The Long-Term Psychosocial Impact of a Surprise Chemical Weapons Attack on Civilians in Halabja, Iraqi Kurdistan

War and human rights abuses contribute to increased prevalence of posttraumatic stress (PTS) disorder and low social functioning among populations affected. There is relatively little evidence, however about the long-term mental health impact of war on general populations. We examined the prevalence of PTS symptoms and poor social functioning in Halabja, Iraqi Kurdistan, 18 years after a chemical attack on civilians in that town. We systematically sampled 291 persons representative of the population of Halabja from the city emergency department and 4 outpatient clinical sites. PTS symptoms and poor social functioning were common. After adjustment for covariates, female gender, older age, and cumulative exposure to multiple traumas, all were associated with higher PTS scores and worse social functioning. Exposure to human rights abuses and warlike conditions seem to continue to be risks for psychiatric and social dysfunction even decades after the initial incident.