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Najem C, Wijma AJ, Meeus M, Cagnie B, Ayoubi F, Van Oosterwijck J, De Meulemeester K, Van Wilgen CP. "It is something you live with, like an organ in your body" a qualitative study on the lived experiences of people suffering from chronic low back pain in Lebanon. Disabil Rehabil 2024:1-12. [PMID: 39087694 DOI: 10.1080/09638288.2024.2384620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 07/18/2024] [Accepted: 07/22/2024] [Indexed: 08/02/2024]
Abstract
PURPOSE This paper aims to understand the distinctive biopsychosocial aspects and patient perspectives on chronic low back pain in Lebanon, an Arab country with a unique and rich cultural heritage. METHOD Qualitative, semi-structured interviews with 12 Lebanese patients purposefully sampled from various governorates. The interviews included participants from different geographic areas and religions. The data underwent analysis through an inductive thematic approach guided by a bounded relativist ontology, a subjectivist epistemology, and a descriptive phenomenological framework. The coding process was managed by computer-assisted qualitative data analysis software (QSR NVivo version 12.0). RESULTS The researchers identified and constructed two themes: (1) Chronic low back pain: understanding the impact, coping strategies, and communication patterns in lived experiences within the Lebanese context. This theme sheds light on the complexities of pain management and societal influences in Lebanon. (2) Explanatory model of patients living with chronic low back pain in Lebanon. This theme allowed an exploration of the multifaceted narratives of chronic low back pain. CONCLUSION This study found that Lebanese individuals attribute chronic low back pain to biomedical factors despite some recognizing psychosocial elements. It emphasizes the need to educate patients on the biopsychosocial model, facilitate better care, and dispel misconceptions.
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Affiliation(s)
- Charbel Najem
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- L3S, Faculty of Public Health, Antonine University, Baabda, Lebanon
- Pain in Motion International Research Group, www.paininmotion.be, Brussels, Belgium
| | - A J Wijma
- Pain in Motion International Research Group, www.paininmotion.be, Brussels, Belgium
- Transcare Transdisciplinary Pain Management Center, Groningen, The Netherlands
- PAIN - VUB Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - M Meeus
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Pain in Motion International Research Group, www.paininmotion.be, Brussels, Belgium
- MOVANT Research Group, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - B Cagnie
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - F Ayoubi
- L3S, Faculty of Public Health, Antonine University, Baabda, Lebanon
- Department of Physiotherapy, Faculty of Public Health, Lebanese University, Beirut, Lebanon
| | - J Van Oosterwijck
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Pain in Motion International Research Group, www.paininmotion.be, Brussels, Belgium
- MOVANT Research Group, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Research Foundation - Flanders (FWO), Brussels, Belgium
| | - K De Meulemeester
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Pain in Motion International Research Group, www.paininmotion.be, Brussels, Belgium
| | - C P Van Wilgen
- Pain in Motion International Research Group, www.paininmotion.be, Brussels, Belgium
- Transcare Transdisciplinary Pain Management Center, Groningen, The Netherlands
- PAIN - VUB Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
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Obeid S, Hemade A, Malaeb D, Sakr F, Dabbous M, Xu J, Ying Y, Jiang C, Meng R, Fekih-Romdhane F, Hallit S. Psychometric properties of the ultra-brief self-report Patient Health Questionnaire-4 (PHQ-4) to assess anxiety and depression in Arabic-speaking adults. BMC Psychiatry 2024; 24:537. [PMID: 39080577 PMCID: PMC11290276 DOI: 10.1186/s12888-024-05978-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 07/22/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Anxiety and depression are psychiatric disorders that often coexist and share some features. Developing a simple and cost-effective tool to assess anxiety and depression in the Arabic-speaking population, predominantly residing in low- and middle-income nations where research can be arduous, would be immensely beneficial. The study aimed to translate the four-item composite Patient Health Questionnaire - 4 (PHQ-4) into Arabic and evaluate its psychometric properties, including internal reliability, sex invariance, composite reliability, and correlation with measures of psychological distress. METHODS 587 Arabic-speaking adults were recruited between February and March 2023. An anonymous self-administered Google Forms link was distributed via social media networks. We utilized the FACTOR software to explore the factor structure of the Arabic PHQ-4. RESULTS Confirmatory factor analysis (CFA) indicated that fit of the two-factor model of the PHQ-4 scores was modest (χ2/df = .13/1 = .13, RMSEA = .001, SRMR = .002, CFI = 1.005, TLI = 1.000). Internal reliability was excellent (McDonald's omega = .86; Cronbach's alpha = .86). Indices suggested that configural, metric, and scalar invariance were supported across sex. No significant difference was found between males and females in terms of the PHQ-4 total scores, PHQ-4 anxiety scores, and PHQ-4 depression scores. The total score of the PHQ-4 and its depression and anxiety scores were significantly and moderately-to-strongly associated with lower wellbeing and higher Depression Anxiety and Stress Scale (DASS) total and subscales scores. CONCLUSION The PHQ-4 proves to be a reliable, valid, and cost-effective tool for assessing symptoms related to depression and anxiety. To evaluate the practical effectiveness of the Arabic PHQ-4 and to further enhance the data on its construct validity, future studies should assess the measure in diverse contexts and among specific populations.
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Affiliation(s)
- Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon.
| | - Ali Hemade
- Faculty of Medicine, Lebanese University, Hadat, Lebanon
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Fouad Sakr
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Mariam Dabbous
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Jiale Xu
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, 311121, China
| | - Yiwei Ying
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, 311121, China
| | - Chen Jiang
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, 311121, China
| | - Runtang Meng
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, 311121, China
- Engineering Research Center of Mobile Health Management System, Ministry of Education, Hangzhou, Zhejiang, 311121, China
| | - Feten Fekih-Romdhane
- Department of Psychiatry "Ibn Omrane", The Tunisian Center of Early Intervention in Psychosis, Razi Hospital, Manouba, 2010, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Psychology Department, College of Humanities, Effat University, Jeddah, 21478, Saudi Arabia.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
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Farhood LF, Doumit MAA, Chamseddine ZM, Farhoud JA. A Framework for School-Based Mental Health Programs in Conflict Zones. Community Ment Health J 2024:10.1007/s10597-024-01322-2. [PMID: 39060697 DOI: 10.1007/s10597-024-01322-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 07/09/2024] [Indexed: 07/28/2024]
Abstract
The significant rise in the prevalence of mental health disorders among school children and adolescents in Lebanon and conflict zones necessitate immediate interventions. Despite this elevated prevalence, such communities currently lack effective programs which clearly identify the concepts of mental health promotion and prevention among school children. Addressing this gap, our paper aims to propose a contextual model and framework for educators, researchers and policy-makers. The proposed model includes 3-levels comprising set of actions and interventions. Interventions adopted at each level should be fine-tuned to produce a caring and supportive learning environment that effectively incorporates the three essential domains of student's mental health: promoting mental health protective factors, notably social and emotional learning (SEL) and resilience, as well as preventing mental health disorders (MHD). Interventions set at each level are elaborated in the framework and linked to the corresponding segments present in the school environment to include teachers, family, community, media, and policymakers. The framework also extends these interventions to encompass the core competencies of SEL, resilience, as well as the prevention of the most prevalent mental health disorders in conflict zones.
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Affiliation(s)
- Laila F Farhood
- Hariri School of Nursing, HSON, American University of Beirut, Riad El Solh, PO Box: 11 0236, Beirut, 1107 2020, Lebanon.
- Psychiatry Department, Faculty of Medicine, American University of Beirut, Riad El Solh, Beirut, 1107-2020, Lebanon.
| | - Myrna A A Doumit
- Hariri School of Nursing, HSON, American University of Beirut, Riad El Solh, PO Box: 11 0236, Beirut, 1107 2020, Lebanon
| | - Zahraa M Chamseddine
- Hariri School of Nursing, HSON, American University of Beirut, Riad El Solh, PO Box: 11 0236, Beirut, 1107 2020, Lebanon
| | - Jad A Farhoud
- American University of Beirut, Riad El Solh, Beirut, 1107-2020, Lebanon
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Khaled SM, Al‐Thani SM, Sampson NA, Kessler RC, Woodruff PW, Alabdulla M. Twelve-month prevalence, persistence, severity, and treatment of mood and anxiety disorders in Qatar's national mental health study. Int J Methods Psychiatr Res 2024; 33:e2012. [PMID: 38726880 PMCID: PMC11323767 DOI: 10.1002/mpr.2012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 12/17/2023] [Accepted: 01/29/2024] [Indexed: 08/16/2024] Open
Abstract
OBJECTIVES To estimate 12-month prevalence, persistence, severity, and treatment of mental disorders and socio-demographic correlates in Qatar. METHODS We conducted the first national population-based telephone survey of Arab adults between 2019 and 2022 using the Composite International Diagnostic Interview and estimated 12-month DSM-5 mood and anxiety disorders and their persistence (the proportion of lifetime cases who continue to meet 12-month criteria). RESULTS The 12-month prevalence of any disorder was 21.1% (10.4% mild, 38.7% moderate, and 50.9% severe) and was associated with: younger age, female, previously married, and with persistence of any disorder. Persistence was 74.7% (64.0% mood and 75.6% anxiety) and was significantly associated with secondary education or lower. Minimally adequate treatment received among those with any 12-month mental disorder was 10.6% (74.6% in healthcare and 64.6% non-healthcare sectors). Severity and the number of disorders significantly associated with each other and with treatment received (χ2 = 7.24, p = 0.027) including adequate treatment within the mental health specialty sector (χ2 = 21.42, p < 0.001). CONCLUSIONS Multimorbidity and sociodemographics were associated with 12-month mental disorder. Treatment adequacy in Qatar are comparable to high-income countries. Low treatment contact indicate need for population-wide mental health literacy programes in addition to more accessible and effective mental health services.
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Affiliation(s)
- Salma M. Khaled
- Department of Population MedicineCollege of MedicineQatar UniversityDohaQatar
| | | | - Nancy A. Sampson
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
| | - Ronald C. Kessler
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
| | - Peter W. Woodruff
- School of Medicine and Population HealthUniversity of SheffieldSheffieldUK
| | - Majid Alabdulla
- Hamad Medical CorporationQatar Hamad Medical CorporationDohaQatar
- College of MedicineQatar UniversityDohaQatar
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Abi Ramia J, Abi Hana R, Noun P, Cuijpers P, Carswell K, van't Hof E, Heim E, Zoghbi E, Sijbrandij M, El Chammay R. Feasibility and uptake of a digital mental health intervention for depression among Lebanese and Syrian displaced people in Lebanon: a qualitative study. Front Public Health 2024; 11:1293187. [PMID: 38317685 PMCID: PMC10840138 DOI: 10.3389/fpubh.2023.1293187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/22/2023] [Indexed: 02/07/2024] Open
Abstract
Introduction Digital interventions are increasingly regarded as a potential solution for the inaccessibility of mental health treatment across low-and-middle-income settings, especially for common mental disorders. Step-by-Step (SbS) is a digital, guided self-help intervention for depression found effective in two Randomized Controlled Trials (RCTs) in Lebanon. For research implementation and further scale-up, this paper reports the results of a qualitative evaluation of SbS among the Lebanese and others and displaced Syrians in Lebanon. Methods Thirty-four Key Informant Interviews (KIIs) were executed with participants of the RCTs, SbS staff members, and external stakeholders. Questions garnered feedback about the feasibility, acceptability, enabling factors, and barriers to adhering to the research, implementation, and the SbS intervention. A thematic analysis was conducted using NVivo, and key themes, topics, and recommendations, on research methods and the intervention itself, were generated and reported. Results Results showed a high level of acceptability of SbS among Lebanese and Syrians and identified sub-groups for whom acceptance or use might be lower, such as older adults and people with limited access to the internet or smartphones. Furthermore, interviews identified the main enabling factors and barriers to adherence related to the research design, content, and delivery approach. Barriers related to feasibility included lengthy assessments as part of the RCTs, and mistrust related to delays in study compensations. Other common challenges were forgetting login credentials, poor internet connection, being busy and competing needs. Enabling factors and best practices included motivating participants to use the intervention through the weekly support provided by helpers, setting an oral contract for commitment, and dividing the compensations into several installments as part of the RCTs. Recommendations regarding sustainability were given. Discussion The findings show that overall, SbS is feasible, acceptable, and much needed in Lebanon among the Lebanese and Syrians. This assessment identifies reasons for low adherence to the research and the intervention and presents improvement solutions. Recommendations generated in this paper inform the upscale of SbS and the planning, design, and implementation of future digital interventions in research and service provision settings in the mental health field.
