Ukrainian Journal of Perinatology and Pediatrics. 2026.1(105): 80-90. doi: 10.15574/PP.2026.1(105).8090
Mityuryayeva-Korniyko I. O., Klets T. D., Odayskyi O. M.
Bogomolets National Medical University, Kyiv, Ukraine

For citation: Mityuryayeva-Korniyko IO, Klets TD, Odayskyi OM. (2026). Changes in the psycho-emotional state of adolescents with acute respiratory infections during the war in Ukraine. Ukrainian Journal of Perinatology and Pediatrics. 1(105): 80-90. doi: 10.15574/PP.2026.1(105).8090.
Article received: Dec 09, 2025. Accepted for publication: Feb 16, 2026.

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.
Keywords: adolescents, martial law, acute respiratory infections (ARIs), recurrent respiratory infections (RRIs), stress disorders, neuroinflammation.

REFERENCES

1. Alotiby A. (2024). Immunology of stress: a review article. J Clin Med. 13(21): 6394. https://doi.org/10.3390/jcm13216394; PMid:39518533 PMCid:PMC11546738

2. Antypkin YG, Marushko RV, Dudina OO, Bondarenko NY, Polyanska LO. (2024). Characteristics of perinatal care in Ukraine during martial law. Ukr J Perinatol and Pediatr. 4(100): 12-21. https://doi.org/10.15574/PP.2024.4(100).1221

3. Barrett B, Brown RL, Mundt MP et al. (2009). Validation of a short form Wisconsin Upper Respiratory Symptom Survey (WURSS-21). Health Qual Life Outcomes. 7: 76. https://doi.org/10.1186/1477-7525-7-76; PMid:19674476 PMCid:PMC2748069

4. Chen MA, LeRoy AS, Majd M et al. (2021). Immune and epigenetic pathways linking childhood adversity and health across the lifespan. Front Psychol. 12: 788351. https://doi.org/10.3389/fpsyg.2021.788351; PMid:34899540 PMCid:PMC8662704

5. Chiappini E, Santamaria F, Marseglia GL et al. (2021). Prevention of recurrent respiratory tract infections in children: an expert consensus on the use of immunostimulants. Ital J Pediatr. 47(1): 1-21. doi: 10.1186/s13052-021-01012-7.

6. Danese A, Lewis SJ. (2017). Psychoneuroimmunology of early-life stress: the hidden wounds of childhood trauma? Neuropsychopharmacology. 42(1): 99-114. https://doi.org/10.1038/npp.2016.198; PMid:27629365 PMCid:PMC5143500

7. Filetti C, Kane-Grade F, Gunnar M. (2023). The development of stress reactivity and regulation in children and adolescents. Child Dev Perspect. 17(3): 163-169. https://doi.org/10.1111/cdep.12484

8. Fogliazza F, Cifaldi M, Antoniol G, Canducci N, Esposito S. (2024). Approaches to Pediatric Chest Pain: A Narrative Review. Journal of Clinical Medicine. 13(22): 6659. https://doi.org/10.3390/jcm13226659; PMid:39597803 PMCid:PMC11594360

9. Frolenkova NO, Kupina IO. (2022). Adaptation of preschool and primary school children to learning under martial law. Perspektyvy ta innovatsii nauky. (7): 471-482. https://doi.org/10.52058/2786-4952-2022-7(12)-471-482

10. Gao P, Morita N, Shinkura R. (2024). Role of mucosal IgA antibodies as novel therapies to enhance mucosal barriers. Semin Immunopathol. 47(1): 1. https://doi.org/10.1007/s00281-024-01027-4; PMid:39567378 PMCid:PMC11579142

11. Hoffmann AT, Kobbe R, Denz R et al. (2024, Dec 5). Health and socio-demographic background of Ukrainian minors and their families in Germany – challenges for refugee medicine. Eur J Pediatr. 84(1): 64. https://doi.org/10.1007/s00431-024-05847-2; PMid:39636479 PMCid:PMC11621194

12. Kadir A, Shenoda S, Goldhagen J, Pitterman S et al. (2019).The effects of armed conflict on children. Paediatr Int Child Health. 142(6): e20182586. https://doi.org/10.1542/peds.2018-2586; PMid:30397168

13. Lecarie EK, Doane LD, Stroud CB et al. (2022). Does stress predict the development of internalizing symptoms in middle childhood? An examination of additive, mediated, and moderated effects of early family stress, daily interpersonal stress, and physiological stress. Dev Psychol. 58(10): 1849-1862. https://doi.org/10.1037/dev0001400; PMid:35816590 PMCid:PMC9615637

