Psychological distress due to war and associated factors among university students in a conflict-affected region of Ethiopia: a Bayesian logistic analysis

Armed conflict may increase the risk of psychological distress among university students through forced displacement, educational disruption, exposure to violence, concerns about personal and family safety, bereavement, economic instability, and weakened social support networks. However, evidence remains limited regarding the magnitude of psychological distress and its associated factors among university students in conflict affected settings in Ethiopia. This study aimed to estimate the prevalence of psychological distress and identify associated factors among students from conflict affected areas. A cross sectional survey was conducted among 714 students selected through simple random sampling at Debre Markos University. Data were collected using structured questionnaires and analyzed using descriptive statistics, Chi-square tests, and Bayesian logistic regression. The prevalence of self reported psychological distress was 81.4%. Chi-square analysis revealed significant associations between psychological distress and gender, region, war zone exposure, family death, physical injury, direct participation, and family support roles. The result showed that, being female (OR = 2.06, 95% CrI: 1.23–3.56), both direct (OR = 2.03, 95% CrI: 1.06–4.17) and indirect (OR = 4.43, 95% CrI: 2.70–7.18) participation were significantly associated with increased psychological distress. Students who had been in a war zone (OR = 2.66, 95% CrI: 1.64–4.41), lost a family member due to war (OR = 3.03, 95% CrI: 1.59–5.56), lost family properties (OR = 1.68, 95% CrI: 1.02–2.81), work status (OR = 2.73, 95% CrI: 1.23–7.18) and physically injured (OR = 5.13, 95% CrI: 2.26–11.29) were significantly more likely to report psychological distress. More than four-fifths of participants reported war-related psychological distress, indicating a substantial mental health burden among university students in this conflict affected setting. The likelihood of psychological distress was higher among female students and those who experienced war related exposure, physical injury, loss of family members, or loss of family property. These findings recommended the need for universities in conflict affected settings to strengthen mental health screening, accessible psychosocial support, and appropriate referral systems for students affected by conflict. Further research using validated mental health instruments is warranted to assess the severity of psychological distress and inform targeted interventions.