A comprehensive review underscores the varied psychological effects of the October 7 attacks and the subsequent war in Israel, highlighting the importance of targeted support and long-term monitoring for affected populations.
A systematic review published in Frontiers in Psychiatry suggests that the mental health impact of the October 7 attacks and the subsequent war in Israel was broad, but not uniform. The review, which analysed studies published over the first two years of the conflict, found that post-traumatic stress symptoms, anxiety and depression were widespread, while addiction-related harms were reported far less often and appeared to affect narrower groups. The authors said the pattern was shaped less by exposure alone than by the intensity, duration and social context of that exposure.
The review screened 4,588 records and included 68 studies that met its criteria. Most of the evidence came from cross-sectional surveys, with fewer longitudinal studies. That mix matters: the authors noted that many studies relied on brief screening tools rather than full clinical diagnosis, and that sampling was often non-random. Even so, the overall picture was consistent. Higher levels of distress were repeatedly reported among people who faced direct danger, prolonged displacement, bereavement, reserve duty, or other forms of sustained strain.
Post-traumatic stress was the most frequently studied outcome and was often pronounced in the early months after the attack. Rates were especially high in groups with close exposure to violence or repeated war-related demands, including reservists, bereaved adults, evacuees and some children. The review also found that symptoms could persist over time in people exposed to ongoing threat, while social support, coping resources and psychological flexibility appeared to offer some protection. Women, older adults with prior trauma, and people with intergenerational trauma histories were among those at higher risk.
Anxiety and depression followed a similar pattern, often rising alongside traumatic stress rather than separately from it. According to the review, these symptoms were linked not only to direct exposure but also to displacement, income loss, food insecurity, media exposure and continued missile alerts. In a number of studies, those pressures affected daily functioning and quality of life. The review also noted that evacuees, postpartum women, spouses of reserve soldiers and some ethnic minority groups faced particular burdens.
Addiction-related outcomes were the least studied area. Only three studies examined them, and the early evidence pointed to increased substance use and gambling in some exposed groups rather than a broad population-wide rise. The authors said this domain remains under-researched and needs closer monitoring, especially as prolonged conflict can push some people towards maladaptive coping. Overall, the review argues for targeted screening, long-term follow-up and services that address both symptoms and everyday functioning.
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