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Affiliation(s)
- Jinane Abi Ramia
- Department of Clinical, Neuro and Developmental Psychology, World Health Organization (WHO) Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- National Mental Health Programme, Ministry of Public Health of Lebanon, Beirut, Lebanon
| | - Racha Abi Hana
- Department of Clinical, Neuro and Developmental Psychology, World Health Organization (WHO) Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- National Mental Health Programme, Ministry of Public Health of Lebanon, Beirut, Lebanon
| | - Philip Noun
- National Mental Health Programme, Ministry of Public Health of Lebanon, Beirut, Lebanon
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, World Health Organization (WHO) Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- International Institute for Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Kenneth Carswell
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Edith van't Hof
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Eva Heim
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Edwina Zoghbi
- Country Office for Lebanon, World Health Organization, Beirut, Lebanon
| | - Marit Sijbrandij
- Department of Clinical, Neuro and Developmental Psychology, World Health Organization (WHO) Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Rabih El Chammay
- National Mental Health Programme, Ministry of Public Health of Lebanon, Beirut, Lebanon
- Psychiatry Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
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Chahine A, El Zouki CJ, Mhanna M, Hallit S, Obeid S. Association between time perspective and metacognition among Lebanese adults: the mediating role of mindfulness. BMC Psychiatry 2023; 23:906. [PMID: 38053111 PMCID: PMC10696690 DOI: 10.1186/s12888-023-05356-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 11/07/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Mindfulness may serve as a component of metacognitive beliefs and can also be viewed as a form of time perspective. The interplay between time perspective and metacognitive beliefs remains understudied. Both aspects, however, display considerable stability over time and significantly influence an individual's life and well-being. Lebanon, marked by its diverse and complex history, struggles with various political, social, and economic challenges. This study offers a valuable and unprecedented opportunity to examine these connections within a distinct cultural context, shedding light on the unique experiences of the Lebanese population. Therefore, our research aims to investigate the connection between time perspective and metacognition, with a focus on the role of mindfulness as a mediator. METHODS This cross-sectional study was conducted from August to November 2022 and involved participants from various regions of Lebanon. The questionnaire included sociodemographic data and scales such as the Arabic versions of the 15-item Short Form of the Zimbardo Time Perspective Inventory, the Metacognitions Questionnaire, the Freiburg Mindfulness Inventory and the Acceptance and Action Questionnaire (AAQ-2). RESULTS Our investigation recruited 423 participants. The analysis showed that individuals with a positive stance on their past, a hedonistic present, or a future-oriented outlook exhibited heightened levels of mindfulness. This elevated state of mindfulness, in turn, demonstrated a significant link to augmented cognitive self-consciousness (An increased introspection into one's own thoughts). We also observed a direct association between a future-focused time perspective and high scores of cognitive self-consciousness. Furthermore, mindfulness emerged as a crucial mediator in the relationships between time perspectives and negative beliefs about the danger of worry. Similarly, individuals with a positive view on their past, a hedonistic present orientation, or a future-focused mindset demonstrated elevated levels of mindfulness, which was correlated with less negative beliefs about the danger of worry. Notably, a positive past perspective was directly associated with less negative views on worry and the subsequent loss of control, whereas higher future focused time perspective scores was significantly and directly associated with more negative beliefs about worry, whereas more future focused time perspective was significantly and directly associated with more negative beliefs about worry. CONCLUSION Our findings found several meaningful associations between our variables, but it primarily underscored the significance of considering distinct subcomponents within mindfulness and psychopathological metacognition that may overlap, shedding light on their differential impacts on psychological well-being. We were also able to mirror the dual pathway theory of time perspective suggested in previous studies. These insights carry notable implications for the development and refinement of mindfulness-based and metacognitive interventions, emphasizing the need for tailored approaches that consider varying time perspectives. Continued investigation in this area promises to advance our understanding of these constructs and refine their practical applications in mental health interventions and well-being enhancement strategies.
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Affiliation(s)
- Abdallah Chahine
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Christian-Joseph El Zouki
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- UFR de Médecine, Université de Picardie Jules Verne, 1 Rue des Louvels, Amiens, 80037, France
- Faculté d'Ingénierie et de Management de la Santé, 42 rue Ambroise Paré, 59120, LOOS, France
| | - Mariam Mhanna
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon.
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Karam E, Al Barathie J, Saab D, Karam AN, Fayyad J. First Onset in Adulthood of Mental Disorders: Exposure to War vs. Non-war Childhood Adversities: A National Study. Clin Pract Epidemiol Ment Health 2023; 19:e17450179216651. [PMID: 38655552 PMCID: PMC11037514 DOI: 10.2174/0117450179216651231106072824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/16/2023] [Accepted: 10/24/2023] [Indexed: 04/26/2024]
Abstract
Background There is evidence that some childhood trauma increases the risk of the first onset of mental disorders and for the first time into adulthood. There are no studies that assessed whether exposure to war has this delayed long-term effect. Objectives To fill this gap by investigating the comparative roles of war and non-war trauma on the first onset of adulthood mood and anxiety disorders. Methods A nationally representative sample of 2,857 Lebanese was assessed using the World Health Organization Composite International Diagnostic Interview 3.0. with the onset of exposure to trauma and of first onset of mood and anxiety disorders. Results Non-war childhood traumata especially those belonging to family malfunctioning continue to exert their effect for the first time well beyond their occurrence as they were the most universal predictors for adult onset of both mood and anxiety disorders. War trauma during childhood predicted mood anxiety and mood (anxiety only in males) only below age 18 y. war childhood trauma predicts the first onset of mood and anxiety disorders before age 18 y in females, but only anxiety in males. Conclusion Childhood traumata are not equal in predicting the first onset of mood and anxiety disorders into adulthood. Family malfunctioning looks to carry the longest such risk and war more of shorter immediate effects. This might change though with re-exposure to war in adulthood which might unravel dormant vulnerability.
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Affiliation(s)
- Elie Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, University of Balamand Faculty of Medicine, Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
| | - Josleen Al Barathie
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Dahlia Saab
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Aimee Nasser Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, University of Balamand Faculty of Medicine, Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
| | - John Fayyad
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, University of Balamand Faculty of Medicine, Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
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Taybeh E, Hamadneh S, Al-Alami Z, Abu-Huwaij R. Navigating miscarriage in Jordan: understanding emotional responses and coping strategies. BMC Pregnancy Childbirth 2023; 23:757. [PMID: 37884884 PMCID: PMC10601352 DOI: 10.1186/s12884-023-06075-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 10/17/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Miscarriages account for 20% of clinically confirmed pregnancies and up to 50% of all pregnancies and is considered one of the most heartbreaking events experienced by women. The current study aimed to explore participants' perceptions and practices and how they link with the negative emotions of miscarriage. METHODS In this cross-sectional study a web-based questionnaire was used to gather data from 355 women living in Jordan who had experienced a previous miscarriage. The questionnaire consisted of four sections, including socio-demographic information, experience with miscarriage, emotions after the experience, and self-care practices. Participants were recruited through social media platforms from April to August 2022. Data were analyzed using SPSS, and descriptive statistics, chi-square test, and binomial regression were performed to examine the results. RESULTS The results show that the majority of participants were in the age group of 22-34 years and a larger percentage of participants hold a Bachelor's degree and were employed. All participants had experienced a previous miscarriage with 53.8% having one, 27.0% having two, and 19.2% having three or more miscarriages. In addition, most miscarriages did not have an explanation for their cause (77.5%), but vaginal bleeding was the most reported symptom (55.2%) and surgical management was predominant (48.7%). Most participants reported adequate emotional support from partners and family (63.7% and 62.3%, respectively). Almost half (48.7%) of the respondents felt like they had lost a child and those who did not receive any social support had a higher association with the same feeling (p = 0.005). Of the participating women, 40.3% decided to postpone another pregnancy while 20.0% planned for a subsequent pregnancy. The feeling of shame regarding the miscarriage was the main driver for women to get pregnant again (Odd ration [OR] 2.98; 95% confidence interval (CI) 1.31-6.82; p = 0.01). CONCLUSIONS The findings highlight the emotional impact of miscarriage on women and the need for proper support and self-care practices.
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Affiliation(s)
- Esra' Taybeh
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan.
| | - Shereen Hamadneh
- Department of Maternal and Child Health, Princess Salma Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan
| | - Zina Al-Alami
- Department of Basic Medical Sciences, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, Amman, Jordan
| | - Rana Abu-Huwaij
- Department of Pharmacy, College of Pharmacy, Amman Arab University, Amman, Jordan
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Marshak A, Atim T, Mazurana D. International humanitarian law violations in northern Uganda: victims' health, policy, and programming implications. J Public Health Policy 2023; 44:196-210. [PMID: 37081136 PMCID: PMC10232562 DOI: 10.1057/s41271-023-00407-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2023] [Indexed: 04/22/2023]
Abstract
Experience of serious violations of International Humanitarian Law (IHL) results in complex physical disability and psychosocial trauma amplifying poverty and multi-generational trauma and impeding long-term recovery. We use data from a representative sample of victims in the case Prosecutor V. Dominic Ongwen brought before the International Criminal Court. Thirteen years after the 2004 massacre, the victims were significantly worse off than the general war-affected population that did not experience serious violations of IHL. The differences in health and wellbeing persisted for individuals and their households, including children born after the massacre. The victims have significantly lower availability of appropriate health services and medications, including significantly greater distance to travel to these services. These findings call attention to the needs of people having experienced IHL violations, for provision of physical and emotional trauma care to allow for recovery, and better understanding of the short- and long-term impacts of IHL violations.
