The 7 October terrorist attack in southern Israel and the increase in anti-Semitic acts have had a significant impact on the mental health of Holocaust survivors (HS), with some experiencing feelings of isolation and loneliness associated with an increased risk of mortality. The main objective of our work was to assess the incidence and intensity of perceived stress among French HS suffering from feelings of isolation and loneliness following the 7 October attack. The secondary objective was to determine the impact on health and to establish a link with the Holocaust period.

The study was conducted between 30 October and 15 December 2023 among HS living in France who were contacted by mail through HS support organisations. They completed a questionnaire that included sociodemographic data and experiences during the Holocaust, an assessment of perceived stress using the PSS-10 scale, the presence or absence of feelings of isolation and loneliness, and health consequences and reactions to the 7 October attacks. Statistical analyses were performed using SPSS 21.0, with Mann-Whitney tests, chi-squared and Student's t-tests used to compare HS experiencing loneliness and isolation with those not experiencing loneliness and isolation, with a p-value of < 0.05 considered statistically significant.

94 respondents completed the questionnaire, of whom 29 (30.5%) were men. The HS had a mean PSS-10 score of 17.7 ± 6.0 (min 5 - max 35). Thirty (31.6%) reported feeling isolated or alone after the 7 October massacre. Those who felt isolated or alone were more likely to feel that they had no support from those around them (73.3% vs. 19.7% p<0.05). The PSS10 scores of HS suffering from isolation and loneliness were significantly higher than those of other HS (21.2 ± 5.2 vs. 16.0 ± 6.2, p ≤0.05). After the 7 October massacre, 93.3% of HS suffering from loneliness and isolation felt that their Holocaust experience had reawakened their vulnerability, especially aggravated health problems (34%). They tend to think about the Holocaust period more often (96.7% vs. 80.3%, p ≤0.05) and are significantly more worried about the future of their children and grandchildren as Jews (93.3% vs. 77.0%, p ≤0.05).

This is the first study to assess the importance of stress among HS, particularly those suffering from loneliness and isolation, following the 7 October terrorist attack. It highlights the importance of implementing intervention programmes to support the last eyewitnesses of the Holocaust period.