The impact of armed conflict on mental health in forcibly displaced populations from the Eastern Mediterranean Region: A rapid systematic review and meta-analysis

Forcibly displaced people (FDPs) from the World Health Organization’s classification of the Eastern Mediterranean Region (EMR) experience substantial exposure to conflict-related trauma and subsequent mental health and substance use disorders. We conducted a rapid systematic review and random-effects meta-analysis of observational studies (1990–2024) reporting the prevalence of mental disorders (post-traumatic stress disorder, major depressive disorder, anxiety) and substance use disorders among EMR-origin FDPs. Studies were identified via PubMed using a prespecified strategy; risk of bias was assessed with a prevalence-appropriate checklist. Proportions were pooled using variance-stabilizing transformations with 95% CIs; heterogeneity (I 2 , τ 2 ) and subgroup analyses by Conflict Death Index (CDI) and age were performed. Nine studies (n=2,465) met criteria. The pooled prevalence of any mental health disorders was 28% (95% CI 18–46%; I 2 ≈97%). Post-traumatic stress disorder and major depressive disorder were most frequently measured. Subgroup estimates were 22% (95% CI 0–48%) in high-CDI settings and ≈30% in medium/low-CDI settings, with substantial heterogeneity. EMR-origin FDPs bear a high burden of mental health disorders and substance use. Apparent lower prevalence in high-intensity settings likely reflects the phenomenology of social cohesion and mutual self-help, and selection, measurement, and access biases rather than true differences. Programs should prioritize scalable, culturally adaptable interventions and robust surveillance; future studies should standardize instruments and reporting, and leverage meta-regression to explain heterogeneity.