{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T06:44:19Z","timestamp":1792046659218,"version":"4.4.0"},"reference-count":31,"publisher":"Royal College of Psychiatrists","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Psychiatry"],"abstract":"<jats:sec id=\"S0007125026108095_as1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Since the full-scale Russian invasion in 2022, health facilities and healthcare workers in Ukraine have been systematically targeted. Despite growing calls to prioritise their mental health, robust evidence on the magnitude of the problem and its determinants remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125026108095_as2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To estimate the prevalence of mental health problems among doctors and nurses in Ukraine, and examine their association with key exposures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125026108095_as3\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We conducted a cross-sectional survey between May and September of 2025, in a non-probabilistic sample of doctors and nurses working in Ukraine. The survey included validated self-report instruments to assess depression (Patient Health Questionnaire-9), anxiety (Generalised Anxiety Disorder-7) and suicidal thoughts, as well as workplace risk factors (bullying, sexual harassment, violent threats, physical violence) and protective factors (social support, purpose and meaning at work). Associations were examined using multilevel regression models with extensive sensitivity analyses, including Bayesian models and survey raking weights.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125026108095_as4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 23 805 respondents, 1 in 3 doctors and 1 in 4 nurses reported symptoms compatible with probable depression, 1 in 4 doctors and 1 in 6 nurses reported symptoms compatible with probable anxiety, and about 1 in 10 doctors and nurses reported suicidal thoughts. Workplace violence \u2013 particularly bullying \u2013 was strongly associated with depression and anxiety, whereas physical violence showed the strongest association with suicidal thoughts. Purpose and meaning at work were consistently associated with better mental health. Associations were overall high and similar across regions with different levels of active conflicts. Estimates were robust across analytic approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125026108095_as5\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Elevated prevalences and strong associations with workplace factors support a zero-tolerance approach to violence and the implementation of scalable mental health strategies that also strengthen protective factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjp.2026.10809","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T05:51:56Z","timestamp":1792043516000},"page":"1-8","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Mental health of nurses and doctors in Ukraine during wartime: nationwide cross-sectional survey"],"prefix":"10.1192","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7786-0500","authenticated-orcid":false,"given":"Vicente Andr\u00e9s","family":"Arrona G\u00f3mez","sequence":"first","affiliation":[{"name":"Autonomous University of Madrid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6411-9439","authenticated-orcid":false,"given":"Roberto","family":"Mediavilla","sequence":"additional","affiliation":[{"name":"Carlos III Health Institute"},{"id":[{"id":"https:\/\/ror.org\/01cby8j38","id-type":"ROR","asserted-by":"publisher"}],"name":"Autonomous University of Madrid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Zapata","sequence":"additional","affiliation":[{"name":"World Health Organisation Regional Office for Europe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Maria","family":"Tijerino-Inestroza","sequence":"additional","affiliation":[{"name":"World Health Organisation Regional Office for Europe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassie","family":"Redlich","sequence":"additional","affiliation":[{"name":"World Health Organisation Regional Office for Europe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Castelpietra","sequence":"additional","affiliation":[{"name":"University of Canberra"},{"name":"Centre Neuchatelois"},{"name":"IRCCS \u2018Burlo Garofolo\u2019"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jarno","family":"Habicht","sequence":"additional","affiliation":[{"name":"World Health Organisation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisa","family":"Ladyk-Bryzghalova","sequence":"additional","affiliation":[{"name":"World Health Organisation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oleksii","family":"Kostiuchenkov","sequence":"additional","affiliation":[{"name":"World Health Organisation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khrystyna","family":"Chaika","sequence":"additional","affiliation":[{"name":"World Health Organisation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iryna","family":"Mykychak","sequence":"additional","affiliation":[{"name":"Ministry of Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ihor","family":"Kuzin","sequence":"additional","affiliation":[{"name":"Ministry of Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ledia","family":"Laz\u00ebri","sequence":"additional","affiliation":[{"name":"World Health Organisation Regional Office for