Introduction
The Kurdistan region has endured numerous traumatic events, including the 1988 chemical attacks and the 2014 Yazidi genocide, which have profoundly affected the psychological and physical health of survivors. This study aims to evaluate the long-term mental health outcomes of individuals exposed to chemical gas, focusing on the prevalence and severity of psychological symptoms and their associations with sociodemographic, clinical, and trauma-related factors.
Study Objectives and Methods
The primary objective of this research is to assess the long-term mental health of Kurdish survivors of chemical attacks. The study involved 534 participants (300 women and 234 men) who completed validated psychological assessments, including the PTSD Checklist for DSM-5 (PCL-5), Patient Health Questionnaire-15 (PHQ-15), and Hopkins Symptom Checklist-25 (HSCL-25). Data collection spanned seven months, from March to September 2023. Multivariate General Linear Modeling (GLM) was used to evaluate the effects of demographic and clinical variables on multiple symptom domains.
Key Findings
The study revealed that a significant majority of participants exhibited clinically significant symptoms, with 78.8% meeting the PTSD threshold and 46.3% showing comorbid symptoms across multiple domains. The GLM analysis indicated that gender, trauma exposure, education level, and clinical factors significantly influenced symptom severity across PTSD, somatic, and anxiety/depression symptoms. The model explained up to 47% of the variance in symptom outcomes. Women exhibited higher symptom severity than men, and greater trauma exposure and lower education levels independently predicted increased symptoms.
Historical Context of the Kurdish Genocide
Kurdistan, a region spanning parts of Syria, Turkey, Iran, and Iraq, is home to the Kurdish people, the fourth-largest ethnic group in the Middle East. The region has witnessed several large-scale atrocities, including the Anfal operations in 1988, which resulted in the deaths of approximately 182,000 Kurdish people. The city of Halabja suffered one of the most significant chemical attacks in history, with the Iraqi regime using nerve agents, cyanide, and mustard gas. Approximately 5,000 people died in the attack, and thousands continue to suffer from its long-term consequences.
Psychological and Physiological Impacts
Research on the psychological and physiological effects of chemical gas exposure has been limited. However, studies indicate that survivors report high rates of PTSD, sleep problems, depression, social isolation, itching, and respiratory complications. Further research highlights the persistent impact of mass violence, with high prevalence rates of PTSD and depression among survivors of the Kurdish Anfal and Yazidi genocide.
Global Comparisons and Implications
Globally, PTSD affects approximately 3.9% of the general population, with prevalence increasing to 48% in trauma-exposed populations. Meta-analytic evidence shows that over one-quarter of adult war survivors suffer from PTSD, with trauma exposure also linked to depression, anxiety, and somatic symptoms. Longitudinal studies among survivors of chemical weapon exposure reveal persistent psychiatric symptoms and physical comorbidities decades after exposure, underscoring the chronicity and complexity of trauma effects.
Study Limitations and Future Directions
While this study provides valuable insights into the long-term psychological consequences of chemical weapons exposure, it has limitations. Survivor bias may affect the sample, as many exposed individuals have died since the chemical attack. Additionally, many survivors have relocated, complicating sample recruitment. Future research should explore the interaction of psychophysiological, psychological, and sociodemographic factors in shaping trauma responses.
Conclusion
This study highlights the severe psychological and somatic effects among Kurdish survivors of chemical attacks, emphasizing the urgent need for targeted mental health interventions. The findings underscore the importance of addressing educational inequalities, gender-specific vulnerabilities, and socioeconomic support to reduce long-term psychological distress and promote sustainable mental health improvements in the Kurdistan region.
🔗 **Fuente:** https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2025.1693072/full