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Affiliation(s)
- Anastasia Marshak
- Feinstein International Center, Tufts University, 75 Kneeland St, 8th Floor, Boston, MA, USA.
| | - Teddy Atim
- Feinstein International Center, Tufts University, Boston, MA, USA
- York University, Toronto, ON, Canada
| | - Dyan Mazurana
- Feinstein International Center, Tufts University, Boston, MA, USA
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Edwards N, Walker S, Paddick SM, Prina AM, Chinnasamy M, Reddy N, Mboya IB, Mtei M, Varghese M, Nakkasuja N, Guerra M, Sapkota N, Dotchin C. Prevalence of depression and anxiety in older people in low- and middle- income countries in Africa, Asia and South America: A systematic review and meta-analysis. J Affect Disord 2023; 325:656-674. [PMID: 36681304 DOI: 10.1016/j.jad.2023.01.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND There is rapid growth of older people in Low- and Middle- Income Countries (LMICs). The aim of this review was to assess the literature on prevalence of anxiety and depression in this demographic, which to our knowledge, has not yet been conducted. METHODS Databases including Medline, PsychInfo, Embase, Scielo and African Journals Online were searched for terms including "mental disorders", "neurotic disorders", "mood disorders" and "anxiety disorders". Studies published between 1990 and 2020 providing data on older people (≥50 years) in LMICs (defined by World Bank Criteria) were included and quality-assessed. Meta-analysis was conducted on a subset of higher-quality studies to derive pooled prevalence estimates of depression. RESULTS One hundred and forty relevant studies were identified, of which thirty-two were included in meta-analysis. One hundred and fifteen studies reported depression prevalence only, 19 reported both depression and anxiety, and six reported anxiety only. In all studies identified, depression prevalence ranged from 0.5 % to 62.7 %, and Generalised Anxiety Disorder prevalence ranged from 0.2 % to 32.2 %. The pooled prevalence of depression on meta-analysis was 10.5 % (95 % CI, 8.9 % - 11.2 %). Reported prevalence rates of depression were significantly different in studies using ICD-10 compared with DSM criteria, and between community and clinical settings. LIMITATIONS The search strategy contained bias towards English language papers and high income country (HIC) publications. There is significant heterogeneity within the meta-analysis. DISCUSSION A wide range of methodologies and clinical criteria are used in prevalence studies of depression and anxiety in older people. Studies using screening tools found higher prevalence rates; clinicians and researchers should ensure diagnosis is made with gold-standard clinical criteria. Meta-analysis data suggest that rates of depression are similar in older people in LMICs compared to HICs but mental healthcare resources are limited, suggesting a large potential treatment gap.
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Affiliation(s)
- N Edwards
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle-Upon-Tyne, UK.
| | - S Walker
- Translational and Clinical Research Institute, Newcastle University, Newcastle-Upon-Tyne, UK
| | - S-M Paddick
- Department of Old Age Psychiatry, Gateshead Health NHS Foundation Trust, Tyne and Wear, UK; Population Health Sciences Institute, Newcastle University, Newcastle-Upon-Tyne, UK
| | - A M Prina
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M Chinnasamy
- Bradford Primary Care NHS Foundation Trust, Bradford, UK
| | - N Reddy
- Newcastle University, Newcastle-Upon-Tyne, UK
| | - I B Mboya
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - M Mtei
- Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - M Varghese
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - N Nakkasuja
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - M Guerra
- Memory and Depression Centre, Cayetano Heredia Peruvian University, Peru
| | - N Sapkota
- B.P Koirala Institute of Health Sciences, Dhahran, Eastern Nepal, Nepal
| | - C Dotchin
- Department of Old Age Psychiatry, Gateshead Health NHS Foundation Trust, Tyne and Wear, UK; Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
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Impact of Preexisting Alcohol Use Disorder, Bipolar Disorder, and Schizophrenia on Ischemic Stroke Risk and Severity: A Lebanese Case-Control Study. Healthcare (Basel) 2023; 11:healthcare11040538. [PMID: 36833072 PMCID: PMC9957385 DOI: 10.3390/healthcare11040538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Stroke remains a major leading cause of morbidity and death globally. For ischemic stroke, the most frequent type of stroke, there are numerous risk models and risk assessments offered. Further research into potential risk factors or triggers is being sought to improve stroke risk models. Schizophrenia, bipolar disorder, and alcohol use disorder are all common causes of serious mental illnesses in the general population. Due to the tangled relationship between stroke and many chronic illnesses, lifestyle factors, and diet that may be present in a patient with a mental disease, the relationship between mental diseases and stroke requires further validation. Consequently, the purpose of this study is to assess the potential influence of bipolar disorder, schizophrenia, and alcohol use disorder on stroke patients as compared to non-stroke participants, after controlling for demographic, physical, and medical conditions. We aimed, as a secondary objective, to evaluate the impact of these pre-existing disorders on stroke severity levels. METHODS This research is a case-control survey study involving 113 Lebanese patients with a clinical diagnosis of ischemic stroke and 451 gender-matched volunteers without clinical signs of stroke as controls recruited from several hospitals in Lebanon (April 2020-April 2021). Based on the participant's consent, data was collected by filling out an anonymous paper-based questionnaire. RESULTS All of the odds ratios (ORs) generated by our regression model were greater than 1, indicating that the factors studied were associated with an increased risk of ischemic stroke. As such having schizophrenia (adjusted OR [aOR]: 6.162, 95% confidence interval [CI]: 1.136-33.423), bipolar disorder (aOR: 4.653, 95% CI: 1.214-17.834), alcohol use disorder (aOR: 3.918, 95% CI: 1.584-9.689), atrial fibrillation (aOR: 2.415, 95% CI: 1.235-4.721), diabetes (aOR: 1.865, 95% CI: 1.117-3.115), heart diseases (aOR: 9.890, 95% CI: 5.099-19.184), and asthma-COPD (aOR: 1.971, 95% CI: 1.190-3.263) were all involved with a high risk of developing an ischemic stroke. Moreover, obesity (aOR: 1.732, 95% CI: 1.049-2.861) and vigorous physical activity (aOR: 4.614, 95% CI: 2.669-7.978) were also linked to an increased risk of stroke. Moreover, our multinomial regression model revealed that the odds of moderate to severe/severe stroke were significantly higher in people with pre-stroke alcohol use disorder (aOR: 1.719, 95% CI: 1.385-2.133), bipolar disorder (aOR: 1.656, 95% CI: 1.281-2.141), and schizophrenia (aOR: 6.884, 95% CI: 3.294-11.492) compared to people who had never had a stroke. CONCLUSION The findings in our study suggest that individuals with schizophrenia, bipolar disorder, and alcohol use disorder may be at a higher risk for ischemic stroke and exhibit more severe symptoms. We believe that the first step toward creating beneficial preventative and treatment interventions is determining individuals with schizophrenia, bipolar disorder, or alcohol use disorder, assessing their risk of ischemic stroke, developing more integrated treatments, and closely monitoring the long-term outcome in the event of an ischemic stroke.
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12
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Powell TM, Qushua N. A qualitative study of a mental health awareness intervention for Jordanian and resettled Syrian refugees in host communities. Int J Soc Psychiatry 2023; 69:161-172. [PMID: 35083938 DOI: 10.1177/00207640221074808] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mental health disorders significantly contribute to the global burden of disease, however, prevention and treatment programs are often inaccessible in low- and middle-income countries. AIMS The goal of this qualitative evaluation was to examine participants experiences of the healthy community clinic (HCC-MH), an integrated mental health awareness intervention delivered in primary care clinics to Jordanians and resettled Syrians in a border community in Jordan. METHODS Four focus group discussions (FGDs) with Jordanians and Syrians (N = 21) who participated in the HCC-MH were conducted. FGDs examined knowledge, acceptability, and applicability of the intervention. Open coding and the constant comparison method were used to identify themes that emerged from the FGDs. RESULTS Six central themes emerged from the data including : (1) awareness; (2) behavior changes; (3) reduction in stigma; (4) connecting physical and mental health; (5) relationships; and (6) coping. Notably, female participants stated participation in the intervention fostered awareness of their own emotional needs, which led to positive lifestyle and behavior changes. Participants also described how the information provided in the intervention normalized emotional distress and aided understanding of the interconnection between physical and mental health. The amplification of healthy coping strategies to reduce stress and distress was also a prominent theme. CONCLUSIONS Findings are discussed within the cultural and contextual setting of the study, and implications for mental health awareness interventions in complex settings are provided.
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Affiliation(s)
- Tara M Powell
- School of Social Work, University of Illinois Urbana Champaign, USA
| | - Najat Qushua
- Brown School, Washington University, St Louis, MO, USA
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13
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Maalouf E, Hallit S, Salameh P, Hosseini H. Eating Behaviors, Lifestyle, and Ischemic Stroke: A Lebanese Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1487. [PMID: 36674240 PMCID: PMC9864864 DOI: 10.3390/ijerph20021487] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Stroke is the second leading cause of death and the third leading cause of disability on a global scale. Most clinicians tend to underestimate the importance of diet and inadequate or dysfunctional eating attitudes in patients with a complicated relationship with food. Concerned about the potential of an independent Lebanese approach, and also because prior international research has revealed a link between eating intake or choice and ischemic stroke risk, it was considered vital to broaden the scope of the literature and evaluate further the association of disordered eating attitudes and focus on the distinct relationship with food in the case of orthorexia nervosa (ON) in the Lebanese community. Consequently, the purpose of the present study is to investigate the potential association between pre-existing disordered eating attitudes, specifically ON, and ischemic stroke risk, with an emphasis on the evidence supporting a Mediterranean-style diet. METHODS This research is a case-control survey study involving 113 Lebanese individuals with ischemic stroke and 451 age-(within 5 years) and sex-matched controls recruited from several hospitals in Lebanon (April 2020-April 2021). RESULTS According to the findings of our first regression model, living 100 m from a crowded road (adjusted odds ratio [aOR]: 3.421, 95% confidence interval [CI]: 1.585-7.387), living 100 m from an electricity generator (aOR: 3.686, 95% CI: 1.681-8.085), higher waterpipe dependence (aOR: 1.204, 95% CI: 1.117-1.297), higher exposure to passive smoking (aOR: 2.651, 95% CI: 2.051-3.426), being married (aOR: 3.545, 95% CI: 1.297-9.689), having a low educational attainment (aOR: 0.239, 95% CI: 0.084-0.679), vigorous physical activity (aOR: 1.003, 95% CI: 1.001-1.006), and having more inappropriate eating (aOR: 1.040, 95% CI: 1.006-1.074) were all associated with higher odds of having ischemic stroke. Furthermore, atrial fibrillation (aOR: 2.945, 95% CI: 1.010-8.585), diabetes (aOR: 2.550, 95% CI: 1.169-5.561), heart diseases (aOR: 6.193, 95% CI: 2.196-17.463), and hypertension (aOR: 2.744, 95% CI: 1.049-7.180) were also linked to an increased risk of stroke. Moreover, having more orthorexia nervosa tendencies (aOR: 1.123, 95% CI: 1.021-1.235) was related to a higher odds of having an ischemic stroke, whereas better adherence to the MeD was significantly linked (aOR: 0.691, 95% CI: 0.583-0.819) to lower odds of ischemic stroke. CONCLUSIONS Ischemic stroke patients were more likely to have disordered eating attitudes and orthorexic behaviors. Furthermore, the MeD has been found to be beneficial in reducing ischemic stroke risk. Despite the study's focus, outdoor pollution, waterpipe dependence, and passive smoking were linked to ischemic stroke. In summary, this review suggests that improving one's nutritional status and making a few lifestyle changes are key stroke prevention and treatment methods.
