The longitudinal toll of loss: The impact of bereavement on PTSD, depression and anxiety following the October 7th attack and the war

Introduction: The magnitude of the October 7, 2023, terror attack and the subsequent war in Israel was unprecedented, with more than 1300 civilians murdered and more than 700 soldiers killed. Bereaved citizens, having experienced the loss of a loved one during the attack and the war, may be at heightened risk for psychopathology. In this national cohort study, we aimed to prospectively assess longitudinal changes in the progression of symptoms of posttraumatic stress disorder (PTSD), depression, and anxiety to ascertain the impact of bereavement on PTSD, depression, and anxiety symptoms following the October 7, 2023, terrorist attack and the subsequent war in Israel. Method: A representative sample of 614 Israeli adults (310 women, 50.4 %) aged 18–85 (M_age = 41.02, SD = 13.79) completed the study at four time points: T1, 6–7 weeks before the attack; T2, 5–6 weeks after the attack; T3, 18–19 weeks after the attack; and T4, 37–38 weeks after the attack. Of the sample, 146 citizens (23.7 %) experienced bereavement following the events. Results: At T4, nine months after the attack, participants who experienced bereavement presented significantly higher rates of probable diagnoses of PTSD (29.5 %), depression (37.3 %), and anxiety (37.3 %) than non-bereaved participants (PTSD: 19.2 %, depression: 22.4 %, anxiety: 21.5 %). Notably, whereas PTSD, depressive, and anxiety symptoms declined significantly from T2 to T4 among non-bereaved participants, no such declines were observed among bereaved participants. Discussion: The findings highlight the evolving gap in mental health needs between bereaved and non-bereaved citizens. Moreover, they stress the acute need to provide timely assessments and triage for interventions to address the mental health needs of bereaved citizens, across a variety of psychiatric diagnoses.