Depression, anxiety, and PTSD among Palestinian detention survivors assessed during the ongoing October 2023 war: Prevalence, comorbidity, and the limits of individual risk factors

Introduction: Palestinian detainees held during the October 2023 war have widely reported torture, but quantitative studies jointly assessing depression, anxiety, and post-traumatic stress disorder (PTSD) remain rare. We aimed to characterise the prevalence, severity, and comorbidity of these conditions and to examine demographic and detention-related predictors. Methods: In this cross-sectional study, we recruited 383 Palestinian adults detained by Israeli authorities during the October 2023 war, subsequently released, and reporting torture. Participants were recruited through rehabilitation centres, human rights organisations, and community networks in Gaza, and completed Arabic-language PHQ-9, GAD-7, and PCL-5 measures in structured, trauma-informed interviews between late 2025 and early 2026. Multiple linear regression assessed predictors of symptom severity, and regression-based path analysis examined the pathway from cumulative torture exposure to depression through PTSD. Results: 76.75% scored in the moderate-to-severe range on the PHQ-9, 65.50% on the GAD-7, and 68.50% met the PCL-5 threshold for probable PTSD. The three conditions were strongly intercorrelated (r = 0.59–0.66, p < .0001), with 49.35% meeting thresholds for all three. Education was the only demographic variable significantly associated with depression, anxiety, and PTSD severity, though models explained under 3% of variance; age, gender, detention duration, and cumulative torture exposure were not significant predictors. PTSD severity was strongly associated with depression, whereas cumulative torture exposure was not significantly associated with either outcome. Internal consistency was good (Cronbach's α = 0.80–0.91). Discussion: Palestinian detention survivors showed an extremely high and highly comorbid burden of depression, anxiety, and PTSD. The near-ceiling torture exposure in this sample may help explain the limited predictive power of individual demographic and exposure variables. These findings support integrated, trauma-informed mental health care and continued human rights documentation for this population.