Screening assessment of psycho-emotional state and cardiometabolic risk factors in combatants and civilians during the war in Ukraine

Objective — to conduct the screening assessment of symptoms of psycho‑emotional disorders (post‑traumatic stress disorder (PTSD), general anxiety, perceived stress) and their relationships with metabolic disorders and body composition indicators in combatants and civilians during the war in Ukraine. Materials and methods. 21 combatants with the duration of participation in active hostilities up to 6 months and 20 civilians of the comparison group who permanently resided in Kharkiv and the unoccupied part of Kharkiv region since the beginning of the war were examined. The study included men aged 25 to 55 years without cardiovascular diseases and diabetes. Questionnaires were surveyed using the Post Traumatic Stress Disorder (PTSD) Checklist Scale‑5 (PCL‑5), the Generalized Anxiety Disorder 7 (GAD‑7), and the Perceived Stress Scale 10 (PSS‑10). The body mass index was determined, visceral fat level, percentage of total body fat mass, and muscle mass were measured by bioimpedance. The levels of lipids, blood glucose, glycated hemoglobin were determined, and the triglyceride‑glucose index (TyG) was calculated. Results. Combatants’ PCL‑5 severity scores were only numerically higher than civilians’, and the GAD‑7 severity score was higher (p=0.028). Perceived stress in civilians corresponded to the low level, in combatants — to the moderate level. The PSS‑10 scale scores in combatants was significantly higher than in the comparison group (p=0.018). Among combatants the proportion of individuals with signs of probable PTSD (33.33%) was significantly higher than in civilians (5.00%, p=0.022). Compared to the civilians among the combatants there were also significantly more individuals with moderate and severe general anxiety (28.6% versus 5.0%, respectively, p=0.045). The combatants had higher systolic blood pressure, lower body fat percentage and greater skeletal muscle percentage than the civilians. Metabolic changes in military personnel were characterized by elevated triglyceride levels and lower glycemic indices in comparison to the civilians. In the cоmbatants the assessed severity of PTSD symptoms and perceived stress level were positively correlated with skeletal muscle mass. There were negative correlations between the general anxiety level and fasting glucose, and between the perceived stress level and body fat mass. In the civilians, the severity of symptoms of probable PTSD was positively correlated with body mass index, body fat and visceral fat accumulation, and the triglyceride‑glucose index. The increase in general anxiety and perceived stress levels were associated with the increase in glycemic indices. In addition, the level of general anxiety was inversely correlated with high density lipoprotein cholesterol. Conclusions. In the conditions of ongoing war, the higher proportion of individuals with signs of probable PTSD were found among combatants than among civilians. Compared with civilians, military personnel had higher levels of general anxiety and perceived stress. In civilians, the increase in psycho‑emotional disorders was associated with adverse changes in metabolic parameters and body composition, while in military personnel the accumulation of stressful experiences was correlated with the increase in skeletal muscle mass, the decrease in fat body mass and in glycemia levels.