14. Lesinskiene S, Lapinskaite A, Kostiuk O, Sambaras R. (2024). A study of the impact of the war in Ukraine on psychosomatic health of preschool children in Lithuania: parents' perspective. Int J Child Youth Fam Stud. 15(2): 32-46. https://doi.org/10.18357/ijcyfs152202422042

15. Manafe N, Ismael-Mulungo H, Ponda F et al. (2024). Prevalence and associated factors of common mental disorders among internally displaced people by armed conflict in Cabo Delgado, Mozambique: a cross-sectional community-based study. Front Public Health. 12: 1371598. https://doi.org/10.3389/fpubh.2024.1371598; PMid:38689772 PMCid:PMC11058794

16. Markova MV, Bielousova OY, Alieva TA et al. (2025). Psychosomatic correlates of war distress in children and adolescents. Psychiatry Neurology Med Psychol. 12(4): 30. https://doi.org/10.26565/2312-5675-2025-30-04

17. Marushko RV, Dudina OO. (2024). Analysis of medical support and health of children in Ukraine during the war. Modern Pediatrics. Ukraine. 8(144): 6-14. https://doi.org/10.15574/SP.2024.8(144).614

18. Matthys H, Kamin W, Lehrl S. (2013). Positioning of the Bronchitis Severity Score (BSS) for standardised use in clinical studies. Curr Med Res Opin. 29(10): 1383-1390. Epub 2013 Aug 23. https://doi.org/10.1185/03007995.2013.832183; PMid:23927521

19. Misiura OM, Sova VA, Anoprienko OV, Sudyka OS. (2022). Emotional state of children of Ukraine who were affected by war factors in the occupied territory. Med Sci Ukr. 18(3): 60-65. https://doi.org/10.32345/2664-4738.3.2022.09

20. Nunez SG, Rabelo SP, Subotic N, Caruso JW, Knezevic NN. (2025). Chronic Stress and Autoimmunity: The Role of HPA Axis and Cortisol Dysregulation. Int J Mol Sci. 26(20): 9994. Published 2025 Oct 14. https://doi.org/10.3390/ijms26209994; PMid:41155288 PMCid:PMC12563903

21. Osokina O, Silwal S, Bohdanova T et al. (2023). Impact of the Russian invasion on mental health of adolescents in Ukraine. J Am Acad Child Adolesc Psychiatry. 62(3): 335-343. https://doi.org/10.1016/j.jaac.2022.07.845; PMid:36441074

22. Public Health Center of Ukraine. (2023). Vplyv stresu na orhanizm dytyny: chym mozhut dopomohty batky i koly varto zvertatysia do fakhivtsiv. Published July 11, 2023. URL: https://phc.org.ua/news/vpliv-stresu-na-organizm-ditini-chim-mozhut-dopomogti-batki-i-koli-varto-zvertatisya-do.

23. Saper RB, Lemaster T, Delitto A et al. (2014). Yoga, physical therapy, or education for chronic low back pain and adjacent outcomes: design and methods of a randomized controlled trial. Trials. 15: 67. https://doi.org/10.1186/1745-6215-15-67; PMid:24568299 PMCid:PMC3944007

24. Skok MV. (2021). Neiroimunolohiia. In: Dziuba IM, Zhukovsky AI, Zhelezniak MH et al, eds. Encyclopedia of Modern Ukraine. Institute of Encyclopedic Research of the NAS of Ukraine. URL: https://esu.com.ua/article-72972.

25. Solonenko O. (2025). Osoblyvosti proiavu tryvaloho travmatychnoho stresu u pidlitkiv pid chas viiny. Psykholohichni perspektyvy. (45): 152-160. https://doi.org/10.29038/2227-1376-2025-45-sol

26. Ueda K, Black KJ. (2021). A Comprehensive Review of Tic Disorders in Children. J Clin Med. 10(11): 2479. Published 2021 Jun 3. https://doi.org/10.3390/jcm10112479; PMid:34204991 PMCid:PMC8199885

27. Voloshyn OM. (2025). Systemic Analysis of the Problem of Recurrent Respiratory Infections in Preschool Children. Doctoral dissertation summary. Bogomolets National Medical University.

28. Volosovets OP, Kryvopustov SP, Kuzmenko AY et al. (2024). Deterioration of health of infants during the war and COVID-19 pandemic in Ukraine. Child's Health. 19(6). https://doi.org/10.22141/2224-0551.19.6.2024.1737

29. Volpe JJ. (2025). Neurologic development and neurologic examination of the child. In: Kliegman RM, St Geme JW III, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 24th ed. Elsevier.