Anxiety, depression, and posttraumatic stress symptoms of Japanese nationals half a year after the 2022 conflict in Ukraine

On 24 February 2022, the Russian military initiated armed attacks on Ukraine. The Japanese government has advised Japanese residents in Russia to evacuate, and many Japanese companies have downsized/withdrawn their business in Russia. People who continued to stay in Russia have been distressed (e.g. air/monetary service discontinuations, family separations). Foreign nationals experience extensive stress even in peacetime (e.g. racial/ethnic minority status, safety/health concerns, language/cultural barriers). In armed conflicts, affected civilians potentially develop anxiety, depression, and posttraumatic stress disorder (PTSD). However, mental health studies of foreign nationals in situations of political uncertainty are limited. To elucidate this research gap, we studied Japanese nationals half a year after the start of the 2022 conflict in Ukraine. We distributed an online, anonymous self-report survey among the Japanese community organizations in Russia (11 August–4 September 2022). This timing was before the Russian government’s “partial mobilization” announcement to their people (21 September 2022). Complete methods are shown in Table S1. Briefly, the two study inclusion criteria were (i) either a current Russian resident or post-conflict evacuee/returnee from Russia and (ii) ≥18 years. We obtained informed consent electronically. The Ethics Committees of Mejiro University and Teikyo Heisei University approved this study’s protocol. The complete list of independent/dependent variables is shown in Table S2. Anxiety, depression, and posttraumatic stress symptoms (PTS) were measured using the Japanese versions of the GAD-7 scale, Patient Health Questionnaire-9, and Short-Form PTSD Checklist 5 (SF-PCL-5), respectively. The participants were instructed to check the SF-PCL-5 items in response to the 2022 conflict in Ukraine. SPSS Statistics version 28 (IBM Corporation, Armonk, New York, USA) was used for statistical analysis. Bivariate relations were calculated using chi-square tests, t-tests, and Pearson’s correlations. Multiple regression analyses were performed to examine the independent-dependent variables’ multivariate associations (P < 0.05). The list of independent variables used for the forced entry models is shown in Table S2. One hundred and thirty-two individuals participated in the study. Since one respondent did not meet the study criteria, the final N was 131 (Table S3). A large majority of the participants were male, married, and highly educated. Two out of five participants were living outside of Russia. Participants with high anxiety, depression, and PTS rates were 16.0%, 14.5%, and 12.2%, respectively (Table S3–S6, Figure S1). Multivariate analysis results are shown in Table 1. Anxiety symptoms were associated with non-Russian resident status (i.e., evacuees/returnees), high worries about health, living abroad, and armed attacks on Russia. Depression symptoms were associated with high worries about relationships and health. PTS were associated with their discrimination experience and high worry about armed attacks on Russia. To our knowledge, this is the first mental health study of foreign nationals in Russia after the beginning of the 2022 conflict in Ukraine. Their outcomes were associated with non-Russian resident status, high worry about armed attacks on Russia, and discrimination experiences. In addition, one-eighth of the participants reported high PTS even without a direct armed attack on Russia. The rates of the participants with high anxiety/depression symptoms were lower than that of past studies. Nonetheless, non-Russian residents reported higher anxiety symptoms than Russian residents. People tend to think that returnees’ mental health will improve after their repatriation. However, our data disprove this belief and suggest that evacuees/returnees should be offered additional support.