The Gaza Strip has been embroiled in a violent military assault since October 2023, with an immense toll on the civilian population. Armed conflicts threaten the mental health of affected communities and survivors, and psychiatric morbidity increases with forced displacement and with severe and recurrent trauma. This study investigates the prevalence and predisposing factors of depression, anxiety, stress, and PTSD symptoms in a group of young adult students from the Gaza Strip during the war. A cross-sectional, internet-based survey recruited medical students from the Gaza Strip and used the DASS21, SWLS, and PCL-5 instruments. PTSD diagnosis required having a PCL-5 score ≥ 23 and fulfilling the DSM-5 criteria. Rates of depression, anxiety, stress, and life satisfaction were compared with a previous dataset collected in 2022. Finally, logistic regression models were fitted using R software to identify factors significantly associated with depression, anxiety, stress, and PTSD. Three hundred thirty-nine medical students participated. Most had been displaced several times, and the great majority had lost a relative, colleague, or friend. Also, a majority had lost their homes and income. 97.05% of participants suffered mild depressive symptoms or higher, while 84.37% and 90.56% reported mild anxiety and mild stress symptoms or higher, respectively. High levels of life dissatisfaction were also found, and 63.40% suffered from PTSD. Symptoms were significantly more prevalent than baseline rates. All participants with PTSD had at least one psychiatric comorbidity. Living in a shelter and having moderate stress symptoms or higher were significantly associated with depression. Being a female, losing a friend, having moderate stress symptoms or higher, and having PTSD predicted having moderate anxiety or higher. Having moderate or higher depression symptoms, moderate or higher anxiety symptoms, and PTSD predicted having moderate stress symptoms or higher. Finally, moderate or higher anxiety and stress symptoms predicted having PTSD. The study detected very high rates of psychiatric disorders among its population of young adult medical students and outlined a myriad of risk factors associated with higher comorbidity. Interventions are needed to prevent a brewing mental health crisis in the Gaza Strip.

Background: Armed conflicts severely impact survivors psychologically, with effects tied to the trauma's intensity and widespread displacement. From October 2023 to January 2025, the Gaza Strip faced violent conflict, leading to major displacement and suffering. This study examines anxiety, PTSD, and depression among displaced adults from Gaza Strip. Methods: This cross-sectional study, conducted in November 2024, surveyed 952 displaced adults using the GAD-7, PCL-5, and PHQ-9 instruments and a convenience sampling method. A PTSD diagnosis required having a PCL-5 score ≥ 23 and fulfilling the DSM-5 criteria. The rates and severity of probable anxiety, PTSD, and depression were reported. Then, using SPSS, logistic regression models identified factors associated with each disorder, while multinomial regression models explored associations with the number of comorbidities. Results: The majority were unemployed (73.7%). Over half of the participants were displaced in camps (55.6%), while 40.4% lived in shelters. Nearly a fifth (20.3%) had lost a first-degree relative, 12.7% were injured, and 4.8% were detained by the military. Moderate or higher levels of anxiety and depression were reported by 79.3% and 84.5%, respectively. The rate of symptomatic PTSD was 67.8% when defined as meeting the DSM-5 criteria for PTSD and having a PCL-5 score ≥ 23, and 88.2% based on the latter criterion alone, while subthreshold PTSD was encountered in 18.1%. Also, 63.1% suffered significant symptoms of all three comorbidities. Significant predictors of anxiety included being female and having PTSD or depression. Significant predictors of PTSD included experiencing more frequent migrations, unemployment or working in the private sector, military detention, or having anxiety or depression. Significant predictors of depression included the death of a first-degree relative, military detention, torture, and having anxiety or PTSD. Additionally, having a higher number of migrations was significantly associated with having one, two, or three disorders compared to having “no disorders,” while those experiencing more forms of harm were significantly more likely to have all three disorders. Conclusions: The study found very high rates of psychiatric disorders among IDPs in Gaza and identified several risk factors contributing to those rates. Interventions must be prioritized to support society's long-term recovery.

Food insecurity is an important aspect of human suffering during wartime. Besides its ferocity, the Gaza conflict of 2023–2024 has been marked by severe food and medication shortages that exacerbated the human toll and worsened the suffering of the population. A cross-sectional, mixed methods study that in April 2024 collected quantitative and qualitative data to assess food insecurity and malnutrition among residents of the Northern part of the Gaza Strip during the first seven months of the war. Quantitative data assessed weight loss among participants as a marker of starvation. Qualitative interviews evaluated food availability, food variability, and changing eating habits. Demographics were represented as counts and percentages. Weight was reported as mean ± SD. The Spearman Correlation Coefficient evaluated potential correlations of weight loss with sex, place of residence, and age. Statistical significance was set at a p-value less than 0.05. 497 participants were recruited, including 330 males (66.4%) and 167 females (33.6%). The age range was (13–83 years). The mean baseline weight was 84.94 kg ± 20.06, with a weight range (35–180 kg). In April 2024, the mean weight had dropped to 66.22 kg ± 14.34, representing an average decline of 18.72 kg (new weight range 28–142 kg). Age was associated with a weak positive correlation with weight loss (r = .204, p = .000). Qualitative interviews with 95 breadwinners or homemakers revealed a high prevalence of hunger and severe shortages in food quantity, quality, and variability. Physical and financial barriers significantly impacted food sourcing. Also, due to food shortages, most participants reported high consumption of edible wild plants and unconventional types of flour such as corn flour or grounded animal feed. The study demonstrated high levels of weight loss and marked food insecurity in the Northern Gaza Strip during the conflict. The quantitative and qualitative food shortages outlined in this study present a risk for a host of potentially serious and irreversible future complications.