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Affiliation(s)
- Elise Maalouf
- Life and Health Sciences Department, Paris-Est University, 94000 Creteil, France
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh P.O. Box 446, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman 11931, Jordan
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib P.O. Box 60096, Lebanon
| | - Pascale Salameh
- School of Medicine, Lebanese American University, Byblos 5053, Lebanon
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut 1103, Lebanon
- Medical School, University of Nicosia, Nicosia 2417, Cyprus
- Faculty of Pharmacy, Lebanese University, Beirut 1103, Lebanon
| | - Hassan Hosseini
- UPE-C, Université Paris-Est Créteil, Faculté de Santé, INSERM U955-E01, IMRB, 94000 Creteil, France
- Hopital Henri Mondor, APHP, 94000 Creteil, France
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14
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Association between Experiences in Life and Quality of Life among Lebanese University Students in a Collapsing Country: The Moderating Role of Religious Coping and Positivity. Healthcare (Basel) 2023; 11:healthcare11010149. [PMID: 36611609 PMCID: PMC9819168 DOI: 10.3390/healthcare11010149] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 01/05/2023] Open
Abstract
(1) Background: No goal can be more important than optimal individual quality of life (QOL); life experiences, religious coping, and positivity play pivotal roles in achieving this goal. The aim is to assess the correlation between positive/negative experiences in life and QOL, taking into consideration the moderating role of positivity and positive/negative religious coping among a sample of Lebanese university students. (2) Methods: This cross-sectional study was carried out between November and December 2021, and enrolled 333 university students, aged between 18 and 30 years, from various areas in Lebanon’s governorates. The 12-item Short Form Health Survey, the brief religious coping methods scale, and the Scale of Positive and Negative Experience were included in the questionnaire. Forward linear regressions were conducted to check for correlates associated with physical and mental QOL scores. All variables that showed a correlation or effect size > |0.24| were entered in the multivariable and moderation models as independent ones. Significance was set at a p < 0.05. (3) Results: A linear regression, taking the physical QOL score as the dependent variable, showed that living in rural areas compared to urban and more positivity were significantly associated with a better physical QOL, whereas more negative religious coping was significantly associated with a lower physical QOL. More positivity and more positive religious coping were significantly associated with a better mental QOL. The moderation analysis showed that in people with high positive experiences, those with higher negative religious coping had lower mental QOL. (4) Conclusions: In a society as deeply religious as Lebanon, it is crucial to organize awareness programs to help in discriminating between religious coping mechanisms. Across order to stop further detrimental effects on QOL, our findings may serve as a solid foundation for future studies of QOL with additional variables, in other groups and nations.
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15
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Maalouf E, Hallit S, Salameh P, Hosseini H. Depression, anxiety, insomnia, stress, and the way of coping emotions as risk factors for ischemic stroke and their influence on stroke severity: A case-control study in Lebanon. Front Psychiatry 2023; 14:1097873. [PMID: 36896347 PMCID: PMC9988919 DOI: 10.3389/fpsyt.2023.1097873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/06/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Stroke is a leading cause of disability and death worldwide. There are numerous debates regarding the relationship between depression, anxiety, insomnia, perceived stress, and ischemic stroke. Moreover, no research on the efficacy of emotion regulation, which is critical for various components of healthy affective and social adaptability, is being conducted. To the best of our knowledge, this is the first study in the MENA region to shed light on the relationship between these conditions and stroke risk, aiming to determine whether depression, anxiety, insomnia, stress, and the way of coping with emotions may be risk factors for ischemic stroke occurrence and to further investigate the ability of two specific types of emotion regulation (cognitive reappraisal and expressive suppression) as possible moderators of the relationship between these psychological diseases and ischemic stroke risk. As a secondary objective, we sought to determine how these pre-existing conditions affect stroke severity levels. METHODS This is a case-control survey study involving 113 Lebanese inpatients with a clinical diagnosis of ischemic stroke admitted in hospitals and rehabilitation centers in Beirut and Mount Lebanon, and 451 gender-matched volunteers without clinical signs of stroke as controls recruited from the same hospitals as the cases or attending outpatient clinics for illnesses or treatments unconnected to stroke or transient ischemic attack, as well as visitors or relatives of inpatients (April 2020-April 2021). Data was collected by filling out an anonymous paper-based questionnaire. RESULTS According to the outcomes of the regression model, depression (aOR: 1.232, 95%CI: 1.008-1.506), perceived stress (aOR: 1.690, 95%CI: 1.413-2.022), a lower educational level (aOR: 0.335, 95%CI: 0.011-10.579), and being married (aOR: 3.862, 95%CI: 1.509-9.888) were associated with an increased risk of ischemic stroke. The moderation analysis revealed that expressive suppression had a significant moderating effect on the relationship between depression, anxiety, perceived stress, insomnia, and ischemic stroke risk, resulting in an increased risk of stroke incidence. In contrast, cognitive reappraisal significantly reduced the risk of ischemic stroke by moderating the association between ischemic stroke risk and the following independent variables: perceived stress and insomnia. On the other hand, our multinomial regression model revealed that the odds of moderate to severe/severe stroke were significantly higher in people with pre-stroke depression (aOR: 1.088, 95% CI: 0.747-1.586) and perceived stress (aOR: 2.564, 95% CI: 1.604-4.100) compared to people who had never had a stroke. CONCLUSION Despite several limitations, the findings of our study suggest that people who are depressed or stressed are more likely to have an ischemic stroke. Consequently, additional research into the causes and effects of depression and perceived stress may provide new directions for preventive strategies that can help reduce the risk of stroke. Since pre-stroke depression and perceived stress were also found to be strongly correlated with stroke severity, future studies should evaluate the association between pre-stroke depression, perceived stress, and stroke severity to gain a deeper understanding of the complex interaction between these variables. Lastly, the study shed new light on the role of emotion regulation in the relationship between depression, anxiety, perceived stress, insomnia, and ischemic stroke.
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Affiliation(s)
- Elise Maalouf
- Life and Health Sciences Department, Paris-Est University, Paris, France
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon.,Applied Science Research Center, Applied Science Private University, Amman, Jordan.,Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Pascale Salameh
- School of Medicine, Lebanese American University, Byblos, Lebanon.,INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicolo-gie-Liban, Beirut, Lebanon.,Medical School, University of Nicosia, Nicosia, Cyprus.,Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Hassan Hosseini
- Faculté de Santé, UPE-C, Université Paris-Est Créteil, Créteil, France.,Hopital Henri Mondor, APHP, Créteil, France
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Validity of Adult Psychopathology Model Using Psychiatric Patient Sample from a Developing Country: Confirmatory Factor Analysis. Ment Illn 2022. [DOI: 10.1155/2022/9594914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objectives. This study is aimed at testing and validating the two-factor measurement model of the Millon Clinical Multiaxial Inventory (MCMI). Specifically, this paper reported construct validity, particularly focusing on convergent and discriminant validities of the internalizing-externalizing MCMI model of adult psychopathology using a psychiatric sample from a developing country, the Republic of Yemen. Methods. MCMI was distributed among 232 outpatients from the Hospital of Taiz City and two private psychiatry clinics in Yemen; data were collected using structured interviews over four months. We used exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to explore and confirm the latent structure MCMI and verify the evidence of convergent and discriminant validity. Results. The CFA results indicated that MCMI was a good fit for the internalizing-externalizing two-factor model of adult psychopathology, comparative fit index
, and
. The results of the CFA provide evidence of convergent and discriminant validity characterized by MCMI with the internalizing-externalizing model. Conclusion. The adult psychopathology of internalizing-externalizing is a valid measurement model of MCMI with ten personality disorders and eight clinical syndromes.
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Cuijpers P, Heim E, Ramia JA, Burchert S, Carswell K, Cornelisz I, Knaevelsrud C, Noun P, van Klaveren C, van’t Hof E, Zoghbi E, van Ommeren M, El Chammay R. Guided digital health intervention for depression in Lebanon: randomised trial. EVIDENCE-BASED MENTAL HEALTH 2022; 25:e34-e40. [PMID: 35577536 PMCID: PMC9811068 DOI: 10.1136/ebmental-2021-300416] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 04/27/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Most people with mental disorders in communities exposed to adversity in low-income and middle-income countries (LMICs) do not receive effective care. Digital mental health interventions are scalable when digital access is adequate, and can be safely delivered during the COVID-19 pandemic. OBJECTIVE To examine the effects of a new WHO-guided digital mental health intervention, Step-by-Step, supported by a non-specialist helper in Lebanon, in the context of concurring economic, humanitarian and political crises, a large industrial disaster and the COVID-19 pandemic. METHODS We conducted a single-blind, two-arm pragmatic randomised trial, comparing guided Step-by-Step with enhanced care as usual (ECAU) among people suffering from depression and impaired functioning. Primary outcomes were depression (Patient Health Questionnaire 9 (PHQ-9)) and impaired functioning (WHO Disability Assessment Schedule-12 (WHODAS)) at post-treatment. FINDINGS 680 people with depression (PHQ-9>10) and impaired functioning (WHODAS>16) were randomised to Step-by-Step or ECAU. Intention-to-treat analyses showed effects on depression (standardised mean differences, SMD: 0.71; 95% CI: 0.45 to 0.97), impaired functioning (SMD: 0.43; 95% CI: 0.21 to 0.65), post-traumatic stress (SMD: 0.53; 95% CI: 0.27 to 0.79), anxiety (SMD: 0.74; 95% CI: 0.49 to 0.99), subjective well-being (SMD: 0.37; 95% CI: 0.12 to 0.62) and self-identified personal problems (SMD: 0.56; 95% CI 0.29 to 0.83). Significant effects on all outcomes were retained at 3-month follow-up. CONCLUSIONS Guided digital mental health interventions can be effective in the treatment of depression in communities exposed to adversities in LMICs, although some uncertainty remains because of high attrition. CLINICAL IMPLICATIONS Guided digital mental health interventions should be considered for implementation in LMICs. TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT03720769.
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Affiliation(s)
- Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands,Babeș-Bolyai University, International Institute for Psychotherapy, Cluj-Napoca, Romania
| | - Eva Heim
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland,Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Jinane Abi Ramia
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands,National Mental Health Programme, Ministry of Public Health of Lebanon, Beirut, Lebanon
| | - Sebastian Burchert
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | | | - Ilja Cornelisz
- Department of Educational, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Philip Noun
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Chris van Klaveren
- Department of Educational, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Edith van’t Hof
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | | | | | - Rabih El Chammay
- National Mental Health Programme, Ministry of Public Health of Lebanon, Beirut, Lebanon,Psychiatry Department, Saint Joseph University, Beirut, Lebanon
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18
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Tarhini Z, Jost J, Ratsimbazafy V, Preux PM, Salameh P, Al-Hajje A, Boumediene F, Mroueh L. Knowledge of epilepsy, quality of life, and psychiatric comorbidities in Lebanese adults with epilepsy. Epilepsy Behav 2022; 136:108924. [PMID: 36195023 DOI: 10.1016/j.yebeh.2022.108924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION People with epilepsy (PWE) face a variety of psychosocial challenges. A lack of knowledge of epilepsy, a high level of depression and anxiety and a low quality of life (QoL) are among the major problems that affect most PWE. The objective of this study was to examine the association of sociodemographic characteristics, clinical factors and knowledge of epilepsy with the level of QoL, and the presence of psychiatric comorbidities. METHOD A cross-sectional study was conducted in Lebanon. The PWE were recruited from neurologists' clinics in Beirut and its suburbs. A questionnaire translated into Arabic was used and composed of four parts: sociodemographic factors, clinical characteristics, psychosocial characteristics (QoL, psychiatric disorders), and knowledge epilepsy scale. Backward logistic regression models were developed, the associations were estimated by odds ratio (OR), and the level of significance was set at p ≤ 0.05. RESULTS Four hundred and four PWE were recruited in this study. About a half of PWE had controlled epilepsy (46.3 %) and 40.3 % had epilepsy for less than 5 years. The QoL was low for 38.6 % of PWE and 30.2 % had psychiatric comorbidities. More than half of PWE had a good level of knowledge (71.5 %). Controlled epilepsy (OR = 1.8; 95 %CI: 1.2-2.9), and good knowledge about epilepsy (OR = 5.5; 95 %CI: 3.4-9.1) were associated with better QoL. Patients on polytherapy with anti-seizure drugs (OR = 0.6; 95 %CI: 0.4-0.9), experienced side effects of anti-seizure drugs (OR = 0.6; 95 %CI: 0.4-0.9) and with psychiatric comorbidities (OR = 0.6; 95 %CI: 0.3-0.9) had a lower QoL. A high number of nonpsychiatric comorbidities (OR = 2.5; 95 %CI: 2.0-3.1) and a polytherapy increased the risk of having psychiatric comorbidities (OR = 1.8; 95 %CI: 1.1-2.8). CONCLUSIONS Good knowledge of epilepsy and the absence of psychiatric comorbidities are important predictors of good QoL in Lebanese PWE. Educational programs are needed to reduce misconceptions about epilepsy and improve mental health of PWE.
