The resuls from this cross-sectional study clearly demonstrate the high prevalence of mental health problems among Ukrainian university students during the war, manifested mainly as moderate and severe symptoms of depression (85.8%) and anxiety (66.1%). Even taking into account the global vulnerability of youth to some mental health problems [30,31,32,33], the above mentioned indicators go far beyond the normal context. According to a 2022–2023 web-based survey of United States college students [34], the prevalence was 41% for depression overall and 36% for anxiety disorder. These rates are approximately half of those observed in our study. A survey of French university students conducted in July-August 2021 showed the prevalence of anxiety symptoms at 23.7% and depression at 15.4% [35]. In addition to depression and anxiety, our study highlights an increased share of Ukrainian university students (56.9%) with of sleep problems (mild, moderate and severe).

Our results confirmed that persistance of specific mental health problems negatively associated with reduced academic performance of university students and could created a barrier to the human capital development, which is critical for the postwar recovery of Ukraine. The results of the regression analysis showed that even mild or moderate symptoms of depression, anxiety, PTSD and sleep problems are associated with 8.7%, 6.1%, 3.8% and 5.5% decrease in academic performance of university students, respectively. However, severe symptoms of mental health disorders showed stronger negative association with poor academic performance of university students.

Our study provides an evidence-based finding that the war in Ukraine is not only associated with direct human losses and the destruction of housing and social infrastructure. Using regression analysis, we quantified the hidden negative effect of war on academic performance through symptoms of mental health disorders, which is threatening the future of the nation by reducing the labor potential of young people who cannot acquire the necessary skills during their studies due to the loss of productivity during the war.

The majority of studies investigated distribution of mental health problems among students are limited in their sample size and survey specific subcategories of students, focusing on particular specialties, years of study, or regions [36,37,38]. For instance, a cross-sectional study of humanities students in Italy found the prevalence of depressive symptoms to be 30.6% [39], while a survey among undergraduate medical students in the United Arab Emirates reported a nearly 35% prevalence of depression [40]. According to a report on first-year students by the Office for National Statistics in England, 37% of them exhibited moderate or severe depressive symptoms, and 39% showed signs of probable anxiety in various forms [41]. Although the available evidence demonstrates a significantly higher burden of mental health problems among Ukrainian university students compared to student populations in other countries, the fragmented nature of most studies complicates adequate comparisons of mental disorders’ prevalence rates.

Assessing the association of mental health problems with academic performance among Ukrainian students is challenging without proper comparison to other studies on the mental states of populations in war-affected countries. The most of the studies in this area investigates the entire or just the adult population [42,43,44,45].

The scientific literature on mental health issues among university students during wartime is very limited and primarily describes the consequences of mental problems acquired against the backdrop of armed conflict for students’ everyday activities, emotional, and physical states. However, war also contributes to the development of mental health problems that hinder students’ academic performance. The association between mental health problems and declining academic performance among school, college, and university students has been thoroughly studied [46,47,48]. Some publications are devoted to a systematic review of the studies on this topic [48], while others focus on determining the association between mental health problems and academic performance of university students using regression analysis of data collected in the United Arab Emirates [46] and China [49]. Nevertheless, we have not found studies on the impact of mental health problems on academic perfomance that take the war context into account. That is why our study filled an important gap in the literature.

This study is one of the first to measure the association of war-related mental health problems with the academic performance of university students. Our results based on extentsive dataset collected from representative population of Ukramian students. Furthermore, we used the appropriate instrument to measure specific mental health problems as well as the effect of mental health problems on academic performance and impairment and this allowed us to etsimate the particular contribution of different mental health problems. In this regards, our study opens up prospects for further development in this scientific area. We hope that our findings will draw attention to the necessity of developing strategies and interventions aimed at improving the mental health of students living in wartime conditions. In the medium and long term, this will help preserve the human and intellectual capital needed for post-war recovery.

Despite a rather large sample size of our cross-sectional study, it has several limitations that must be taken into account when interpreting the results of the analysis. First of all, the number of students who answered the questions of the WPAI: SHP section was 1,398, i.e. 59.1% of the survey respondents (2,364 students). Although this section of the questionnaire has an adequate Crombach’s alpha coefficient and the validity of the data is not in doubt, the level of representativeness of the data is lower compared to the total sample of 2,364 survey participants, likely due to the questionnaire’s length, complexity, and disruptions to students’ routines caused by wartime conditions. Given that the total number of university students in Ukraine in 2023–2024 was 1.05 million [29], according to the generally accepted formula, the minimum size of a representative sample with a 3% statistical error and 95% reliability is 1,067 students. While in our survey, the number of students who fully answered all the questions is 1,398. Since the purpose of our study was to analyze the mental condition and academic performance of all students in Ukraine as a separate population group, the sample is representative in this context.

