Journal of affective disorders · 2026
The long-term psychological and sleep-related consequences of the Halabja chemical attack: A cross-sectional and cross-generational study over three generations.
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Mohammadi Hiwa, Seidi Pegah, Kakakhan Mehraban H, Jaff Dilshad, Brühl Annette B, Sadeghi-Bahmani Dena, Brand Serge
Аннотация
BACKGROUND: In 1988, an Iraqi chemical attack on Halabja (Kurdistan Region of Iraq) killed about 3200-5000 people and injured about 7000-10,000. The aims were: To assess the general health status and sleep disturbances among three generations currently living in Halabja. To compare their health status. To compare prevalence rates of sleep disturbances and posttraumatic stress disorder (PTSD) with normative data. To explore which dimensions were associated with sleep disturbances. To identify possible sex-specific patterns.
METHODS: We assessed three generations: VICTIMIZED AS ADULTS (VasAD); VICTIMIZED AS CHILDREN (VasCHI); NOT-AFFECTED (NOA/not exposed). Participants completed a booklet of self-rating questionnaires covering sociodemographic information, general health, critical life events/symptoms of PTSD, and sleep disturbances.
RESULTS: 218 adults participated in the study; VasAD: n = 67; mage 52.72y; 65.7% females; VasCHI: n = 75; mage 43.37y; 10.7% females; NOA: n = 76; mage 22.06y; 86.8% females. Compared to the NOA, VasCHI and VasAD reported lower scores for general health, including depression, and higher scores for PTSD symptom severity and sleep disturbances. Compared to normative data, all three cohorts had higher scores for probable PTSD and sleep disturbances. Female sex and higher symptoms of PTSD were independently associated with higher sleep disturbances. Compared to male participants, female participants reported higher scores for health-related issues, including depression, PTSD symptom severity, and sleep disorders, though the pattern was complex and non-uniform.
CONCLUSIONS: Cohorts directly (VasAD; VasCHI) and not (NOA) exposed to the chemical attack reported higher mental health issues, including depression, PTSD symptom severity, and sleep disturbances. War-related atrocities appeared to impact the following generation. Females appeared to be particularly vulnerable to mental health issues.
METHODS: We assessed three generations: VICTIMIZED AS ADULTS (VasAD); VICTIMIZED AS CHILDREN (VasCHI); NOT-AFFECTED (NOA/not exposed). Participants completed a booklet of self-rating questionnaires covering sociodemographic information, general health, critical life events/symptoms of PTSD, and sleep disturbances.
RESULTS: 218 adults participated in the study; VasAD: n = 67; mage 52.72y; 65.7% females; VasCHI: n = 75; mage 43.37y; 10.7% females; NOA: n = 76; mage 22.06y; 86.8% females. Compared to the NOA, VasCHI and VasAD reported lower scores for general health, including depression, and higher scores for PTSD symptom severity and sleep disturbances. Compared to normative data, all three cohorts had higher scores for probable PTSD and sleep disturbances. Female sex and higher symptoms of PTSD were independently associated with higher sleep disturbances. Compared to male participants, female participants reported higher scores for health-related issues, including depression, PTSD symptom severity, and sleep disorders, though the pattern was complex and non-uniform.
CONCLUSIONS: Cohorts directly (VasAD; VasCHI) and not (NOA) exposed to the chemical attack reported higher mental health issues, including depression, PTSD symptom severity, and sleep disturbances. War-related atrocities appeared to impact the following generation. Females appeared to be particularly vulnerable to mental health issues.