A study on long-term trauma-related mental health outcomes among Kurdish survivors of chemical attacks

Background: The Kurdistan region experienced a series of devastating events, such as the 1988 chemical attacks and the 2014 Yazidi genocide, which have had substantial impacts on the psychological and physical health of survivors. Objectives: This study evaluates the long-term mental health of individuals who were exposed to chemical gas, with a focus on the prevalence and severity of psychological symptoms and their associations with sociodemographic, clinical, and trauma-related factors. Methods: (PCL-5), Patient Health Questionnaire-15 (PHQ-15), and Hopkins Symptom Checklist-25 (HSCL-25). Multivariate General Linear Modeling (GLM) was performed, adjusting for trauma exposure to simultaneously assess the effects of demographic and clinical variables on multiple symptom domains. Results: Most of the participants exhibited clinically significant symptoms, with 78.8% meeting the post-traumatic stress disorder (PTSD) threshold and 46.3% exhibiting comorbid symptoms across multiple domains. The GLM demonstrated that gender, trauma exposure, education level, and clinical factors were significantly associated with symptom severity across PTSD, somatic, and anxiety/depression symptoms (p < 0.001). The model explained up to 47% of variance in symptom outcomes. After adjusting for covariates, women showed higher symptom severity than men. Greater trauma exposure and lower education independently predicted increased symptoms. Conclusion: These findings highlight serious psychological and somatic effects among survivors and underscore the urgent need for targeted mental health interventions for those affected by chemical attacks, with particular attention to individuals with lower levels of education and socioeconomic status, while incorporating gender-sensitive approaches to address differential vulnerabilities.