Integrated care programmes for severe mental illnesses and comorbid physical health disorders: the EU-MIND umbrella review to inform future actions in Europe.

In this study, we aim to evaluate whether patients perceived more stress than healthy controls after the conflict between Iran and Israel and what symptoms were correlated with this stress, measured by the Impact of Event Scale-Revised (IES-R). However, PD patients exhibited significantly lower stress levels than healthy controls. Parkinson's Disease (PD) is the second most common neurodegenerative movement disorder. It is stated that chronic stress can be a potential trigger factor for PD occurrence . Moreover, people with PD (PwPD) are very vulnerable to the negative effects of psychological distress . One of these stressful phenomena that can cause excessive challenges for patients is war. In this observational cross-sectional study, an online survey was conducted to assess post-traumatic stress disorder using the Persian-language version of the IES-R, which has been validated in Iran with good psychometric properties in PD patients. This study was done in the context of a recent armed conflict in Iran that occurred from June 2025 13th to 25th. Data were collected from a week after the war and continued for more than two months. The population of the study was adults (age ≥ 18 years) with a confirmed diagnosis of PD by the Movement Disorder Society Criteria by a movement disorder specialist. They should also have been in Iran during the time of the conflict. Written informed consent was obtained. We removed any PD patients who had been diagnosed with significant mental or stress-related disorders before the war. A comparison group of healthy controls (HC) who lived in Iran during the conflict was chosen from volunteers or hospital staff and was age- and sex-matched to the patients. The questions were based on the feelings of subjects during and after the war for about a week.