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Affiliation(s)
- Zeinab Tarhini
- Univ. Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France; Inserm, U1094, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France; IRD, U270, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France
| | - Jeremy Jost
- Univ. Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France; Inserm, U1094, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France; IRD, U270, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France; CHU Limoges, Department of Pharmacy, Limoges, France
| | - Voa Ratsimbazafy
- Univ. Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France; Inserm, U1094, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France; IRD, U270, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France; CHU Limoges, Department of Pharmacy, Limoges, France
| | - Pierre-Marie Preux
- Univ. Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France; Inserm, U1094, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France; IRD, U270, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France
| | - Pascale Salameh
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Hadath, Beirut, Lebanon; Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie - Liban (INSPECT-LB), Beirut, Lebanon; University of Nicosia Medical School, Nicosia, Cyprus; Lebanese American University, School of Medicine, Lebanon
| | - Amal Al-Hajje
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Hadath, Beirut, Lebanon
| | - Farid Boumediene
- Univ. Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France; Inserm, U1094, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France; IRD, U270, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France
| | - Lara Mroueh
- Univ. Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France; Inserm, U1094, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France; IRD, U270, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France; Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Hadath, Beirut, Lebanon.
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El Zouki CJ, Chahine A, Mhanna M, Obeid S, Hallit S. Rate and correlates of post-traumatic stress disorder (PTSD) following the Beirut blast and the economic crisis among Lebanese University students: a cross-sectional study. BMC Psychiatry 2022; 22:532. [PMID: 35931970 PMCID: PMC9356397 DOI: 10.1186/s12888-022-04180-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is a mental illness that develops in some people after they have experienced a stunning, scary, or dangerous incident. Due to major disasters like as the Economic Crisis and the Beirut Blast, Lebanese people are struggling with a variety of mental health issues. The study objectives were to find the rate of PTSD and its association with stress, anxiety, depression, financial well-being and coping strategies among university students in Lebanon. METHODS This is a cross-sectional study, conducted between May and August 2021, which enrolled 419 university students from all districts of Lebanon. The PTSD Checklist-Specific Version (PCL-S) was used to evaluate manifestation of PSTD. RESULTS The results showed that 132 (31.5%), 109 (26.0%) and 169 (40.3%) had PTSD from COVID, Beirut blast and economic crisis respectively. More avoidant coping (Beta = 0.52) and more anxiety (Beta = 0.62) were significantly associated with more PTSD from the Beirut Blast. More avoidant coping (Beta = 0.56), depression (Beta = 0.40) and anxiety (Beta = 0.49) were significantly associated with more PTSD from the economic crisis, whereas more financial wellbeing (Beta = - 0.31) was significantly associated with less PTSD from the economic crisis. CONCLUSION Significant rates of PTSD were found in our sample of Lebanese university students, whether from the Beirut blast, or from the current economic crisis. Significant correlations of these PTSD rates were found with factors such as avoidant coping, depression, anxiety and financial wellbeing. Such findings must raise the attention to serious mental and psychosocial alteration endured by Lebanese youth that are still under fatal cumulative traumatic events, that were and even may be, intergenerationally and unintentionally transmissible, therefore, affecting not only the present, but also the future of a whole nation.
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Affiliation(s)
- Christian-Joseph El Zouki
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Abdallah Chahine
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Mariam Mhanna
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Sahar Obeid
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- Psychology Department, College of Humanities, Effat University, Jeddah, 21478 Saudi Arabia
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
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20
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Kovess-Masfety V, Karam E, Keyes K, Sabawoon A, Sarwari BA. Access to Care for Mental Health Problems in Afghanistan: A National Challenge. Int J Health Policy Manag 2022; 11:1442-1450. [PMID: 34124868 PMCID: PMC9808366 DOI: 10.34172/ijhpm.2021.46] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 04/18/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND This paper describes the access to care for mental health problems in Afghanistan, according to the nature of the mental health problems and the service provider. Following the Andersen model, it evaluates the respective roles in access to care of "predisposing," "needs," "enabling" factors, and other "environmental" factors such as exposure to traumatic events and level of danger of the place of residence. METHODS Trans-sectional probability survey in general population by multistage sampling in 16 provinces, nationally representative: N=4445 (15 years or older), participation rate of 81%. Face to face interviews using standardized measures of mental health (CIDI, Composite International Diagnostic Interview). Different logistic regression models are presented. RESULTS The 12-month rate of mental health help-seeking was 6.56% with substantial regional variation (2.35% to 12.65%). Providers were mainly from the health sector; the non-health sector (religious and healers) was also prevalent. Most consultations were held in private clinics (non-governmental organisation, NGO). The severity of mental health disorders as well as the perceived impairment due to mental health were independently very important: odds ratio (OR) = 6.04 for severe disorder, OR=3.79 for perceived impairment. Living in a dangerous area decreased access to care: for high level of danger and for very high level: OR=0.22. Gender, education and ethnicity were not associated with mental health help-seeking after controlling for exposure to trauma. CONCLUSION Access to care for mental health problems depended mainly on the needs as defined as disorder severity level and impairment, and on environmental factors such as exposure to traumatic events. The system seems equitable; however, this is counterbalanced by a very challenging environment. This survey is a testimony to the hardship experienced by the Afghan population and by health professionals, and to the efforts to deliver organized mental healthcare in a challenging situation. This research may inform and support policy-makers and NGOs in other countries undergoing similar challenges.
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Affiliation(s)
- Viviane Kovess-Masfety
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Conseil Santé, Clichy, France
- Laboratoire de Psychopathologie et Processus de Santé (LPPS), Université de Paris, Boulogne-Billancourt, France
| | - Elie Karam
- Department of Psychiatry & Clinical Psychology, St. George Hospital University Medical, Beirut, Lebanon
- Faculty of Medicine, University of Balamand Medical Center, University of Balamand, Beirut, Lebanon
- Institute for Development, Research, Advocacy & Applied Care (IDRAAC), Beirut, Lebanon
| | - Katherine Keyes
- Mailman School of Public Health, Columbia University, New York City, NY, USA
| | - Ajmal Sabawoon
- Governance Institute of Afghanistan (GI-A), Kabul, Afghanistan
| | - Bashir Ahmad Sarwari
- Department of Mental Health & Substance Abuse, Primary Health Care Directorate, Ministry of Public Health, Kabul, Afghanistan
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21
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Kobeissi E, Abdul-Sater Z, Farhat T, Abu-Sittah G. Challenges of conducting research on emergency response and health services provided during conflict in LMICs - case of Lebanon. Med Confl Surviv 2022; 38:224-232. [PMID: 35915859 DOI: 10.1080/13623699.2022.2103042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Elsa Kobeissi
- Conflict Medicine Program, Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Zahi Abdul-Sater
- Conflict Medicine Program, Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Theresa Farhat
- Conflict Medicine Program, Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Ghassan Abu-Sittah
- Conflict Medicine Program, Global Health Institute, American University of Beirut, Beirut, Lebanon
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22
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Youssef L, Salameh P, Dagher M, Akel M, Hallit S, Obeid S. Association between mental illness and cycle phases and physical, social, and task attraction in female university students. Perspect Psychiatr Care 2022; 58:986-993. [PMID: 34105164 DOI: 10.1111/ppc.12887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 03/16/2021] [Accepted: 05/30/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To examine the association between menstrual cycle phases and other factors (depression, anxiety, and stress) with social, physical, and task attraction. METHODS This cross-sectional study enrolled 662 female university students (December 2019-January 2020). RESULTS Higher stress was associated with higher social and task attraction. Higher stress and depression were associated with higher physical attraction, whereas higher anxiety was associated with lower physical attraction. None of the cycle's phases was associated with attraction. PRACTICAL IMPLICATIONS This study results showed a lot of contradictory information to what is present in the literature, in addition to new associations that are not tackled enough in the literature. Therefore, there is a crucial need for new firm studies that explore the relationship between women's hormonal levels and attraction levels.
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Affiliation(s)
- Lara Youssef
- Department of Biomedical Sciences, Faculty of Medicine and Medical Sciences, University of Balamand (UOB), Al-Kurah, Lebanon
| | - Pascale Salameh
- INSPECT-LB: National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon.,University of Nicosia Medical School, Nicosia, Cyrus.,Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Maya Dagher
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Marwan Akel
- INSPECT-LB: National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon.,School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Souheil Hallit
- INSPECT-LB: National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon.,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Sahar Obeid
- INSPECT-LB: National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon.,Department of Research and Psychology, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
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23
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Doumit R, Habre M, Cattan R, Abi Kharma J, Davis B. Health-promoting behaviors and self-efficacy among nursing students in times of uncertainty. Worldviews Evid Based Nurs 2022; 19:500-507. [PMID: 35638707 DOI: 10.1111/wvn.12590] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 04/20/2022] [Accepted: 04/24/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Nursing students are often faced with academic and personal stressors that threaten their Health-Promoting Behaviors (HPB) and well-being. Research on how living in a context of high political uncertainty can impact nursing students' HPB is limited. The aim of this study was to investigate the associations between HPB and self-efficacy among nursing students in a context of high political uncertainty. METHODS This was a cross-sectional, descriptive study that included 120 undergraduate nursing students from Lebanon who completed an electronic self-reported questionnaire. RESULTS The results indicated that HPB measured by HPLP-II scores were negatively correlated with overall uncertainty scores (r = -.29, p < .01) and positively correlated with the General Self-Efficacy (GSE) scale scores (r = .41, p < .001). Results from the multiple linear regression model indicated that physical activity frequency and GSE were independent predictors of the total health-promoting lifestyle profile and the model explained 30.28% of the variance in the total HPLP-II scale. LINKING EVIDENCE TO ACTION This study further emphasizes the importance of regular physical activity (at least 3 h a week) as a strategy to improve HPB among nursing students. Culturally sensitive strategies that aim to enhance HPB should be embedded in undergraduate nursing curricula. Public health nurses and university counselors should join efforts to develop strategies to maintain or enhance self-efficacy and to promote regular physical activity among nursing students. Future research should further study the association between self-efficacy, resilience, and uncertainty in contexts of ongoing conflicts.
