Review: Prevalence of depression, anxiety, and PTSD symptoms among patients of opioid agonist treatment programmes in Ukraine during wartime {under peer review}

 

Reviewer 1: Kamala Poudel

 

Completed: 29-07-2025 05:27

 

Recommendation: Accept Submission

 

 

	Yes	No	N/A
Is the research question clearly defined?	+
Are the methods appropriate and sufficiently detailed?	+
Is the data analysis robust and replicable?	+
Are the conclusions supported by the results?	+
Is the manuscript well organised and clearly written?	+
Are tables, figures, and supplementary material informative and necessary?	+
Is the abstract an accurate summary of the study?	+
Does the manuscript contribute meaningfully to the field?	+
Is it relevant to the field of mental health or related disciplines that are connected to the scope of the Journal?	+
Are ethical approvals and participant consents adequately described?	+
Have competing interests, funding, and data availability been transparently declared?	+

 

Comments for the authors:

A lot of hard work has gone into the research paper and there is a lot of data given in the paper which can form the basis of further studies in the future. However, certain aspects have not been taken into consideration. Firstly, data as to socio-economic engagement of subject of research not collected and analyzed. This was important as a gainful socio-economic engagement can reduce the mental health issues of OAT therapy patients. 

Also, the benefit of the research for the subjects of research has not been mentioned either directly or indirectly. It is very important that the research should aim at comforting the subjects so that they cooperate happily in the research process. Here, 1/3 of the OAT therapy patients declined to cooperate fully in the research.

"Trauma and PTSD data were collected in 2/3 of the patients screened for Depression and Anxiety, and the other 1/3 refused to fill in the LEC-5 and PCL-5 screeners. Therefore, it is impossible to make reliable conclusions on PTSD prevalence."

Counselling, other psychosocial supports such as breathing exercises, etc., could have persuaded the 1/3  subjects to fill in the screeners. Nothing has been mentioned to the effect that efforts were made to persuade the 1/3 of the patients. Of course, the patients' cooperation had to be voluntary, but little counselling could have made them understand that the screener survey was for their benefit, as it would decide the medicines and their dosage for these 1/3 patients.

Also, there are no specific recommendations made in the paper. The conclusion is very general. Specific recommendations are lacking. Dosage variation due to heightened stress of war is not recommended when it is categorically mentioned that "A significant deterioration in the mental health of OAT patients in Ukraine during the second year of the full-scale Russian invasion" was found.

An effective occupation of the research subjects at the Socio-cultural levels is not recommended.

A recommendation for the psychosocial support is mentioned, which is very important.

".....the need for further development of psychosocial support services, integrated into the work of OAT centres and potentially transforming them into community-based mental health and psychosocial centres. Such integration can improve mental health outcomes for OAT patients, providing them with much-needed support in a consistent way and supporting their reintegration and inclusion into society....."

The absence of any change in suicidal ideation is interesting. Some additional authorities could be added to explain that generally, suicide ideation does not increase during wartime, rather it increases in the post-war phases.