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Introduction: According to UNICEF, 2 million children have left the country since the beginning of the war. 2.5 million Ukrainian children are internally displaced persons. Minors often become victims or witnesses of violence. The events of 2022-2023 are the largest military conflict in the world since World War II. The impact on the mental health of the population is characterized by the variety and mass of traumatizing factors. Mental trauma causes PTSD, depressive disorders (DD), anxiety disorders (AD), behavioral disorders (CD), attention deficit hyperactivity disorder (ADHD). Objectives: The aim of the study was to determine the prevalence of PTSD and its comorbidities at different stages of experiencing a traumatic experience. Methods: 785 teen's displaced from the zone of military operations, occupied territories were surveyed. Examinations included: K-SADS-PL, PSC-17, SCARED, CATS. 260 teen's were examined during - 6, 400 – 6–12 months after traumatization. Results: After 6 months of trauma, PTSD was diagnosed in 9.8%, ADHD – 10.2%, DD-22.3%, AD-30.8%, CD – 15.4%, 28.8%; examined 6 to 12 months after the injury, respectively: 21.9%, 12.6, 33.3%, 11.5%, 18.0%. Conclusions: In war-affected children, PTSD is a risk factor for the subsequent development of comorbid depression, anxiety, conduct disorders, and ADHD. Female sex, secondary traumatization after displacement increase the risk of developing depression, signs of pervasive development and ADHD - the risk of destructive and self-injurious behavior. The prevalence of PTSD, DD, ADHD increases within 6-12 months after the trauma, the sensitivity of children with PTSD to secondary traumatic events increases. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction Military action in Ukraine led to increasing in the number of patients with PTSD among children. Open-label studies demonstrated the efficacy of SSRI’s for the treatment of PTSD, primarily paroxetine. Feasibility of using of these drugs in children and adolescents is controversial [1-2]. Objective To evaluate a short and long-term efficacy and tolerability of fluoxetine in the treatment of PTSD in children. Methods double-blind, placebo-controlled 12-week study with a fixed dose of fluoxetine (20-40 mg). The trial design consisted of 1-week, single-blind, placebo run-in period, followed by a 12-week treatment period and a 2-week taper phase. Were randomized 110 children aged from 12 to 18 years (MD = 14,2), that have been moved from the combat zone in the east of Ukraine and met the DSM-5criterias for PTSD. Drug efficacy was assessed weekly using the CAPS-2; CGI-I / CGI-S. Safety assessed: Adverse event (AE) recording, suicidality assessment. Result The reduction in CAPS-2 scales was statistically significant among children randomized to fluoxetine treatment compared with placebo in a week 12 endpoint (treatment difference -11.10; 95% Cl-13.4, -7,38; p <0.001). Significant greater proportion of fluoxetine-treated patient (52%) than placebo-treated (43%) were defined as treatment responders based on CGI scale (adjusted odds ratio = 2.28; 95% Cl 1.75, 2.93; p <0.001). The most common adverse effects in fluoxetine group were somnolence, headache and irritability, each occurring in <20% patients. Conclusion Fluoxetine at a dose of 20-40 mg / day is more effective than placebo, well-tolerated and can be recommended in pediatric practice. [ABSTRACT FROM AUTHOR]