Sudan’s war: psychological impact on medical students, University of Khartoum, Sudan, 2024

Abstract Background The ongoing conflict in Sudan has disrupted many aspects of life, and university students are among those most affected. Medical students at the University of Khartoum, in particular, are under intense pressure, completing their studies while facing displacement, uncertainty, and emotional stress. Objective To assess the prevalence of war exposure, war-related nightmares, insomnia, and probable Post Traumatic Stress Disorder (PTSD), as well as gender differences, among medical students at the University of Khartoum during the active conflict in Sudan. Methods A cross-sectional study was conducted between July and September 2024 using an online survey distributed to 320 medical students. The survey included validated instruments: the Athens Insomnia Scale (AIS), a 6-item Post-Traumatic Stress Checklist (PCL-6), and scales measuring war exposure and nightmare frequency.Statistical analyses involved non-parametric tests for group comparisons, Spearman’s correlations, and multiple linear regression models to identify independent predictors of PTSD severity. Results High prevalence rates were observed: 98.1% for war exposure symptoms, 88.8% for war-related nightmares symptoms, 64.1% for clinically significant insomnia (the Athens Insomnia Scale (AIS) ≥ 6), and 48.1% for probable PTSD (6-item PTSD Checklist [PCL-6] ≥ 14). The most common stressors were economic deterioration (63.7%) and the emigration of family or friends (66.9%), rather than direct exposure to bomb explosions. Female and displaced students demonstrated significantly higher PTSD symptom severity compared to their counterparts (P < 0.001). Insomnia severity and nightmare frequency were independently associated with increased PTSD severity in regression models. Conclusion This study revealed the impact of the ongoing conflict on medical students, it also highlights the need for gender-sensitive mental health interventions and the need to safeguard the psychological well-being of future healthcare providers during and after conflict.