Two Gaza studies begin to measure the war's mental-health toll

Two peer-reviewed studies have started to put measured numbers on the psychological toll of the war in Gaza, in populations that had gone almost entirely uncounted. In one, of 383 patients on hemodialysis, 83.6% screened positive for moderate-to-extreme anxiety and 58% met the cutoff for post-traumatic stress disorder [s2]; in the other, all 250 adolescents surveyed had been exposed to at least three war-related traumatic events, and that exposure correlated closely with post-traumatic and depressive symptoms [s1].

Neither study can tell a reader how common a mental-health condition is across Gaza as a whole. Both are cross-sectional surveys of specific, non-random groups, using screening scales rather than clinical diagnosis — and that is exactly why the numbers should be read as signposts, not prevalence estimates.

The adolescents

The study in the European Journal of Psychotraumatology surveyed 250 young people aged 12 to 18 who had been displaced into refugee camps during the war [s1]. Exposure was measured with the Gaza Traumatic Event Checklist; post-traumatic symptoms with the International Trauma Questionnaire, which distinguishes PTSD from the broader "complex" PTSD; and depression, anxiety and stress with a youth version of the Depression, Anxiety and Stress Scale [s1].

The headline is the universality of exposure: every participant had lived through at least three distinct traumatic events, so this is not a study of whether children in Gaza were affected but of how the degree of exposure maps onto symptoms [s1]. Greater trauma exposure went with higher PTSD and complex-PTSD scores, and boys reported more exposure than girls — yet the study found no gender difference in who met the threshold for a PTSD or complex-PTSD diagnosis [s1]. Older adolescents reported more stress, anxiety and depression, though age did not predict the post-traumatic diagnoses themselves [s1].

What the design does not support is a single "X% of children have PTSD" figure, and the authors do not offer one; the value is in the dose-response shape, not a population rate. With 250 self-selected participants in camps, the sample cannot stand in for every child in Gaza, and self-report during an ongoing war carries its own distortions.

The dialysis patients

The second study, in PLOS Mental Health, took a very different group — 383 people dependent on hemodialysis across five centres in Gaza — and asked how the destruction of homes related to their mental health [s2]. Anxiety was measured with the DASS-21 and PTSD with the PCL-5 checklist for DSM-5 [s2]. Home destruction was widespread among these patients: 66.1% had experienced it, and 53.5% had lost their residence entirely [s2].

The analytic core is a mediation model, and it needs careful language. The researchers found that anxiety statistically accounted for the whole of the association between home destruction and PTSD: once anxiety was in the model, the direct link from losing a home to PTSD was no longer significant, and the model explained 42% of the variance in PTSD scores [s2]. The authors are explicit that, because the data are cross-sectional, this is a statistical association and not proof of a causal chain — you cannot tell from a single snapshot whether anxiety sits on the path from loss to PTSD or simply travels alongside both [s2]. That caution is the responsible reading, and they call for longitudinal work before anyone treats the pathway as established.

Why two such different groups

Pairing displaced adolescents with dialysis patients is not arbitrary. It illustrates how thin the measured mental-health record for Gaza still is: the evidence arrives population by population, through whatever group a research team can reach, rather than as any systematic surveillance. Each study inherits the bias of its sampling frame — camp-based teenagers in one case, patients tied to a functioning dialysis centre in the other — and neither was designed to generalise beyond it.

Taken together they mark a shift from assertion to measurement. For most of the war, statements about Gaza's mental-health toll rested on plausibility and on what clinicians reported informally; these are among the first studies to attach validated instruments and denominators to specific groups. That is a real advance, and its limits are the point: high screening rates in a dialysis ward and a tight dose-response curve among displaced teenagers are strong signals, not a census.

The gap they expose — coverage — is the same one seen across the region's conflicts, from the treatment gap among displaced young people in Lebanon to the difficulty of even counting the dead in Gaza. What to watch is whether any of these cross-sectional snapshots is followed up over time, which is the only design that can turn a correlation into a trajectory.

Sources

• [s1] Exposure to war-related trauma and symptoms of complex posttraumatic stress disorder among children and adolescents in Gaza — European Journal of Psychotraumatology. https://doi.org/10.1080/20008066.2026.2665509
• [s2] Home destruction, anxiety and PTSD among hemodialysis patients in Gaza: a mediation analysis — PLOS Mental Health. https://doi.org/10.1371/journal.pmen.0000682