Work

Biological Correlates of Psychological Distress Among Conflict-Affected Youth in Yemen: The Association of Vitamin D Status and Helicobacter Pylori Infection

Year: 2026

Type: article

Abstract: Background: Conflict-affected youth face intersecting biological and psychosocial stressors; however, integrated data are scarce. This study examined the associations between vitamin D deficiency, H. pylori infection, and psychological distress among youth in Yemen. Methods: A community-based cross-sectional study was conducted among 400 young adults (18-30 years) in Al-Dhalea, Yemen. Depression, anxiety, and stress were assessed using the DASS-21. Serum 25-hydroxyvitamin D, H. pylori stool antigen (confirmed by urea breath test), inflammatory markers (CRP, IL-6, TNF-α), and morning cortisol were measured. Hierarchical regression models examined independent and combined associations. Results: Moderate-to-severe depression, anxiety, and stress affected 49%, 60%, and 46% of participants. Suboptimal vitamin D levels (< 30 ng/mL) were present at 87.5%, and 45% had an active H. pylori infection. Vitamin D showed the strongest independent association with depression (β = -0.41, 95% CI: -0.50, -0.32), anxiety (β = -0.35, 95% CI: -0.45, -0.25), and stress (β = -0.29, 95% CI: -0.39, -0.19). H. pylori infection was independently associated with higher stress (β = 0.14, 95% CI: 0.05, 0.23). An exploratory post-hoc subgroup analysis identified a high-risk subgroup (n = 68, 17.0%) with concurrent severe vitamin D deficiency, H. pylori infection, severe psychological symptoms, and elevated inflammatory markers and cortisol (all p < 0.001). Conclusion: This study identifies a clustered vulnerability pattern of psychological distress, vitamin D deficiency, and H. pylori infection among conflict-affected youth. An exploratory "triple burden" subgroup warrants investigation. These hypothesis-generating findings suggest the potential utility of integrated interventions, though rigorous evaluation is required. Major limitations include unmeasured trauma, a single-governorate scope, and post-hoc subgroup analysis requiring replication. Clinical data indicate a substantial trauma burden in this setting, underscoring the need for future studies with validated trauma instruments.

Source: Psychology Research and Behavior Management

DOI: 10.2147/prbm.s638108

Authors: Khalil A Saleh, Naif Taleb Ali, Galal Faisal Albani, Nazeh Mohammed Al-Abd, Gamila Saleh Ali

Institutions: University of Ha'il, University of Science and Technology, University of Lahej, University of Aden

Language: English

Topic: Vitamin D Research Studies

Subfield: Endocrinology, Diabetes and Metabolism

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Zero hunger

Open Access status: gold

Estimated APC paid: $2,836