The 2022 full-scale invasion of Ukraine has subjected millions of civilians to profound traumatic experiences. Recent findings highlight the significant burden of ICD-11 PTSD and CPTSD among internally displaced persons (IDPs) seeking outpatient care. Understanding these diagnostic patterns is essential for clinicians providing trauma-informed support in conflict-affected regions. Specifically, this study evaluates how relocation and bereavement influence mental health outcomes in clinical settings.

Identifying ICD-11 PTSD and CPTSD in Clinical Practice

Researchers examined 224 adult IDPs in Ukraine using the International Trauma Questionnaire. Consequently, the results revealed that 24.5% of participants met the criteria for PTSD, while 7.6% were diagnosed with CPTSD. Notably, those actively seeking psychological treatment showed higher prevalence rates compared to those seeking general medical care. However, the overall CPTSD rate was lower than in previous studies. Because of this, researchers suggest that domestic relocation avoids the severe stressors of international forced migration. For this reason, local support systems play a vital role in mitigating complex trauma symptoms.

Predictors and Risk Factors for Complex Trauma

In addition, the study identified specific war-related predictors that correlate with severe psychological outcomes. For instance, losing a loved one due to conflict significantly increased the risk for both ICD-11 PTSD and CPTSD. Moreover, male gender emerged as an independent predictor for CPTSD. This finding suggests that sociocultural expectations regarding masculine roles during wartime may increase vulnerability. Furthermore, evidence from India indicates similar trends. In fact, disturbances in self-organization (DSO) strongly predict emotional distress among trauma-exposed populations. Therefore, clinicians should prioritize screening for these specific risk groups.

Clinical Implications for Targeted Support

Finally, healthcare providers must integrate mental health screenings into general outpatient services for displaced populations. Since bereavement acts as a primary driver for trauma, targeted psychosocial interventions are necessary. Similarly, longitudinal research is required to understand how symptom trajectories evolve over time. By doing so, addressing these conditions early can prevent long-term disability and improve the quality of life for survivors of conflict.

Frequently Asked Questions

What is the difference between PTSD and CPTSD in ICD-11?

ICD-11 distinguishes CPTSD by adding three 'Disturbances in Self-Organization' (DSO) clusters to core PTSD symptoms. These include affective dysregulation, negative self-concept, and interpersonal difficulties.

How does bereavement impact trauma risk in IDPs?

Research indicates that losing someone close due to war is a powerful predictor for both PTSD and CPTSD, necessitating specialized grief and trauma counseling.

Are men at higher risk for CPTSD during wartime?

While PTSD is often more common in women, this study found that male IDPs had a higher independent risk for CPTSD, potentially due to gender-specific stressors and roles.

Disclaimer: This content is for informational and educational purposes only. It does not constitute medical advice or establish a doctor-patient relationship. Refer to the latest local and national guidelines for clinical practice.

References

Barbieri A et al. ICD-11 PTSD and Complex PTSD Among Internally Displaced Civilian Outpatients in Ukraine During Wartime. Int J Soc Psychiatry. 2026 Mar 22. doi: 10.1177/00207640261427415. PMID: 41865301.

Maercker A, et al. Complex post-traumatic stress disorder in ICD-11: a new diagnosis. CNS Spectr. 2019;24(2):199-205.

Karatzias T, et al. Initial Insights into ICD-11 Complex PTSD and Emotional Distress in Emerging Adults in India. Int J Environ Res Public Health. 2025.