Prevalence of depression, anxiety, and PTSD symptoms among patients of opioid agonist treatment programmes in Ukraine during wartime {<i>peer reviewed}</i>

Background: The ongoing war in Ukraine has intensified psychological distress, particularly among patients receiving opioid agonist therapy (OAT). This study explores the prevalence and co-occurrence of depression, anxiety, post-traumatic stress disorder (PTSD) symptoms, and suicidal ideation among OAT patients during wartime in 2023. Objectives: To assess the point prevalence of mental health symptoms among OAT program participants during the second year of the full-scale Russian invasion of Ukraine, and to compare these findings with pre-war baseline data. Methods: A descriptive cross-sectional study was conducted using standardized screening tools (GAD-7, PHQ-9, and PCL-5) to measure symptoms among patients across OAT centres in Lviv, Sumy, and Vinnytsia between April and October 2023. Additional measures included missed visits and dose satisfaction over the past month. The data were compared to pre-invasion data collected from October 2021 to January 2022 in Kyiv, Sumy, and Lviv. Results: Among the screened population, 17.43% reported concurrent depressive, anxiety, and PTSD symptoms. Females exhibited higher depressive symptoms (45.26%) compared to males (31.28%). Patients on buprenorphine showed a higher prevalence of suicidal ideation (33.96%) and PTSD symptoms (44.96%) than those on methadone (22.64% and 31.1%, respectively). The mean trauma exposure was 4.11 events per person. A significant increase in depression (mean PHQ-9 score from 7.42 to 7.90) and anxiety (mean GAD-7 from 5.06 to 6.39) was observed, alongside an increase in probable depression (from 26.73% to 32.62%) and generalized anxiety (from 14.72% to 25.51%). Suicidal ideation rates remained largely unchanged. Conclusions: The findings highlight the compounding mental health burden among OAT patients during wartime and underscore the urgent need to embed psychosocial support services within OAT programs to enhance patient well-being and societal reintegration.