Assessment of anxiety, depression, stress and vitamin d levels in women in warfare

Authors

  • N.V. Kosei SI “O.M. Lukyanova IPOG of the NAMS of Ukraine”; SSI “Center for Innovative Medical Technologies of the NAS of Ukraine”, Kyiv, Ukraine https://orcid.org/0000-0003-3085-3285
  • T.F. Tatarchuk SI “O.M. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”; State Scientific Institution “Center for Innovative Medical Technologies of the NAS of Ukraine”, Kyiv, Ukraine https://orcid.org/0000-0002-5498-4143
  • V.M. Yakimets State Scientific Institution “Center of Innovative Medical Technologies” of the NAS of Ukraine, Kyiv, Ukraine https://orcid.org/0000-0002-8457-5949
  • N.V. Iarotska State Scientific Institution “Center for Innovative Medical Technologies of the NAS of Ukraine”, Kyiv, Ukraine https://orcid.org/0000-0002-0134-920X
  • I.S. Kolesnichenko State Institution “Territorial Medical Association of the Ministry of Internal Affairs of Ukraine in the City of Kyiv and the Kyiv Region”, Kyiv, Ukraine https://orcid.org/0009-0001-5223-0524
  • K.D. Plaksiieva State Scientific Institution “Center for Innovative Medical Technologies of the NAS of Ukraine”, Kyiv, Ukraine https://orcid.org/0000-0002-3021-4515

DOI:

https://doi.org/10.18370/2309-4117.2024.72.35-45

Keywords:

military women, civilian women, vitamin D, deficiency, stress, depression, anxiety

Abstract

Objective of the study: to assess the levels of vitamin D (25(OH)D) in the blood serum of military women and women involved in a military conflict, as well as to identify the relationship of its indicators with the level of anxiety, depression and stress.
Materials and methods. 52 women serving in the Armed Forces of Ukraine and other categories of women involved in the military conflict were surveyed. They entered the main group. The comparison group includes 50 women who are not related to military conflict.
The concentration of vitamin D (25(OH)D) in blood serum was determined by enzyme immunoassay In all women. The level of stress was studied using the Depression Anxiety and Stress Scale (DASS-21).
Results. The vast majority of women in the main group (76.5%) were diagnosed with vitamin D hypovitaminosis conditions, which significantly exceeded the specific gravity of such patients in the comparison group – 46.0% (р < 0.05). Only 12 (23.08%) women of the main group had a normal level of this vitamin, which was half as much as the specific gravity of such patients in the comparison group – 54% (р < 0.05).
The values of the DASS-21 test on the depression scale were 5.74 ± 0.26 points In the main group, while in the comparison group – 4.57 ± 0.31 points (p < 0.05), on the stress scale – 8.22 ± 0.24 points and 6.67 ± 0.28 points, respectively (p < 0.05). Anxiety levels, on the contrary, were more pronounced in civilian women – 5.81 ± 0.24 points compared to the main group (р < 0.001). Signs of anxiety were found in 84.0% of civilian women and in 61.54% of women involved in the military conflict (p < 0.05). However, the specific weight of patients with different levels of this disorder almost did not differ between groups.
Conclusions. Today, vitamin D deficiency is a widespread problem among women, regardless of profession. But a more pronounced decrease in its levels was found in female military personnel and other categories of women involved in the military conflict, which is related to the type of chosen profession, service conditions and psycho-emotional stress.
It has been established that women who serve in the Armed Forces of Ukraine are more prone to depression and stress. Civilian women, on the other hand, show more signs of anxiety. The revealed relationship between the levels of vitamin D in the blood and elevated scores of the DASS-21 questionnaire in both groups indicates the importance of this vitamin in psycho-emotional stability. The pronounced decrease in the concentration of vitamin D, found in military women against the background of high stress load, substantiates the feasibility of a rational approach to the examination before military service and periodic determination of the vitamin D level, as well as the regular use of its adequate preventive doses.