Background: Burnout, characterized by emotional exhaustion (EE), depersonalization (DP), and diminished personal accomplishment (PA), has been extensively studied in various populations. However, there is limited research on burnout among healthcare workers (HCWs) in conflict zones, particularly in the Gaza Strip. This study aims to assess the prevalence of burnout, associated factors, coping strategies, and mental health among HCWs in the Gaza Strip during the ongoing conflict. Methods: This cross-sectional study included 667 HCWs from various hospitals. Burnout was assessed using the Arabic version of the MBI-HSS Burnout Scale, which evaluates EE, DP, and PA. Sociodemographic and job-related characteristics, war-related experiences, coping mechanisms, and access to mental health services were also documented. Univariable analyses were followed by multivariable linear regression to identify factors associated with burnout subscales. Results: Among the participants, 53% were female, and the median age was 25–34 years. Most participants were nurses (54.6%) or physicians (32.2%), with 39.7% living in tents due to forced displacement. High levels of EE, DP, and low PA were observed in 52%, 25%, and 40% of participants, respectively. Religious coping was the most reported mechanism (63.7%), but 78% lacked access to mental health services. Regression analyses identified significant associations between burnout subscales and variables such as age, profession, religious coping, and access to mental health services. Physicians reported higher EE, while religious coping and mental health access were associated with lower DP and higher PA. Conclusions: HCWs in Gaza demonstrate alarmingly high burnout levels exacerbated by the ongoing conflict and inadequate mental health infrastructure. Religious coping emerged as a prominent mechanism, yet gaps in mental health service availability remain critical. Interventions to support HCWs’ mental health and address burnout are urgently needed.

Objective. To identify the risk factors, etiologies, length of stay, severity, and predictors of disability among patients with the first ischemic stroke in Jordan.Methods. A retrospective cohort study of 142 patients who were admitted to the Neurology Department at King Abdullah University Hospital between July/2017 and March/2018 with a first ischemic stroke. Etiology was classified according to the TOAST criteria. Severity was represented by NIHSS score, disability by mRS score, and prolonged length of stay as hospitalizations more than 75^thpercentile of the cohort’s median length of stay. Analysis of the sample demographics and descriptive statistics were done, including frequencies of prevalence of independent variables (risk factors) and frequencies of stroke and etiology work-up. Chi-square and univariate analysis of variance “ANOVA” were used to investigate the relationship between risk factors and type of stroke. Finally, logistic regression analysis was used to measure the contribution of each of the independent variables. IRB approval was obtained as necessary.Results. The mean age for the cohort was 66.5 years. The most common risk factors were hypertension (78.8%), diabetes mellitus (60.5%), and ischemic heart disease (29.4%). The most common stroke etiology was small-vessel occlusion (54.2%). Median length of stay was 4 days. Prolonged length of stay was observed in 23.23% of patients, which was associated with several factors, the most common of which were persistent dysphagia (57.5%), nosocomial infection (39.3%), and combined dysphagia and nosocomial infection (21.2%). The mean admission NIHSS score was 7.94, and on discharge was 5.76. In-hospital mortality was 2.81%, while 50% of patients had a favorable outcome on discharge (mRS score between 0-2). The mean discharge mRS score for the cohort was 2.47 (SD±1.79). Large artery atherosclerosis was associated with the highest residual disability with a mean score of 3.67 (SD±1.88), while the stroke of undetermined etiology was associated with the lowest residual disability with a mean score of 1.60 (SD±1.78). Significant predictors of mRS score were smoking (t3.24,P<0.001), age (t1.98,P<0.049), and NIHSS score (t9.979,P0.000).Conclusion. Ischemic strokes have different etiologies that are associated with different levels of impact on the patient’s clinical status and prognosis. Large artery atherosclerosis was associated with the highest residual disability. Regarding predictors of prognosis, current smoking status, age above 50, gender, and NIHSS on admission appear to be the strongest predictors of prognosis. Finally, higher NIHSS score on admission resulted in a longer hospital stay.

Maternal mortality is an important health indicator for the overall health of a population. This study assessed the causes and contributing factors to maternal mortality that occurred in the Gaza-Strip between July 2014 and June 2015. This is a retrospective study that used both quantitative and qualitative data. The data were collected from available medical records, investigation reports, death certificates, and field interviews with healthcare professionals as well as families. A total of 18 maternal mortalities occurred in Gaza between 1st July 2014 and June 30th 2015. Age at time of death ranged from 18 to 44 years, with 44.4% occurring before the age of 35 years. About 22.2% were primiparous, while 55.6% were grand multiparous women. The most common causes of death were sepsis, postpartum haemorrhage, and pulmonary embolism. The most striking deficiency was very poor medical documentation which was observed in 17 cases (94%). In addition, poor communication between doctors and women and their families or among healthcare teams was noticed in nine cases (50%). These were repeatedly described by families during interviews. Further aspects surfacing in many interviews were distrust by families towards clinicians and poor understanding of health conditions by women. Other factors included socioeconomic conditions, poor antenatal attendance and the impact of the 2014 war. Low morale among medical staff was expressed by most interviewed clinicians, as well as the fear of being blamed by families and management in case of adverse events. Substandard care and lack of appropriate supervision were also found in some cases. This study revealed deficiencies in maternity care, some of which were linked to the socioeconomic situation and the 2014 war. Others show poor implementation of clinical guidelines and lack of professional skills in communication and teamwork. Specialised training should be offered for clinicians in order to improve these aspects. However, the most striking deficiency was the extremely poor documentation, reflecting a lack of awareness among clinicians regarding its importance. Local policymakers should focus on systematic application of quality improvement strategies in order to achieve greater patient safety and further reductions in the maternal mortality rate.