Evidence map›Paper›PMID 41408662›Full record

ArticleBMC psychology2025

The invisible wounds of war: a study of insomnia and psychological distress among healthcare students in conflict-affected Syria.

Hamdah Hanifa, Maya Alzoubi, Enas Saleem Khallouf, Lujain Alzoubi, Feras Hamesh, Mohamad Esmail Qashqash, Fadiah Hazem Albaroudi, Maya Al-Baroudy, Mohi Alddin Moustafa Mahouk, Yihea Mohammad Al-Mashaqbah and 10 more

Abstract read
In one paragraph

Article in BMC psychology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Hamdah HanifaFaculty of Medicine, University of Kalamoon, Al-Nabk, Syria. hamdahhanifa@gmail.com.ORCID http://orcid.org/0000-0003-2970-7379
Maya AlzoubiFaculty of Medicine, University of Kalamoon, Al-Nabk, Syria.ORCID http://orcid.org/0009-0001-7500-8774
Enas Saleem KhalloufFaculty of Pharmacy, Al-Wataniya Private University, Hama, Syria.ORCID http://orcid.org/0009-0000-1933-800X
Lujain AlzoubiFaculty of Medicine, University of Kalamoon, Al-Nabk, Syria.ORCID http://orcid.org/0009-0002-3532-7209
Feras HameshFaculty of Medicine, University of Kalamoon, Al-Nabk, Syria.ORCID http://orcid.org/0009-0001-9995-8862
Mohamad Esmail QashqashFaculty of Medicine, University of Kalamoon, Al-Nabk, Syria.ORCID http://orcid.org/0009-0002-5504-8629
Fadiah Hazem AlbaroudiFaculty of Pharmacy, University of Kalamoon, Al-Nabk, Syria.ORCID http://orcid.org/0009-0008-0164-6790
Maya Al-BaroudyFaculty of Pharmacy, Wadi International University, Homs, Syria.ORCID http://orcid.org/0009-0007-0714-3660
Mohi Alddin Moustafa MahoukFaculty of Medicine, University of Kalamoon, Al-Nabk, Syria.ORCID http://orcid.org/0009-0002-7451-981X
Yihea Mohammad Al-MashaqbahFaculty of Medicine, Hashemite University, Zarqa, Jordan.ORCID http://orcid.org/0009-0009-6287-4911
Anwar Hazem TibiFaculty of Medicine, University of Kalamoon, Al-Nabk, Syria.ORCID http://orcid.org/0009-0004-8565-4317
Abdul Rahim HamoudaFaculty of Medicine, University of Kalamoon, Al-Nabk, Syria.ORCID http://orcid.org/0009-0002-7704-9737
Amal AlmohammadFaculty of Medicine, University of Kalamoon, Al-Nabk, Syria.ORCID http://orcid.org/0009-0004-9668-2567
Deemah DanawerFaculty of Medicine, University of Kalamoon, Al-Nabk, Syria.ORCID http://orcid.org/0009-0004-0945-492X
Amneh Mahmoud ZaidanFaculty of Medicine, University of Kalamoon, Al-Nabk, Syria.ORCID http://orcid.org/0009-0001-7727-913X
Mariam AlhumsiFaculty of Medicine, University of Kalamoon, Al-Nabk, Syria.ORCID http://orcid.org/0009-0006-0814-6014
Zahra HouijehFaculty of Medicine, University of Kalamoon, Al-Nabk, Syria.ORCID http://orcid.org/0009-0005-3388-8047
Alaa HouriehFaculty of Medicine, University of Kalamoon, Al-Nabk, Syria.ORCID http://orcid.org/0009-0003-4772-724X
Leen AlfrraFaculty of Medicine, University of Kalamoon, Al-Nabk, Syria.ORCID http://orcid.org/0009-0006-2226-8659
Nihad AssafCES De Nephrologie, Associate Professor at the University of Kalamoon, Damascus, Syria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMedical students globally face high rates of depression, anxiety, and burnout, exacerbated by stressful academic environments and recent crises like the COVID-19 pandemic. This is particularly critical in conflict-affected regions like Syria, where psychological support is limited. This study aims to investigate the prevalence and impact of these mental health issues among healthcare students in such challenging contexts.

methodsThis cross-sectional study surveyed 507 healthcare students (medicine, dentistry, pharmacy) at the University of Kalamoon between June 26 and July 24, 2025. Data were collected using the Insomnia Severity Index (ISI) and the Depression, Anxiety, and Stress Scale (DASS‑21). Statistical analysis was performed using SPSS with Mann‑Whitney U and Kruskal‑Wallis H tests.

resultsSubthreshold insomnia (44.8%), moderate depression (26.2%), and extremely severe anxiety (24.9%) were common in the sample. Female students reported significantly higher anxiety (p = 0.033). Pharmacy students demonstrated the highest levels of depression, anxiety, stress, and insomnia (p-values = 0.001 to 0.042). Low income was significantly associated with elevated depression and insomnia (p = 0.026, p = 0.022). Overall, the direction of associations showed that female gender, pharmacy faculty, low income, and prior psychiatric history were linked to worse psychological outcomes.

conclusionOur findings underscore the urgent need for more comprehensive, broader, and multicenter studies, both at the level of Syrian universities and the Middle East as a whole, to gain a deeper understanding of students’ mental health and the factors influencing it. In addition, there is an urgent need for preventive and therapeutic psychological interventions, including counseling, psychological support, and health education.

Indexed as

AnxietyDepressionPsychological DistressSleep Initiation and Maintenance DisordersStress, PsychologicalStudents, MedicalAdultCross-Sectional StudiesFemaleHumansMalePrevalenceSyriaYoung AdultAnxietyDASS-21DepressionInsomniaMedical studentsStressWar

Identifiers

PMID41408662
PMCPMC12829234

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.