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Affiliation(s)
- Rita Doumit
- Alice Ramez Chagoury School of Nursing, Lebanese American University, Byblos, Lebanon
| | - Maha Habre
- Alice Ramez Chagoury School of Nursing, Lebanese American University, Byblos, Lebanon
| | - Rebecca Cattan
- Alice Ramez Chagoury School of Nursing, Lebanese American University, Byblos, Lebanon.,Escale - Soins Infirmiers et Developpment Communautaire, Sin el Fil, Lebanon
| | - Joelle Abi Kharma
- School of Arts & Sciences, Lebanese American University, Beirut, Lebanon
| | - Beena Davis
- School of Nursing, Los Angeles County College of Nursing and Allied Health, Los Angeles, California, USA
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24
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Abou Kassm S, Naja W, Saadeh D, Baddoura R, Ibrahim W, Hachem S, Salloum D, Chehade I, Nasr F, Haddad R. Depression prevalence and associated factors among cancer patients in Lebanon: A cross-sectional study. J Psychosom Res 2022; 156:110764. [PMID: 35220108 DOI: 10.1016/j.jpsychores.2022.110764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/15/2022] [Accepted: 02/19/2022] [Indexed: 10/19/2022]
Affiliation(s)
- Sandra Abou Kassm
- Lebanese University, Faculty of Medical Sciences, Psychiatry Department, Beirut, Lebanon; Mount Lebanon Hospital, Beirut, Lebanon.
| | - Wadih Naja
- Lebanese University, Faculty of Medical Sciences, Psychiatry Department, Beirut, Lebanon; Mount Lebanon Hospital, Beirut, Lebanon; King Hussein Cancer Center, Amman, Jordan
| | - Danielle Saadeh
- INSPECT-LB (Institut National de Santé Publique et d'Epidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon; Lebanese University, Faculty of Public Health, Fanar, Lebanon; CERIPH, Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Lebanese University, Faculty of Public Health, Fanar, Lebanon
| | - Rafic Baddoura
- Saint Joseph University, Faculty of Medical Sciences, Rheumatology Department, Beirut, Lebanon
| | - Walid Ibrahim
- Lebanese University, Faculty of Medical Sciences, Internal Medicine Department, Beirut, Lebanon
| | - Shaha Hachem
- Lebanese University, Faculty of Medical Sciences, Internal Medicine Department, Beirut, Lebanon
| | - Dima Salloum
- American University of Beirut, Faculty of Medical Sciences, Obstetrics and Gynecology Department, Beirut, Lebanon
| | - Issam Chehade
- Beirut Governmental University Hospital, Beirut, Lebanon
| | - Fadi Nasr
- Mount Lebanon Hospital, Beirut, Lebanon; Balamand University, Faculty of Medical Sciences, Beirut, Lebanon; Saint Joseph University, Faculty of Medical Sciences, Oncology Department, Beirut, Lebanon
| | - Ramzi Haddad
- Lebanese University, Faculty of Medical Sciences, Psychiatry Department, Beirut, Lebanon; Mount Lebanon Hospital, Beirut, Lebanon
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25
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Mourad M, Kazour F, Sleilaty G, Bou Khalil R, El Hage W, Richa S, Sabbagh C. Positive and negative correlates of suicidal ideations and behaviors in the emergency department of a university hospital in Beirut: A cross-sectional comparative study. Encephale 2022; 49:248-253. [DOI: 10.1016/j.encep.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/04/2021] [Accepted: 11/23/2021] [Indexed: 11/26/2022]
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26
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El Hayek S, Cherro M, El Alayli A, El Hayek R, Ghossoub E. Stigma Towards Mental Illness at an Academic Tertiary Care Center in Lebanon. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2021; 45:725-732. [PMID: 34286455 PMCID: PMC8294272 DOI: 10.1007/s40596-021-01511-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 07/07/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Individuals with mental illness may fall victim to stigma. In this cross-sectional study, the authors aimed to explore correlates of stigma towards mental health in a Lebanese private university and its associated tertiary medical center. METHODS The authors surveyed students, staff, and faculty at the American University of Beirut and its associated medical center. They assessed stigmatizing behaviors via the Reported and Intended Behavior Scale (RIBS), perceived stigma via the Perceived Devaluation and Discrimination Scale (PDDS), and attitudes towards collaborating with mental health professionals via the Doctors' Attitudes toward Collaborative Care for Mental Health (DACC-MH). RESULTS A total of 270 participants (response rate of 18%) provided their responses. The mean scores on the RIBS and PDDS were 15.26 ± 4.75 and 32.25 ± 2.70, respectively. Participants who had higher scores on RIBS were more likely to be younger than 25 years of age (OR=1.869; p=0.026), to have a history of mental illness (OR=2.657; p=0.003), and to interact with individuals with a psychiatric disorder (OR=2.287; p=0.028). CONCLUSIONS Results show a mixed pattern of stigmatizing behaviors and perceptions towards mental illness. This highlights the need for mental health awareness campaigns and interventions in the country.
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27
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Farran N. Mental health in Lebanon: Tomorrow's silent epidemic. MENTAL HEALTH & PREVENTION 2021; 24:200218. [PMID: 34660191 PMCID: PMC8503814 DOI: 10.1016/j.mhp.2021.200218] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 09/05/2021] [Indexed: 12/14/2022]
Abstract
Lebanon is a middle-income country that has been recently crippled by several tragedies including the economic collapse, COVID-19, and the fourth of August Beirut port explosion, the world's most powerful non-nuclear explosion of the twenty-first century. Recent data on mental health from Lebanon is summarised, and other topics such as the psychological impact of cumulative adversities and the role of international support in Lebanon are examined. Data from Lebanon shows severe levels of distress among the people, in a country with minimal resources. Given current adversities in Lebanon, recent data in the country, and the literature on adversity and mental health outcomes of man-made disasters, Lebanon is most likely going to face an epidemic in poor mental health. A call is made for the wider scientific community and international organizations to support the mental health field in the country and help prevent further negative mental health outcomes. Understanding how to better navigate mental health in places with extreme adversity and emergencies can be beneficial to other communities which might face similar challenges.
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Affiliation(s)
- Natali Farran
- Institute of Psychiatry, Psychology, and Neuroscience. King's College London, 16 De Crespigny Park, Camberwell, London SE5 8AB, UK
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28
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Khaled SM, Petcu C, Bader L, Amro I, Al‐Assi M, Le Trung K, Mneimneh ZN, Sampson NA, Kessler RC, Woodruff PW. Conducting a state-of-the-art mental health survey in a traditional setting: Challenges and lessons from piloting the World Mental Health Survey in Qatar. Int J Methods Psychiatr Res 2021; 30:e1885. [PMID: 34224172 PMCID: PMC8412229 DOI: 10.1002/mpr.1885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/03/2021] [Accepted: 06/23/2021] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES A small country in the Arabian Peninsula, Qatar experienced rapid economic growth in the last 3 decades accompanied by major socio-demographic shifts towards a younger and more highly educated population. To date, no national epidemiological study has examined the prevalence, associated factors, or sequelae of mental disorders in Qatar's general population. METHODS The World Mental Health Qatar (WMHQ) is a national mental health needs assessment survey and is the first carried out in collaboration with the World Mental Health Survey initiative to assess the prevalence and burden of psychiatric illnesses among the full Arabic speaking population (nationals and non-nationals) within the same country. RESULTS Standard translation and harmonization procedures were used to develop the WMHQ instrument. A survey quality control system with standard performance indicators was developed to ensure interviewer adherence to standard practices. A pilot study was then carried out just prior to the COVID-19 pandemic. Endorsement from public health authorities and sequential revision of the interview schedule led to full survey completion (as opposed to partial completion) and good overall response rate. CONCLUSIONS The WMHQ survey will provide timely and actionable information based on quality enhancement procedures put in place during the development and piloting of the study.
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Affiliation(s)
- Salma M. Khaled
- Social and Economic Survey Research InstituteQatar UniversityDohaQatar
| | - Catalina Petcu
- Social and Economic Survey Research InstituteQatar UniversityDohaQatar
| | - Lina Bader
- Social and Economic Survey Research InstituteQatar UniversityDohaQatar
| | - Iman Amro
- Social and Economic Survey Research InstituteQatar UniversityDohaQatar
| | - Marwa Al‐Assi
- Social and Economic Survey Research InstituteQatar UniversityDohaQatar
| | - Kien Le Trung
- Social and Economic Survey Research InstituteQatar UniversityDohaQatar
| | - Zeina N. Mneimneh
- Survey Research CenterInstitute for Social ResearchUniversity of MichiganAnn ArborMichiganUSA
| | - Nancy A. Sampson
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
| | - Ronald C. Kessler
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
| | - Peter W. Woodruff
- Department of Neuroscience, Faculty of Medicine Dentistry and HealthThe University of SheffieldSheffieldUK
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29
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El Hajj M. Prevalence and associated factors of post-traumatic stress disorder in Lebanon: A literature review. Asian J Psychiatr 2021; 63:102800. [PMID: 34340165 DOI: 10.1016/j.ajp.2021.102800] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/24/2021] [Accepted: 07/27/2021] [Indexed: 10/20/2022]
Abstract
Lebanon has been under continuous conflict for more than four decades, putting millions of Lebanese at a high risk for post-traumatic stress disorder (PTSD) and creating a complex collective trauma. This paper aimed to review all studies from Lebanon reporting on PTSD in order to describe the prevalence of PTSD and its associated risk factors among Lebanese adults. A search of the MEDLINE/PubMed database was conducted in February/March 2021 to identify research articles on PTSD in Lebanese adults. A total of 1064 articles were identified, out of which 11 articles (5875 participants) published between 2003 and 2020 were included. PTSD prevalence estimates were highly variable across the individual studies, ranging from 2 % to 98 %. Female sex, economic hardship, lower educational level, being unemployed, number of witnessed/experienced traumatic events, and presence of comorbid psychological disorders were associated with higher PTSD rates. In light of the increasing PTSD risk in the Lebanese population as a result of the recent Beirut blast and ongoing social and economic crises, further culturally competent research is needed to provide rigorous evidence on the prevalence, course, and severity of PTSD in Lebanon.
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30
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Bou-Hamad I, Hoteit R, Harajli D. Health worries, life satisfaction, and social well-being concerns during the COVID-19 pandemic: Insights from Lebanon. PLoS One 2021; 16:e0254989. [PMID: 34324533 PMCID: PMC8321151 DOI: 10.1371/journal.pone.0254989] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 07/07/2021] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 outbreak has struck Lebanon in its worst period of instability, not only impacting physical health, but also increasing psychological distress. Using an online survey enhanced by response time measurement, this study describes the overall patterns in mental well-being outcomes and examines their association with sociodemographic characteristics during the COVID-19 pandemic. Furthermore, it identifies significant predictors for COVID-19 good practices. A total of 988 Lebanese were surveyed, with participants providing written online consent prior to filling the survey. Regression-based models were estimated. Findings show that individuals with higher education levels exhibit lower health concerns. People with children face higher health worries than those without. Men are more worried than women about their health and they are less satisfied with their lives during the pandemic. Descriptive statistics show that most Lebanese are very satisfied with their families (93.1%), but they are highly dissatisfied with their country (63%). Young adults and individuals who live alone exhibit significantly higher social well-being concerns. Age and having children were strong predictors for good COVID-19 practices. The odds of having good practices for older adults are 3.13 times higher than that of youth, while the odds for those with children are 3.18 times higher than those without. The findings of this study could pave the way for a well-coordinated national strategy and increased collaboration with public health professionals to mitigate the pandemic's adverse effects on mental health in the long-term.
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Affiliation(s)
- Imad Bou-Hamad
- Department of Business Information and Decision Systems, Suliman S. Olayan School of Business, American University of Beirut, Beirut, Lebanon
| | - Reem Hoteit
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Dunia Harajli
- Department of Information Technology and Operations Management, Adnan Kassar School of Business, Lebanese American University, Beirut, Lebanon
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31
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Al-Hajj S, Pawliuk C, Smith J, Zheng A, Pike I. History of injury in a developing country: a scoping review of injury literature in Lebanon. J Public Health (Oxf) 2021; 43:e24-e44. [PMID: 32323720 DOI: 10.1093/pubmed/fdaa043] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 12/01/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Lebanon, an Eastern Mediterranean country, suffers a large burden of injury as a consequence of conflict and war, political instability, and the lack of policies and safety regulations. This article aims to systematically map and comprehensively describe the injury research literature in Lebanon and, to identify gaps for future research. METHODS MEDLINE, Embase, Eric and SafetyLit, and the grey literature, including conference proceedings, theses and dissertations, government and media reports, were searched without any date or language limits. Data were extracted from 467 documents using REDCap. RESULTS War-related injuries were the most prevalent type of injury in Lebanon, followed by homicide and other forms of violence. While existing literature targeted vulnerable and at-risk populations, the vast majority focused solely on reporting the prevalence of injuries and associated risk factors. There are considerable gaps in the literature dealing with the integration of preventive programs and interventions across all populations. CONCLUSIONS Lebanon, historically and currently, experiences a high number of injuries from many different external causes. To date, efforts have focused on reporting the prevalence of injuries and making recommendations, rather than implementing and evaluating interventions and programs to inform policies. Future injury related work should prioritize interventions and prevention programs.
