Srinagar, Oct 09: A systematic review of research on civilians in Kashmir has found that between 15.9 and 24.5 per cent of adults in community-based studies experienced post-traumatic stress disorder (PTSD) or probable PTSD.
As October 10 is observed as World Mental Health Day, the figures paint grim picture of Kashmir’s mental health graph. Published in Frontiers in Psychiatry on September 15, 2026, the review examined 16 quantitative studies published between 2006 and 2025, bringing together evidence on the prevalence of PTSD, associated risk factors and the relationship between traumatic experiences and lasting psychological distress.
The review, authored by Tamkeen Sakeena of the University of Nottingham, Aneeza Pervez of the University of Cambridge and Cecilie Lolansen of the University of Nottingham, highlights a substantial mental health burden among civilians.
The researchers did not calculate a single prevalence rate for Kashmir because the studies differed considerably in their populations, sampling methods, study quality and tools used to assess PTSD. Their findings were synthesised narratively rather than combined into one overall estimate.
The results nevertheless point to recurring patterns of trauma-related distress across community surveys, clinical populations and groups exposed to particularly severe experiences.
“Up to 49.8% of college students meet the screening threshold,” the research notes. “Among selected populations, the review found higher screening-based estimates of probable PTSD. These included up to 49.8 per cent among college students and up to 40 per cent among children in individual studies.”
The figures require careful interpretation. “They represent the proportions meeting specified screening thresholds for probable PTSD, not necessarily people whose condition was confirmed through a clinical diagnosis. Nor can these estimates be applied to all college students or children in Kashmir,” according to the study. “The review found that PTSD prevalence and symptom severity varied according to exposure, population characteristics and assessment methods. In one study involving conflict-related amputees, 66 per cent met criteria for PTSD following structured clinical assessment, illustrating the substantial psychological burden reported in a particularly vulnerable group.”
The authors noted that the evidence base included community surveys as well as studies involving children, orphans, healthcare professionals and people seeking clinical treatment. “These populations are not directly comparable, making distinctions between screening results and confirmed diagnoses essential,” they stressed.
The research states that one of the review’s key findings was a pattern linking greater exposure to traumatic events with higher PTSD prevalence or more severe symptoms. “Studies included in the review associated repeated or cumulative exposure to conflict-related experiences with elevated trauma-related distress. A large population-based survey using the Harvard Trauma Questionnaire reported an increase in probable PTSD as the number of traumatic events increased,” the study notes. “A similar pattern was reported among college students, where greater cumulative exposure was associated with a higher likelihood of meeting the screening threshold.”
The review also found that symptoms could persist years after exposure. The authors discussed prolonged insecurity, repeated disruption and everyday social and economic stressors as relevant factors when interpreting the persistence of psychological distress.
“However, the predominantly cross-sectional nature of the evidence limits the extent to which researchers can establish how symptoms change over time or determine the precise contribution of individual factors,’ the research states. “Women, children and poorer groups face greater vulnerability.”
The review identified higher PTSD prevalence or symptom severity among women and people experiencing socioeconomic disadvantage, including unemployment and lower socioeconomic status, the research reads further.
“Children affected by family loss or violence were another vulnerable group. Studies involving orphaned children reported substantial psychiatric morbidity, including PTSD, while research on children exposed to terrorist violence found elevated trauma-related behavioural symptoms compared with non-exposed controls,” the study states. “Healthcare professionals reported secondary traumatic stress linked to occupational exposure, suggesting that the psychological effects of traumatic events may extend beyond people directly affected.”
The researchers also found that PTSD frequently occurred alongside depression, anxiety and substance misuse, highlighting the overlapping nature of mental health difficulties among affected populations. Despite identifying recurring patterns, the authors highlighted important limitations in the available evidence. Study quality varied, assessment instruments differed, and most research used cross-sectional designs that could not adequately track symptoms over time.
The review calls for more consistent assessment methods, longitudinal research and studies combining quantitative evidence with detailed accounts of people’s experiences.
It also points to the need to explore community-based mental healthcare and task-sharing approaches, in which trained non-specialist workers help deliver support under appropriate professional supervision. The authors argue that the scale of need exceeds the capacity of conventional specialist-led care alone. The findings underline the importance of treating mental health as a sustained public health concern rather than viewing psychological distress only as an immediate response to a traumatic event.
