Changes in the psycho-emotional state of adolescents with acute respiratory infections during the war in Ukraine

Abstract

Studying the correlation between the severity of acute respiratory infections (ARIs) and manifestations of psychological maladaptation in adolescents at the epicenter of military conflict is a strategically important task for developing integrated programs of medical and psychological support for this age group.

Aim - to determine the specific impact of long-term war-related stress on the course of acute respiratory infections (ARIs) in adolescents (aged 10-18) in Ukraine by assessing the frequency of prior recurrent respiratory infections (RRIs) and the severity of current symptoms.

Materials and methods. A total of 123 adolescents with ARIs were examined. The infectious history over the preceding year, current disease severity (WURSS-21 scale), bronchitis symptoms (BSS scale), and markers of stress disorders were analyzed. Statistical analysis was performed using non-parametric methods (Mann-Whitney U test, Spearman’s rank correlation (r), and Benjamini-Hochberg correction (P_{adj})).

Results. Psycho-emotional distress was identified in 92.6–100.0% of adolescents, regardless of their immunological history. The war factor obliterates the impact of past ARI frequency on patients' current psycho-emotional status (P_{adj}>0.05). However, a critical dependence on the severity of the current illness was established: moderate ARI was associated with a statistically significant increase in scores on the aggression and anger scales (P_{adj}=0.0052) compared to a mild course, indicating acute emotional decompensation. Correlation analysis confirmed a direct, moderate relationship between somatic symptoms and the destabilization of the emotional and sleep spheres: loss of appetite and eating disorders (r=0.491; p<0.001), as well as sputum production and abdominal pain (r=0.331; p<0.001).

Conclusions. In wartime conditions, acute respiratory pathology in adolescents acts as a biological detonator of latent distress, transforming a somatic problem into affective decompensation. The psychosomatic response exhibits a two-tier structure: the baseline level is a hidden somatized profile (irritability, sleep/eating disorders, headache). Under the influence of infectious intoxication and aggravated somatic status (moderate ARI, bronchitis), this latent pattern decompensates, triggering a phase of asthenic hyperexcitability (anger, aggression) with a risk of further development of post-viral depression.

The study was conducted in accordance with the principles of the Declaration of Helsinki.

The authors declare no conflict of interest.