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Affiliation(s)
- Samar Al-Hajj
- Health Management and Policy Department, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Colleen Pawliuk
- BC Children's Hospital Research Institute, Vancouver, BC V6H3V4, Canada
| | - Jennifer Smith
- BC Injury Research and Prevention Unit, BC Children's Hospital Research Institute, Vancouver, BC V6H3V4, Canada
| | - Alex Zheng
- BC Injury Research and Prevention Unit, BC Children's Hospital Research Institute, Vancouver, BC V6H3V4, Canada
| | - Ian Pike
- BC Children's Hospital Research Institute, Vancouver, BC V6H3V4, Canada.,BC Injury Research and Prevention Unit, BC Children's Hospital Research Institute, Vancouver, BC V6H3V4, Canada.,Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC V6H3V4, Canada
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Maddah D, Saab Y, Safadi H, Abi Farraj N, Hassan Z, Turner S, Echeverri L, Alami NH, Kababian-Khasholian T, Salameh P. The first life skills intervention to enhance well-being amongst university students in the Arab world: 'Khotwa' pilot study. Health Psychol Open 2021; 8:20551029211016955. [PMID: 34188948 PMCID: PMC8212383 DOI: 10.1177/20551029211016955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Although Life Skills programs showed to improve the psychological and physical
wellbeing of individuals, little attention has been paid, worldwide and in the
Arab countries in specific to implementing life skills intervention for
university students. In this study, we tested the effectiveness of a life skills
based health promotion intervention KHOTWA (STEP) in enhancing the wellbeing of
university students in Lebanon, a country that faces economic and political
instability. This is a quasi-experimental study, with pre and post-test,
intervention-control design. Each group was formed of 78 participants studying
in a private university in Lebanon. Mixed design was used to address the process
and outcomes objectives of the intervention. The program was carried online due
to COVID-19 pandemic. Significant differences were observed between the
intervention and the control groups for life skills, dietary habits and mental
health scores at the 3-month follow-up. For the intervention group, a
significant increase was observed in the mean score of each of the following
Life Skills subscales: self-care (p = 0.001), work and study
(p = 0.013), career and education planning
(p = 0.011) and looking forward/goal settings
(p < 0.001). Students also achieved a healthier eating
habit compared to those in the control group by decreasing their consumption of
processed food. There was no significant effect in terms of body mass index
(p = 0.827). Also, there was a significant change in the
mental health status (p = 0.012) only in the intervention group
as its mean score decreased after 3 months of the intervention implementation.
This intervention enhances the mental health and promotes healthy habits leading
consequently to a better quality of life and more productivity amongst
university students. Therefore, such interventions should be replicated in other
similar context to improve university students’ well-being.
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Affiliation(s)
| | | | | | | | | | | | | | - Nael H Alami
- Modern University for Business and Science, Lebanon
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Abstract
The coronavirus disease 2019 pandemic (COVID-19) has an important direct and indirect impact on both physical and mental health. We aim to describe the impact of an emergency state period due to COVID-19 on psychiatric emergency department (ED) visits. We conducted a retrospective observational study analysing all emergency visits occurring at a metropolitan psychiatric ED between March 19th and May 2nd 2019 and 2020 (the beginning/end date of the emergency state which Portugal was under due to COVID-19). Data regarding age, sex, diagnoses, admission date, discharge destiny and status were collected. Diagnoses were classified using the International Classification of Diseases version 9, Clinical Modification (ICD-9-CM). There was a 52·2% decrease on the number of psychiatric emergency visits during the emergency state period (n2020 = 780 vs n2019 = 1633 episodes). The decrease on psychiatric ED visits was greater in the female sex and in the younger age groups. Episodes with a primary diagnosis of Mood disorders lead the decrease on psychiatric ED visits with 68·3% less episodes. Schizophrenia and other psychotic disorders was the diagnosis group with the smaller decline (9·8% decrease). COVID-19 emergency state period had an important impact on the number and characteristics of psychiatric ED visits, reinforcing the great indirect effects of COVID-19 on mental health.
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Haddad C, Salameh P, Sacre H, Clément JP, Calvet B. General description of cognitive deficits in schizophrenia and assessment tools in Lebanon: A scoping review. SCHIZOPHRENIA RESEARCH-COGNITION 2021; 25:100199. [PMID: 34094889 PMCID: PMC8163972 DOI: 10.1016/j.scog.2021.100199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 11/19/2022]
Abstract
Many cognitive functions are affected in schizophrenia patients, particularly memory, attention, motor skills, executive function, and social cognition. Cognitive assessment is one of the best indicators of the functional and social prognosis of schizophrenic patients. In Lebanon, no study has yet examined the assessment of cognitive functions in patients with neurological or psychiatric diseases. This review aims to provide an overview of the cognitive profiles of schizophrenia and describe the different cognitive tests used in Lebanon. The MEDLINE/PubMed database was used to conduct a literature review covering all studies related to cognition in psychosis patients from 1990 until March 2021. This screening resulted in 97 articles focused on cognition in psychiatric patients or cognitive tests in schizophrenia and required an in-depth analysis. The majority of measures developed to evaluate cognition in patients with schizophrenia were from Western countries, most of which are long and complex and may require several hours to administer. The number of neuropsychological tests available in Arab countries is unknown, although it is likely to be limited compared to what is available in Western countries. In Lebanon, some neuropsychological batteries have been locally used to assess cognition without being translated and validated to be adapted to the Lebanese sociocultural context. Clinicians in Lebanon underestimate the extent of cognitive impairment in schizophrenia patients as they have limited options, using untranslated tests or using translations that have not been validated. Future studies should target the development and adaptation of instruments that predict and measure cognition and functional ability. Many cognitive functions are generally impaired in patients with schizophrenia The number of neuropsychological tests available in Arab countries is unknown In Lebanon, some neuropsychological batteries have been used to assess cognition without being translated and validated Few studies conducted in Lebanon have used neurocognitive tests among schizophrenia.
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Affiliation(s)
- Chadia Haddad
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
- Pôle Universitaire de Psychiatrie de l'Adulte, de l'Agée et d'Addictologie, Centre Hospitalier Esquirol, 87000 Limoges, France
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Corresponding author at: Psychiatric Hospital of the Cross, P.O. Box 60096, Jall-Eddib, Lebanon.
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- University of Nicosia Medical School, Nicosia, Cyprus
| | - Hala Sacre
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
| | - Jean-Pierre Clément
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
- Pôle Universitaire de Psychiatrie de l'Adulte, de l'Agée et d'Addictologie, Centre Hospitalier Esquirol, 87000 Limoges, France
- Centre Mémoire de Ressources et de Recherche du Limousin, Centre Hospitalier Esquirol, 87000 Limoges, France
| | - Benjamin Calvet
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
- Pôle Universitaire de Psychiatrie de l'Adulte, de l'Agée et d'Addictologie, Centre Hospitalier Esquirol, 87000 Limoges, France
- Centre Mémoire de Ressources et de Recherche du Limousin, Centre Hospitalier Esquirol, 87000 Limoges, France
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Bizri M, El Hayek S, Beaini H, Kobeissy F, Talih F. National trauma and substance use disorders: A slippery slope in Lebanon. Subst Abus 2021; 42:264-265. [PMID: 33955819 DOI: 10.1080/08897077.2021.1915919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Lebanon, a small middle-income nation in western Asia, has been crippled by decades of political turmoil and armed conflict. A "quadruple crisis" hit the country over the past years, starting with the protracted humanitarian Syrian refugee crisis, followed by a severe socioeconomic collapse, the global COVID-19 pandemic, and lastly the Beirut port catastrophic blast. With the exposure to repetitive traumatic events and associated organic brain injury, the Lebanese population has become at a higher risk of addiction, among other psychiatric comorbidities. With the scarce statistics about the topic and limited addiction services in the country, collaborative local efforts and international help are urgently needed to fight the upcoming substance use epidemic. Raising awareness, providing adequate training, and securing resources for the management of both addiction and trauma are of utmost importance.
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Affiliation(s)
- Maya Bizri
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
| | - Samer El Hayek
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
| | - Hadi Beaini
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Firas Kobeissy
- Program for Neurotrauma, Neuroproteomics, and Biomarkers Research, Department of Emergency Medicine, University of Florida, Gainesville, Florida, USA.,Faculty of Medicine, Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut, Lebanon
| | - Farid Talih
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
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Nawfal O, Nasreddine W, Hmaimess G, Dassouki M, Beydoun A, Toufaili H, Wazne J, Dirani M, Beydoun A. Depression and anxiety in patients from Lebanon with new onset functional seizures. Seizure 2021; 88:22-28. [PMID: 33799136 DOI: 10.1016/j.seizure.2021.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/09/2021] [Accepted: 03/12/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To prospectively compare the frequencies of depression and anxiety in patients with new onset functional seizures versus two age and gender-matched control groups consisting of patients with new onset epileptic seizures and normal individuals. METHODS Consecutive patients, 16 years and older, enrolled in a prospective study for suspected new onset epileptic seizures and diagnosed with documented functional seizures were included. We compared the depression and state and trait anxiety scores using the Beck Depression Inventory (BDI) and the State Trait Anxiety Inventory (STAI) between patients with functional seizures and the other two control groups. RESULTS The 33 patients with functional seizures had significantly higher depression and anxiety scores compared to those with epileptic seizures and normal controls. Twenty patients (60.6%) in the functional seizures group scored in the "depression" range compared to 5/33 (15.2%) in the epileptic seizures and 1/33 (3%) in the control groups. In the functional seizures group, 14/33 (42.4%) had scores in the "state anxiety" range compared to 6/33 (18.2%) and 2/33 (6.1%) in the epileptic seizures and normal control groups, respectively. Similarly, 15/33 (51.5%) of patients in the functional seizures group had scores in the "trait anxiety" range compared to 4/33 (12.1%) and 1/33 (3%) in the epileptic seizures and normal control groups, respectively. CONCLUSIONS Our results indicate that patients with new onset functional seizures frequently suffer from depression and anxiety at the time of their initial evaluation. These findings underscore the importance of screening for depression and anxiety in that patient population.
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Affiliation(s)
- Omar Nawfal
- American University of Beirut Medical Center, Lebanon.
| | | | - Ghassan Hmaimess
- Saint George Hospital University Medical Center University of Balamand, Lebanon.
| | | | | | | | | | - Maya Dirani
- American University of Beirut Medical Center, Lebanon.
| | - Ahmad Beydoun
- American University of Beirut Medical Center, Lebanon.