Europe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7544-826X","authenticated-orcid":false,"given":"Jos\u00e9 Luis","family":"Ayuso-Mateos","sequence":"additional","affiliation":[{"name":"Autonomous University of Madrid"},{"name":"Carlos III Health Institute"},{"name":"Biomedical Research Institute \u2013 La Princesa University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"S0007125026108095_ref5","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0302597"},{"key":"S0007125026108095_ref10","volume-title":"Mental Health of Nurses and Doctors Survey in the European Union, Iceland and Norway","year":"2025"},{"key":"S0007125026108095_ref8","unstructured":"8 Ukrainian Public Health Centre. Summary Data from Medical Reports on Municipal Healthcare Facilities, Healthcare Facilities under the Jurisdiction of the Ministry of Health, Other Ministries, and Private Facilities . Ukrainian Public Health Centre, 2024 (https:\/\/phc.org.ua\/monitoring-i-statistika\/meddata-2)."},{"key":"S0007125026108095_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2025.101489"},{"key":"S0007125026108095_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2024.115836"},{"key":"S0007125026108095_ref4","doi-asserted-by":"publisher","DOI":"10.1192\/j.eurpsy.2024.12"},{"key":"S0007125026108095_ref31","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2025.1659301"},{"key":"S0007125026108095_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2023.100765"},{"key":"S0007125026108095_ref17","doi-asserted-by":"publisher","DOI":"10.1017\/S2045796017000385"},{"key":"S0007125026108095_ref21","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201200587"},{"key":"S0007125026108095_ref18","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092"},{"key":"S0007125026108095_ref27","doi-asserted-by":"publisher","DOI":"10.1037\/amp0001323"},{"key":"S0007125026108095_ref15","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016009606.x"},{"key":"S0007125026108095_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2017.03.037"},{"key":"S0007125026108095_ref29","first-page":"91","article-title":"On the meaning of work: a theoretical integration and review","volume":"30","author":"Rosso","year":"2010","journal-title":"Res Organ Behav"},{"key":"S0007125026108095_ref30","doi-asserted-by":"publisher","DOI":"10.1136\/bmjment-2023-300697"},{"key":"S0007125026108095_ref12","unstructured":"12 Arrona G\u00f3mez, V , Mediavilla, R , Redlich, C , Langins, M , Lazeri, L , Zapata, T , et\u00a0al. Addressing Mental Health Challenges in Eastern Europe: Armenia, Azerbaijan, Georgia, Moldova, and Ukraine. A Survey Study on Healthcare Workers . Open Science Framework, 2025 (https:\/\/osf.io\/n6bwf)."},{"key":"S0007125026108095_ref2","unstructured":"2 Interfax Ukraine. About 3% of Doctors Registered in NHSU Left Ukraine at Beginning of War \u2013 Liashko . Interfax Ukraine, 2024 (https:\/\/interfax.com.ua\/news\/general\/997499-amp.html)."},{"key":"S0007125026108095_ref13","doi-asserted-by":"publisher","DOI":"10.1177\/1403494809349858"},{"key":"S0007125026108095_ref24","doi-asserted-by":"publisher","DOI":"10.1177\/00207640221143919"},{"key":"S0007125026108095_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(23)00096-8"},{"key":"S0007125026108095_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2023.100773"},{"key":"S0007125026108095_ref7","volume-title":"WHO European Framework for Action on Mental Health 2021\u20132025","year":"2022"},{"key":"S0007125026108095_ref9","unstructured":"9 World Health Organization Regional Office for Europe. Results of Initial Health Labour Market Analysis in Ukraine . World Health Organization Regional Office for Europe, 2024 (https:\/\/iris.who.int\/server\/api\/core\/bitstreams\/196c4d39-7bdd-4218-ab74-84642acc5dd6\/content)."},{"key":"S0007125026108095_ref1","unstructured":"1 World Health Organization. Surveillance System for Attacks on Health Care (SSA) . Surveill. World Health Organization, 2017 (https:\/\/extranet.who.int\/ssa\/Index.aspx)."},{"key":"S0007125026108095_ref19","doi-asserted-by":"publisher","DOI":"10.32999\/2663-970X\/2024-11-5"},{"key":"S0007125026108095_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30934-1"},{"key":"S0007125026108095_ref28","doi-asserted-by":"publisher","DOI":"10.1080\/02678373.2023.2169968"},{"key":"S0007125026108095_ref14","doi-asserted-by":"publisher","DOI":"10.1177\/1069072711436160"},{"key":"S0007125026108095_ref16","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291723000818"},{"key":"S0007125026108095_ref26","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-015-1954-4"}],"container-title":["The British Journal of Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0007125026108095","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T05:51:59Z","timestamp":1792043519000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0007125026108095\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,15]]},"references-count":31,"alternative-id":["S0007125026108095"],"URL":"https:\/\/doi.org\/10.1192\/bjp.2026.10809","relation":{},"ISSN":["0007-1250","1472-1465"],"issn-type":[{"value":"0007-1250","type":"print"},{"value":"1472-1465","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,15]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial licence (https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original article is properly cited. The written permission of Cambridge University Press or the rights holder(s) must be obtained prior to any commercial use.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}