Author Biographies

N.V. Kosei, SI “O.M. Lukyanova IPOG of the NAMS of Ukraine”; SSI “Center for Innovative Medical Technologies of the NAS of Ukraine”, Kyiv

MD, professor, chief researcher, Endocrine Gynecology Department;
head of Department of Reproductive Health

T.F. Tatarchuk, SI “O.M. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”; State Scientific Institution “Center for Innovative Medical Technologies of the NAS of Ukraine”, Kyiv

MD, professor, corresponding member of the NAMS of Ukraine;
deputy director for research work, head of the Endocrine Gynecology Department;
chief researcher, Department of Reproductive Health

V.M. Yakimets, State Scientific Institution “Center of Innovative Medical Technologies” of the NAS of Ukraine, Kyiv

MD, deputy director for scientific, organizational and methodological work

N.V. Iarotska, State Scientific Institution “Center for Innovative Medical Technologies of the NAS of Ukraine”, Kyiv

psychologist, researcher, Department of Reproductive Health

I.S. Kolesnichenko, State Institution “Territorial Medical Association of the Ministry of Internal Affairs of Ukraine in the City of Kyiv and the Kyiv Region”, Kyiv

PhD, gynecologist

K.D. Plaksiieva, State Scientific Institution “Center for Innovative Medical Technologies of the NAS of Ukraine”, Kyiv

