Children in Syria are suffering from “toxic stress,” a severe form of psychological trauma that can cause life-long damage, according to a report released Thursday.

The report by the nonprofit Save the Children paints a horrifying picture of terrified children developing speech disorders and incontinence, and some even losing the capacity to speak. Others attempt self-harm and suicide.

Authors of the study, the largest of its kind to be undertaken during the conflict, warned that the nation’s mental health crisis had reached a tipping point, where “staggering levels” of trauma and distress among children could cause permanent and irreversible damage.

“We are failing children inside Syria, some of whom are being left to cope with harrowing experiences, from witnessing their parents killed in front of them to the horrors of life under siege, without proper support,” said Marcia Brophy, a mental health adviser for Save the Children in the Middle East.

 

Researchers spoke with 450 children, adolescents and adults in seven of Syria’s 14 governorates.

Adults said the main cause of psychological stress is the constant shelling and bombardment that characterize the war that is nearing its sixth anniversary.

Half the children the researchers talked to said they never or rarely feel safe at school and 40 percent said they don’t feel safe to play outside, even right outside their own home.

More than 70 percent of children interviewed experienced common symptoms of “toxic stress” or post-traumatic stress disorder, such as bedwetting, the study found. Loss of speech, aggression and substance abuse are also commonplace. About 48 percent of adults reported seeing children who have lost the ability to speak or who have developed speech impediments since the war began, according to the report.

More than half of the adults interviewed by Save the Children said they knew of children or adolescents who were recruited into armed groups.

The report called on the combatants to stop using explosives in populated areas, halt attacks on schools and hospitals, and stop recruiting children to fight.

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