The predominance of female respondents (75%) reflects gender distribution trends in major branches of science in Ukraine’s higher education, particularly in humanities and social sciences, where women constitute the majority. However, there are certain academic programs where men prevail, which can cause additional biases. To address these biases, gender and age were included as variables in the regression model, which indicated that male students demonstrated greater resilience to mental health challenges, showing a 4.0% lower reduction in academic performance. At the same time, while our model accounts for age and gender as influencing factors, a more detailed stratified analysis of variations in academic performance by these variables could provide additional insights. This aspect presents an opportunity for further research to deepen the understanding of how these demographic factors interact with mental health and academic outcomes.

The coefficient of determination of our linear regression is moderate, which demonstrates that our regression can only partially explain the negative changes in students’ academic performance by the symptoms of certain mental health problems. Furthermore, the high value of the regression’s intercept shows the influence of all other factors that were not included in the regression analysis. We believe that this limitation is objective in nature, as students’ academic performance depends on an extremely large number of different variables that cannot be quantified in a single cross-sectional field study. Moreover, the cross-sectional design of our research does not allow us to establish causality, meaning that while our findings demonstrate an association between mental health symptoms and academic performance, they do not confirm a direct cause-and-effect relationship. However, this does not diminish the relevance of our findings, as the T-statistics, F-statistics, and Chi-square test confirm the validity of the model and the significance of the independent variables.

Academic performance is objectively measured by the academic achievements of students, i.e. as the ratio between an output (knowledge that the student has acquired, measured by the grades of the examination or study performance) and input in academic activity measured by the time spent on studying [50]. Unfortunatelly, our cross-sectional study, which included more than 2,300 students from 17 universities from different regions of Ukraine, did not allow us to collect reliable and accurate data on the performance of their study in terms of grades in different courses and knowledge they had acquired. Thus, while our regression model accounts for key mental health-related factors, it does not capture all potential contributors to academic performance, reinforcing the need for further research incorporating additional academic and environmental variables. That is why we used the API variable as a measure of negative changes in academic performance of university students.

In the third year of full-scale war in Ukraine, mental health remains an urgent issue for the Ukrainian population [51, 52], including students and adolescents. Given that less than 1 million students continue their studies in Ukraine in 2023, there is a significant demand for psychosocial support services for this population group. Additionally, the API among students during the war have long-term negative consequences, as its hinder the acquisition of knowledge and the development of competencies required for future professional careers. Therefore, the mental health problems among students during wartime is gaining a broader socio-economic dimension as it begins to hinder the development of human capital, which is critical for the successful post-war reconstruction of Ukraine’s economy.

The considerable deterioration in the mental health of Ukrainian university students during the war requires a quick response at both the institutional and public policy levels. At the level of Ukrainian higher education institutions, there should be implemented measures for timely monitoring of students’ mental conditions, prevention of mental health disorders, screening for mental health problems, and the implementation of modern interventions. Universities need to recognize the important role of students’ mental health and the need to protect it as part of educational activities, prioritize students’ mental health and turn it into a strategic objective of the higher education institution, apply effective screening methods for the timely recognition of mental health problems among students, introduce modern prevention tools using digital technologies and a system of information materials, and apply a set of interventions (including online) adapted to the peculiarities of the mental condition and needs of Ukrainian students during the war.

At the public policy level, disseminating of best practices for organizing support for students’ mental health during the war, shoud be provided for Ukrainian universities. Furthemore, the government has to secure funding for implementation of relevant programs including: educational activities to promote the concept of mental health, forming basic knowledge about the symptoms of major mental health disorders, introducing screening of students’ mental health at the university level, identifying the first signs of mental health problems, forming risk groups for timely response and determining further diagnostic procedures, as well as implementing adequate psychosocial and therapeutic interventions. Additionally, it is nessasry to increase funding for psychological support cabinets at the universities as well as launching new psychosocial and group support programs based on the best practices of leading universities in the EU, the UK, the US and Canada [53]. Given the well-researched vulnerability of female students to anxiety and depression, as well as their significant representation in certain academic programs, gender-oriented mental health interventions must be integrated into university support systems. These initiatives should go beyond individual counseling to include structured group-based resilience training, crisis adaptation strategies, and tailored psychosocial interventions designed to empower female students in navigating the unique challenges they face during wartime.