Srinagar, Oct 28: For many people in Kashmir, the trauma they experienced years ago is re-lived every day, unknowingly, unpleasantly, uncannily. A review of 16 studies on post-traumatic stress disorder (PTSD) among civilians in Kashmir has found that trauma-related mental health difficulties remain a significant concern. The review calls for better mental health support networks.
The review was published in the journal Frontiers in Psychiatry on September 15, 2026. It is based on quantitative research published between 2006 and 2025 to examine PTSD prevalence and associated risk factors. It explores the relationship between trauma exposure and mental health outcomes.
Authored by Tamkeen Sakeena, Aneeza Pervez and Cecilie Lolansen. It found that reported PTSD prevalence varied considerably depending on the population studied and the assessment methods used. It also leaned heavily on the extent of exposure to conflict-related trauma.
The reported prevalence ranged from 15.9% to 24.5% in studies in adults. Higher screening-based estimates were reported in selected groups, including college students. Among these, up to 49.8 % met a screening threshold for probable PTSD. Children in certain samples had a prevalence of 40%.
These figures are not directly comparable, the authors cautioned. That is because the studies differed in sampling, study design and methods of assessing PTSD. The higher estimates among students and children do not represent prevalence across the general population.
Greater exposure to traumatic events was associated with higher levels of PTSD, the review found. Many studies reported a relationship between cumulative trauma exposure and PTSD symptoms. Symptoms persisted years after exposure.
Women, socioeconomically disadvantaged groups, orphans and individuals who had sustained conflict-related injuries had higher prevalence. However, the strength of evidence varied across studies.
PTSD was also frequently associated with depression, anxiety and substance misuse. The review found that substance use was reported among some individuals experiencing PTSD symptoms. It suggested that trauma-related distress may be accompanied by difficulties in coping. One community-based study included in the review reported maladaptive coping behaviours, including substance use. This was more frequent among people with PTSD symptoms. The authors also found that PTSD was often present in individuals with depression and anxiety.
However, the review does not establish that trauma directly causes substance use. The association does not confirm a cause-and-effect relationship.
The authors have said the available evidence indicated a substantial mental health burden among the general population in Kashmir. However, they identified limitations in the research – considerable variation in study quality and the predominance of cross-sectional studies. This restricts the ability to establish how symptoms develop or change over time.
The researchers did not combine the findings into a single pooled prevalence estimate because the studies used different populations and assessment methods. They called for more consistent assessment methods and longitudinal research to improve PTSD understanding in Kashmir.
There is a need to explore community-based and task-shared approaches to mental health care, the review advocates. It has elaborated on the limitations of relying solely on specialist-led services in a scenario where mental health resources are limited.
