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Peer-reviewedCC BY-NC 4.0Psychology Research and Behavior Management

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

  • Khalil A Saleh1
  • Naif Taleb Ali2,3
  • Galal Faisal Albani4
  • Nazeh Mohammed Al-Abd2,5
  • Gamila Saleh Ali5
5 affiliations
  1. 1Department of Medical Surgical, College of Nursing, University of Ha’il, Hail, Saudi Arabia
  2. 2Department of Health Sciences, Faculty of Medicine and Health Sciences, University of Science and Technology, Aden, Yemen
  3. 3Department of Laboratory Sciences, Radfan College University, University of Lahej, Al-Houta, Yemen
  4. 4Department of Maternal and Child Health Nursing, College of Nursing, University of Ha’il, Hail, Saudi Arabia
  5. 5Department of Medicine, Faculty of Medicine and Health Sciences, University of Aden, Aden, Yemen
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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.

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Cite

BibTeXRIS
BibTeX
@article{saleh2026biological,
  title = {{Biological Correlates of Psychological Distress Among Conflict-Affected Youth in Yemen: The Association of Vitamin D Status and Helicobacter Pylori Infection}},
  author = {Khalil A Saleh and Naif Taleb Ali and Galal Faisal Albani and Nazeh Mohammed Al-Abd and Gamila Saleh Ali},
  journal = {Psychology Research and Behavior Management},
  year = {2026},
  month = oct,
  doi = {10.2147/prbm.s638108},
  url = {https://doi.org/10.2147/prbm.s638108},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Biological Correlates of Psychological Distress Among Conflict-Affected Youth in Yemen: The Association of Vitamin D Status and Helicobacter Pylori Infection
AU  - Khalil A Saleh
AU  - Naif Taleb Ali
AU  - Galal Faisal Albani
AU  - Nazeh Mohammed Al-Abd
AU  - Gamila Saleh Ali
PY  - 2026
DA  - 2026/10/21
JO  - Psychology Research and Behavior Management
DO  - 10.2147/prbm.s638108
UR  - https://doi.org/10.2147/prbm.s638108
AB  - 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.
SN  - 1179-1578
ER  -