Background: War-related media exposure may adversely affect mental health, including PTSD, anxiety, depression, and stress; however, evidence among Iranian civilians remains limited. This study assessed these outcomes among Kashan residents following the Iran–Israel war, in a city near the Natanz nuclear facility.
Methods: This cross-sectional study included 500 Kashan residents selected through multistage cluster sampling in July–August 2025, following the Iran–Israel war (June 13–24, 2025). Participants aged ≥15 years were proportionally recruited from five geographic clusters. Data were collected using validated instruments (PCL-5, DASS-21, and RS-14) and analyzed using SPSS version 26 (p < 0.05).
Results: Among 500 participants (mean age 40.65 years; 50.6% female), PTSD prevalence was 39.4%, followed by anxiety (36%), depression (31.4%), and stress (21%) .More than 10 news exposures increased PTSD odds (OR = 4.97; 95% CI: 2.32–10.64), as did university education (OR = 4.29; 95% CI: 1.49–12.36). No prior war exposure reduced PTSD odds by 64% (OR = 0.36; 95% CI: 0.21–0.61). Furthermore, Higher resilience was associated with 3% lower odds of anxiety and depression per one-point increase (OR = 0.97; 95% CI: 0.95–0.98). Family support was associated with higher odds of PTSD (OR = 1.83; 95% CI: 1.17–2.87), depression (OR = 2.00; 95% CI: 1.26–3.20), and stress (OR = 2.37; 95% CI: 1.41–3.98). Friend support was associated with higher odds of PTSD (OR = 1.98; 95% CI: 0.81–4.82), depression (OR = 1.54; 95% CI: 0.62–3.82), and stress (OR = 1.75; 95% CI: 0.65–4.73).
Conclusions: War-related media exposure was associated with stress, anxiety, depression, and PTSD, particularly among women and educated individuals, while resilience was protective. These findings underscore the need for media literacy, stress management, and targeted psychological support, integrated into mental health and emergency response policies in conflict settings.