PhD, researcher, Department of Reproductive Health

References

  1. Lurin IA, Khomenko IP, Nazarenko OYA, Deynyuk KD. Reproductive and somatic health of women servicewomen and those in the combat zone during armed conflicts. Reproductive endocrinology. 2019;49:78-82. DOI: 10.18370/2309-4117.2019.49.78-83
  2. Tsymbalyuk VI. Reproductive health of women servicewomen in a special period. А monograph. Kyiv, 2020:19–20.
  3. It became known how many women serve in the Ukrainian army [Internet]. Express-online. 2017. Available from: https://expres. online/archive/ news/2017/04/10/237115-stalo-vidomo-skilky-zhinoksluzhat-ukrayinskiy-armiyi
  4. Verkhovna Rada of Ukraine. Ed. from 20.06.2024. Available from: https://zakon.rada.gov.ua/laws/show/2232-12#Text
  5. Braun LA, Kennedy HP, Womack JA, Wilson C. Integrative Literature Review: U.S. Military Women’s Genitourinary and Reproductive Health. Military medicine. 2016;181(1):35–49. DOI: 10.7205/MILMED-D-15-00242
  6. Patten E, Parker K. Women in the US military: Growing share, distinctive profile. Electronic resource Pew Research Centre. [Internet] 2011 Dec 22. Available from: https://www.pewsocialtrends.org/2011/12/22/womenin-the-u-s-military-growing-share-distinctive-profile.
  7. Zhuk SI, Nochvina OA. Prevention and correction of dyshormonal disorders of the reproductive system in modern conditions of chronic stress. Women’s health. 2020; 8(154):17–23. DOI: 10.15574/HW.2020.154.17
  8. Burlaka O, Chaban O, Bezsheiko V. The Relationship between Indicators of Mental and reproductive Health among Military Servicewomen Deployed in the Current War Zone in Eastern Ukraine. The 8th annual conference of the Canadian Institute for Military and Veteran Health Research. [Internet]. CIMVHR FORUM. Abstracts. 2017:6. Аvailable from: https://cimvhr.ca/ documents/forum-abstracts-2017.pdf
  9. Krulewitch CJ. Reproductive Health of Active Duty Women in Medically Austere Environments. Mil Med 2016 Jan;181(1 Suppl):63-9. DOI: 10.7205/MILMED-D-15-00221
  10. Chaban OS, Frankova IA. Guilt, shame and social withdrawal in the context of post-traumatic stress disorder. Likarska sprava. 2019;1:83–92. DOI:10.31640/JVD.1-2.2019(12)
  11. Hamlin I, Banaag A. Women’s Health Care in the Deployed Setting 2013-2020: A Health Services Research Approach. Military Medicine. 2022 Feb 17:usac025. 1–7. DOI: 10.1093/milmed/usac025
  12. Grundmann M, von Versen-Höynck F. Vitamin D-roles in women’s reproductive health? Reprod. Biol. Endocrinol. 2011 Nov 2:9:146. DOI: 10.1186/1477-7827-9-146.
  13. Lim ICZY, Tam, WWS, Chudzicka Czupala A, et al. Prevalence of depression, anxiety and post-traumatic stress in war- and conflict-affected areas: A meta-analysis. Front. Psychiatry. 2022 Sep 16:13:978703. DOI: 10.3389/fpsyt.2022.978703.
  14. Kuznetsova IV, Burchakova MN, Burchakov DI, et al. Psychogenic stress-dependent disorders of menstrual cycle: role of non-hormonal correction. Health Woman. 2018;10(136):68-72.
  15. Bouma EM, Riese H, Ormel J, Verhulst FC, Oldehinkel AJ. Adolescents’ cortisol responses to awakening and social stress; effects of gender, menstrual phase and oral contraceptives, the trails study. Psychoneuroendocrinology. 2009;34(6):884–93. DOI: 10.1016/j.psyneuen.2009.01.003
  16. Colonese F, Laganà AS, Colonese E, et al. The pleiotropic effects of vitamin D in gynaecological and obstetric diseases: an overview on a hot topic. Biomed. Res. Int. 2015; 2015: 986281. DOI: 10.1155/2015/986281
  17. Povorozniuk VV, Balatska NI. Vitamin D deficiency in the population of Ukraine and risk factors for its development. Reproduct. Endocrinol. 2013;5(13):7–13. DOI: 10.18370/2309-4117.2013.13.7-13
  18. Abdi F, Amjadi MA, Zaheri F, Rahnemaei FA. Role of vitamin D and calcium in the relief of primary dysmenorrhoea: a systematic review. Obstet Gynaecol Sci. 2021 Jan;64(1):13–26. DOI: 10.5468/ogs.20205.
  19. Carrelli A, Bucovsky M, Horst R et al. Vitamin D storage in a dipose tissue of obese and normal weight women. J Bone Miner Res. 2019; 32(3): 237–242. DOI: 10.1002/jbmr.2979
  20. Krul YHP, Snackey C, Louwers Y, et al. The role of vitamin D in metabolic disturbances in polycystic ovary syndrome: a systematic review. Eur. J.Endocrinol. 2013 Oct 23;169(6):853–65. DOI: 10.1530/EJE-13-0617
  21. Khmil MS, Khmil SV, Chudiiovych NY, et al. Efficiency of vitamin D using in complex treatment of infertility in women with polycystic ovary syndrome. Act Probl Pediatr. 2019;(2):103–10. DOI: 10.11603/24116-4944.2019.2.10912
  22. Chen L, Zhu H, Harshfield GA, et al. Serum 25-Hydroxyvitamin D Concentrations Are Associated with Mental Health and Psychosocial Stress in Young Adults. Nutr. 2020;12(7):1938. DOI: 10.3390/nu12071938.
  23. Płudowski P, Karczmarewicz E, Bayer M, et al. Practical guidelines for the supplementation of vitamin D and the treatment of deficits in Central Europe – recommended vitamin D intakes in the general population and groups at risk of vitamin D deficiency. Endokrynol Pol. 2013;64(4):319–27. DOI: 10.5603/ep.2013.0012
  24. Shurpyak SO. Management of vitamin D deficiency in women with dyshormonal combined proliferative diseases of the reproductive organs. Women’s health, 2018;4 (130): 14–8. DOI: 10.15574/HW.2018.130.14
  25. Heaney RP. Vitamin D in health and disease. Clin J Am Soc. Nephrol, 2008 Sep;3(5):1535-1541. DOI: 10.2215/CJN.01160308
  26. Komisarenko YI. Vitamin D and its role in the regulation of metabolic disorders. Lectures, reviews, news. [Interhet]. Medicines of Ukraine 2013;4:51–54. Available from: http://nbuv.gov.ua/UJRN/likukr_2013_4_11

Published

2024-06-30

How to Cite

Kosei, N., Tatarchuk, T., Yakimets, V., Iarotska, N., Kolesnichenko, I., & Plaksiieva, K. (2024). Assessment of anxiety, depression, stress and vitamin d levels in women in warfare. REPRODUCTIVE ENDOCRINOLOGY, (72), 35–45. https://doi.org/10.18370/2309-4117.2024.72.35-45

Issue

Section

Gynecology