Persistent depressive symptoms among Ukrainian women refugees in Czechia: longitudinal evidence

Abstract Background The Russian invasion of Ukraine has triggered a large-scale displacement crisis, with Czechia-an EU member with limited prior experience in refugee integration-hosting hundreds of thousands of refugees. Highly educated Ukrainian women form a demographically unique subgroup, simultaneously exposed to war-related trauma, precarious migration status, and disrupted professional trajectories. This study examines the determinants of depressive symptoms and their persistence in this population, highlighting implications for health policy in Central and Eastern Europe (CEE). Methods Longitudinal panel data from 2022 (N = 963) and 2023 (N = 773) were used, with 406 participants surveyed in both waves. Depressive symptoms were assessed using the PHQ-8. Logistic regression was employed to identify key predictors of elevated symptoms, and predicted probabilities were calculated to illustrate the persistence of risk. Results More than 40% of respondents reported elevated depressive symptoms in both waves. Younger age, absence of close family, intention to return to Ukraine, and poor health status were significant correlates. Critically, severe symptoms in 2022 were associated with a 17-fold increase in odds of persistent depression in 2023 (OR = 17.40; 95% CI: 7.52-40.23). Conclusions These findings reveal a substantial and enduring mental health burden among Ukrainian refugee women and expose a critical gap in the mental health infrastructure of CEE countries, many of which lack prior institutional frameworks for refugee care. Targeted, gender-sensitive mental health policies must be urgently developed and mainstreamed into national integration strategies and EU-wide refugee support mechanisms. Without sustained intervention, the long-term psychosocial toll risks undermining both individual well-being and broader integration outcomes. Key messages • Significant burden of depressive symptoms persists among an already vulnerable population of refugees. Different interconnected factors contribute to their poor mental health outcomes. • The strong wave of Ukrainian refugees and their poor mental health outcomes calls for an urgent, targeted and systematic response from receiving countries.