Exposure to war-related traumatic events carries the risk of developing psychiatric disorders (Charlson et al., 2019). Studies have mostly focused on soldiers, and far less is known about civilian populations under war or on the long-term impact of terrorist attacks and kidnapping on mental health. Although several reviews have examined the mental health consequences of war for specific populations, a comprehensive evaluation across different populations has been lacking. Armed conflicts have affected multiple populations, making such a comprehensive review needed to guide planning a response to the anticipated need for psychiatric care that is optimized for each population.

Global exposure to war and terror-related traumas is currently at a peak (Institute for Economics & Peace, 2024), raising the question of how to respond to the anticipated mental health sequelae. The first step is to consider what types of war-related psychopathology can be anticipated after different types of exposure, and what is the time course of the elevated risk for psychopathology. Here, we consider data on the time course of the appearance of mental health disorders following exposure to terrorist attacks, civilians living in or fleeing from war zones, exposure to combat as a soldier, and prisoner of war or wartime hostage experiences.

The current war in Israel and Gaza, together with related conflicts in Lebanon, Syria, and Iran, involves all these forms of war-related trauma. The war in Israel and Gaza began with an attack that included the killing of about 1200 Israeli and foreign civilians and army personnel, atrocities that were broadcast via social media as they occurred by the terrorists involved, and the capture of 251 hostages. This phase was followed by an intense war that exposed over two million civilians in Gaza to the full brunt of the war and involved the destruction of most homes and hospitals in Gaza. Military operations in crowded urban areas in Gaza involving booby-trapped tunnels and ambushes created enormous stress for the military, and the prolonged war devastated buildings, roads, and basic infrastructure, impacting civilian populations in terms of deaths, injuries, homelessness, food and water shortages, and lack of health care. The same war led to the evacuation of >250,000 civilians from affected areas in Israel, and most only return to their homes recently. Daily bombings of Gaza and sporadic rocket and missile attacks on Israeli population centers have continued until recently.

Some studies of the Israel-Gaza war have examined the immediate mental health consequences. A study in Israel that assessed the national mental health helpline calls in the two months after the October 7th, 2023, attack compared with three months before, found a substantial increase in calls immediately after the attack, followed by a gradual decrease. Suicide-related calls did not increase in the days after the attack, and so their percentage of total calls showed a sharp decline, followed by a gradual increase (Benatov et al., 2024). In a representative sample of Israeli adults, who were assessed about 6–7 weeks before and 5–6 weeks after October 7th, 2023, rates of psychopathology rose from 16 % to 30 % for post-traumatic stress disorder (PTSD), from 25 % to 43 % for generalized anxiety disorder (GAD), and from 31 % to 45 % for depression (Levi-Belz et al., 2024). A cross-sectional study following the start of the war found that rates of PTSD among Arab and Jewish populations in Israel were 12 % and 15.4 %, respectively (Mayer et al., 2024) compared with 9 % in a prewar study of a representative Israeli sample (Ben‐Ezra et al., 2018).

To review data on the psychiatric consequences in different populations experiencing different types of war-related stress, we reviewed data from the last six decades in the United States and other countries to obtain relevant findings that can inform the mental health services needed to address the mental health consequences of the many scenarios of this war. We reviewed studies that examined the impact of exposure to terror attacks, and wars, on civilians, active and nonactive combat exposure, the experience of civilian hostages, and of tortured military prisoners of war.