continues Sourander.

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

“At a time when children worldwide are increasingly affected by armed conflict, understanding these experiences is urgently needed,” stresses Sourander.

Taken together, the findings portray a generation growing up under extraordinary strain and highlight an urgent need for sustained mental health support and stronger evidence to guide future interventions.