Background Syria has experienced war since 2011, leaving over 80% under the poverty line and millions displaced. War and its retaliations have significantly impacted the mental health of Syrians. This study evaluates the post-traumatic stress disorder (PTSD), and the severity of the mental distress caused by war and other factors such as low social support. This study also evaluates other variables and compares the findings with those of multiple studies on Syria and refugees. Methods This is a cross-sectional study that included people who lived in Syria in different governorates. Online surveys were distributed into multiple online groups and included the Kessler 10 (K10) scale which screens for anxiety and depression, the Screen for Posttraumatic Stress Symptoms (SPTSS) tool, the Multidimensional Scale of Perceived Social Support, and questionnaires on demographic and war-related factors. Results Our study included 1951 participants, of which, 527 (27.0%) were males and 1538 (78.8%) between the age of 19 and 25. Among participants, 44% had likely severe mental disorder, 27% had both likely severe mental disorder and full PTSD symptoms, 36.9% had full PTSD symptoms, and only 10.8% had neither positive PTSD symptoms nor mental disorder on the K10 scale. Around 23% had low overall support. Half of the responders were internally displaced, and 27.6% were forced to change places of living three times or more due to war. Around 86.6% of the responders believed that the war was the main reason for their mental distress. Those with high SPTSS and K10 scores were found to take more days off from work or school due to negative feelings and having somatic symptoms. Moreover, the number of times changing places of living due to war, educational level, and being distressed by war noise were the most prominent factors for more severe PTSD and mental distress. No differences in PTSD and mental disorder prevalence were noted in participants living in different governorates or among different types of jobs. A strong significant correlation (r = 0.623) was found between SPTSS and K10 scores. Conclusion The conflict in Syria has left the population at great risk for mental distress which was higher compared to Syrian refugees elsewhere. Many measures with an emphasis on mental health are needed to help the people against a long-term avoidable suffering.

Background: Syria has experienced war over the past seven years, leaving a high percentage of the population below the poverty line. This has significantly impacted Syrians which is reflected in the psychiatric aspect. This study evaluates the severity of the mental disorder caused by war and other factors, and evaluates the post-traumatic stress disorder (PTSD) in addition to support provided to Syrians. Methods: Online surveys including the Kessler 10 (K10) survey, the Screen for Posttraumatic Stress Symptoms (SPTSS) tool, the Multidimensional Scale of Perceived Social Support (MSPSS) and demographic and war-related questions were used for this study. Results: Our study included 1951 participants, comprising 527 (27.0%) males and 1538 (78.8%) aged (19-25) years. Of all the participants in the study, 44% had severe mental disorder, 27% had severe mental disorder with full PTSD symptoms, 36.9% had full PTSD symptoms, 79% had at least one PTSD symptom, and 10.8% had neither PTSD symptoms nor mental disorder. Only 23.2% had low overall support. Half of the responders were internally displaced and 27.6% of these participants were forced to move three times or more due to war. Only 13.4% of the responders did not believe that the crisis was the reason for their distress. Those with high SPTSS and K10 scores were found to take more days off of work or school due to negative feelings and have somatic symptoms. Moreover, low levels of education, low socioeconomic status, chronic medical conditions, war variables for example distress caused by war noises, changing place of living due to war were all associated with high distress and the presence of PTSD symptoms in this study. Strong significant correlation (r=0.623) was found between SPTSS and k10 score. Conclusion: The conflict in Syria has left the country’s population at great risk of psychological and mental distress. Drastic measures are required to save an entire population from permanent psychological suffering.

Background: Lockdown restrictions due to COVID-19 have affected many people's lifestyles and ability to earn a living. They add further distress to the lives of people in Syria, who have already endured 9 years of war. This study evaluates distress and the major causes of concerns related to COVID-19 during the full lockdown.Methods: Online questionnaires were distributed using SPTSS, K10, and MSPSS which were used with other demographic, war- and COVID-19-related questions that were taken from The (CRISIS) V0.1 Adult Self-Report Baseline Form.Results: Our sample included 5,588 with the mean age of 26.84 ± 7.815 years. Of those, only one case of COVID-19 was confirmed. Over 42.7% had two or more positive PTSD symptoms, 42.6% had moderate or severe mental disorder, but only 14.9% had low social support. Higher PTSD and K10 scores overall were seen in female participants and with most of war variables (P < 0.05). Relationships with the partner being negatively affected and distress from a decline in ability to work and provide food were the most prominent.Conclusions: The indirect effects of COVID-19 are far more than that of the pathogen itself. A reduced ability to earn and to provide food were the main concerns indicated in this study. Relationships deteriorated in participants with high K10 and PTSD scores who also had more symptoms and used more hypnotics in the last four weeks. Smoking patterns were not related to K10 and PTSD. Social support played a role in reducing stress, but when relationships were affected, lower support was observed.