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Karnouk C, Böge K, Lindheimer N, Churbaji D, Abdelmagid S, Mohamad S, Hahn E, Bajbouj M. Development of a culturally sensitive Arabic version of the Mini International Neuropsychiatric Interview (M.I.N.I.-AR) and validation of the depression module. Int J Ment Health Syst 2021; 15:24. [PMID: 33736659 PMCID: PMC7977598 DOI: 10.1186/s13033-021-00447-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/23/2021] [Indexed: 11/10/2022] Open
Abstract
Background Arabic represents one of the most frequently spoken languages worldwide, especially among refugee populations. There is a pressing need for specialized diagnostic tools corresponding to the DSM-5 criteria in Modern Standard Arabic, which can be administered on Arabic speakers in the West and Arab region alike. Objectives To develop and validate the culturally-adapted version of the most recent M.I.N.I. 7.0.2 into Modern Standard Arabic—a form of Arabic commonly used across all Arab countries. Methods 102 participants were recruited between April 2019 to March 2020 at the Charité - Universitätsmedizin in Berlin. Symptoms were assessed with Arabic versions of rater-based and self-rated measures, including Mini International Neuropsychiatric Interview (M.I.N.I.), Patient Health Questionnaire (PHQ-9), and Harvard Trauma Questionnaire (HTQ). Arabic-speaking psychiatrists saw participants for diagnostic assessment. Results Cohen’s kappa (κ) values were moderate for major depression, and slight for post-traumatic stress disorder, as well as generalized anxiety disorder. Moreover, kappa values indicated moderate agreement between M.I.N.I.-AR and PHQ-9 for depression, as well as HTQ for post-traumatic stress disorder, respectively. Conclusion The translated and culturally adapted version of the M.I.N.I. addresses an existing need for a reliable, efficient, and effective comprehensive diagnostic tool using the most recent DSM-5 criteria in Modern Standard Arabic (MSA). Based on the obtained results, only a validation of the depression module (Module A) of the M.I.N.I-AR was possible. Study outcomes also show evidence for the validation of Module H covering Post-Traumatic Stress Disorder. Potential valuable contributions can be extended to this translation and validation. Supplementary Information The online version contains supplementary material available at 10.1186/s13033-021-00447-1.
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Affiliation(s)
- Carine Karnouk
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Kerem Böge
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Nico Lindheimer
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Dana Churbaji
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | | | - Sara Mohamad
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Eric Hahn
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Malek Bajbouj
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany.
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Heim E, Ramia JA, Hana RA, Burchert S, Carswell K, Cornelisz I, Cuijpers P, El Chammay R, Noun P, van Klaveren C, van Ommeren M, Zoghbi E, van't Hof E. Step-by-step: Feasibility randomised controlled trial of a mobile-based intervention for depression among populations affected by adversity in Lebanon. Internet Interv 2021; 24:100380. [PMID: 33747798 PMCID: PMC7967003 DOI: 10.1016/j.invent.2021.100380] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/16/2021] [Accepted: 02/22/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND E-mental health interventions may help to bridge the mental health treatment gap. Evidence on their effectiveness is compelling in high-income countries. Not enough evidence has been generated on their use with communities affected by adversity in low- and middle-income countries. The World Health Organization (WHO), the National Mental Health Programme (NMMP) at Ministry of Public Health (MoPH) in Lebanon and other partners have adapted a WHO intervention called Step-by-Step for use with Lebanese and displaced people living in Lebanon. Step-by-Step is a minimally guided, internet-based intervention for adults with depression. In this study, a feasibility randomised controlled trial (RCT) and a qualitative process evaluation were conducted to explore the feasibility and the acceptability of the research methods, and the intervention, in preparation for two fully powered trials to assess the effectiveness and cost-effectiveness of Step-by-Step in Lebanon. METHOD Participants were recruited through social media. Inclusion criteria were: being able to understand and speak Arabic or English; access to an internet connected device; aged over 18; living in Lebanon; scores above cut-off on the Patient Health Questionnaire and the WHO Disability Assessment Schedule 2.0. Participants were randomly assigned to the intervention or enhanced care as usual. They completed post-assessments eight weeks after baseline, and follow-up assessments another three months later. Primary outcomes were depression and level of functioning, secondary outcomes were anxiety, post-traumatic stress, and well-being. Qualitative interviews were conducted to evaluate the feasibility and acceptability of the research procedures and the intervention. RESULTS A total of N = 138 participants, including 33 Syrians, were recruited and randomised into two equal groups. The dropout rate was higher in the control group (73% post- and 82% follow-up assessment) than in the intervention group (63% post- and 72% follow-up assessment). The intervention was perceived as relevant, acceptable and beneficial to those who completed it. Suggestions were made to further adapt the content and to make the intervention more engaging. Statistical analyses were conducted despite the small sample size. Complete cases analysis showed a statistically significant symptom reduction in depression, anxiety, disability, and post-traumatic stress, and statistically significant improvement in well-being and functioning. Intention-to-treat analysis revealed non-significant effects. CONCLUSION The research design, methods and procedures are feasible and acceptable in the context of Lebanon and can be applied in the RCTs. Preliminary findings suggest that Step-by-Step may be effective in reducing symptoms of depression and anxiety and improving functioning and well-being.
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Affiliation(s)
- Eva Heim
- Department of Psychology, University of Zurich, Switzerland,Corresponding author at: University of Zurich, Department of Psychology, Binzmuehlestrasse 14/17, 8050 Zurich, Switzerland.
| | - Jinane Abi Ramia
- National Mental Health Programme, Ministry of Public Health, Beirut, Lebanon,Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Racha Abi Hana
- National Mental Health Programme, Ministry of Public Health, Beirut, Lebanon,Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Sebastian Burchert
- Department of Education and Psychology, Freie Universität Berlin, Germany
| | - Kenneth Carswell
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Ilja Cornelisz
- Amsterdam Center for Learning Analytics, Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Rabih El Chammay
- National Mental Health Programme, Ministry of Public Health, Beirut, Lebanon,Psychiatry Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Philip Noun
- National Mental Health Programme, Ministry of Public Health, Beirut, Lebanon
| | - Chris van Klaveren
- Amsterdam Center for Learning Analytics, Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Mark van Ommeren
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Edwina Zoghbi
- Country Office for Lebanon, World Health Organization, Beirut, Lebanon
| | - Edith van't Hof
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
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Dagher M, Farchakh Y, Barbar S, Haddad C, Akel M, Hallit S, Obeid S. Association between problematic social media use and memory performance in a sample of Lebanese adults: the mediating effect of anxiety, depression, stress and insomnia. Head Face Med 2021; 17:6. [PMID: 33622360 PMCID: PMC7901207 DOI: 10.1186/s13005-021-00260-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 02/16/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Psychological factors such as depression, anxiety, stress and insomnia and problematic social media use are able to alter our memories and might have an impact on memory function and retrieval. More studies are needed to better understand the relationship between memory performance and mental health disorders, especially the ones that could be related to problematic social media use. The objective of this study was to evaluate any association between problematic social media use, depression, anxiety, stress, and insomnia vs memory performance among a representative sample of Lebanese people. METHODS This cross-sectional study, conducted between January and May 2019, enrolled 466 community dwelling participants using a proportionate random sample from all Lebanese governorates. The questionnaire consisted of the following measures: the Memory Awareness Rating Scale (MARS) to assesses views of memory performance, the problematic social media use scale to measure the degree of addiction to social media, the Hamilton depression rating scale and Hamilton anxiety scale to assess depression and anxiety respectively, the Beirut Distress Scale to assess stress and the Lebanese Insomnia sale to assess insomnia. The data analysis was performed using the SPSS software version 25. A linear regression was conducted, taking the memory performance scale as the dependent variable. A mediation analysis was performed to test the effect of problematic social media use on memory performance mediated by depression, anxiety, stress and insomnia. RESULTS Higher problematic social media use (Beta = - 0.21) and higher anxiety (Beta = - 0.25) were significantly associated with lower memory performance. The association between problematic social media use and memory performance was partially mediated by anxiety (21.19%) but not depression, stress or insomnia. CONCLUSION Concerning problematic social media use, a clear correlation was demonstrated in this study linking it to lower memory performances. Future studies should evaluate the possible mechanisms and methods for effective awareness especially towards the younger generation.
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Affiliation(s)
- Maya Dagher
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Youssef Farchakh
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Sam Barbar
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Chadia Haddad
- Univ. Limoges, UMR 1094, Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, GEIST, 87000, Limoges, France
- Research and Psychology Departments, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Marwan Akel
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie-Liban, Building 560, Street 8, Biakout, Beirut, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie-Liban, Building 560, Street 8, Biakout, Beirut, Lebanon.
| | - Sahar Obeid
- Research and Psychology Departments, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie-Liban, Building 560, Street 8, Biakout, Beirut, Lebanon.
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
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40
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van 't Hof E, Heim E, Abi Ramia J, Burchert S, Cornelisz I, Cuijpers P, El Chammay R, Harper Shehadeh M, Noun P, Smit F, van Klaveren C, van Ommeren M, Zoghbi E, Carswell K. Evaluating the Effectiveness of an E-Mental Health Intervention for People Living in Lebanon: Protocol for Two Randomized Controlled Trials. JMIR Res Protoc 2021; 10:e21585. [PMID: 33507158 PMCID: PMC7878105 DOI: 10.2196/21585] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/31/2020] [Accepted: 11/10/2020] [Indexed: 12/12/2022] Open
Abstract
Background The lack of availability of evidence-based services for people exposed to adversity globally has led to the development of psychological interventions with features that will likely make them more scalable. The evidence for the efficacy of e-mental health from high-income countries is compelling, and the use of these interventions could be a way to increase the coverage of evidence-based psychological interventions in low- and middle-income countries. Step-by-Step is a brief (5-session) intervention proposed by the World Health Organization as an innovative approach to reducing the suffering and disability associated with depression. Objective This study aims to evaluate the effectiveness and cost-effectiveness of a locally adapted version of Step-by-Step with Syrian nationals (trial 1) and Lebanese nationals and other populations residing in Lebanon (trial 2). Methods This Step-by-Step trial involves 2 parallel, two-armed, randomized controlled trials comparing the e-intervention Step-by-Step to enhanced care as usual in participants with depressive symptoms and impaired functioning. The randomized controlled trials are designed and powered to detect effectiveness in 2 populations: Syrians in Lebanon (n=568) and other people residing in Lebanon (n=568; Lebanese nationals and other populations resident in Lebanon). The primary outcomes are depressive symptomatology (measured with the Patient Health Questionnaire-9) and functioning (measured with the World Health Organization Disability Assessment Scale 2.0). Secondary outcomes include anxiety symptoms, posttraumatic stress disorder symptoms, personalized measures of psychosocial problems, subjective well-being, and economic effectiveness. Participants are mainly recruited through online advertising. Additional outreach methods will be used if required, for example through dissemination of information through partner agencies and organizations. They can access the intervention on a computer, tablet, and mobile phone through a hybrid app. Step-by-Step has 5 sessions, and users are guided by trained nonspecialist “e-helpers” providing phone-based or message-based support for around 15 minutes a week. Results The trials were funded in 2018. The study protocol was last verified June 20, 2019 (WHO ERC.0002797) and registered with ClinicalTrials.gov (NCT03720769). The trials started recruitment as of December 9, 2019, and all data collection was completed in December 2020. Conclusions The Step-by-Step trials will provide evidence about the effectiveness of an e-mental health intervention in Lebanon. If the intervention proves to be effective, this will inform future scale-up of this and similar interventions in Lebanon and in other settings across the world. Trial Registration ClinicalTrials.gov NCT03720769; https://clinicaltrials.gov/ct2/show/NCT03720769 International Registered Report Identifier (IRRID) DERR1-10.2196/21585
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Affiliation(s)
- Edith van 't Hof
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Eva Heim
- Department of Psychology Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland
| | - Jinane Abi Ramia
- National Mental Health Programme, Ministry of Public Health of Lebanon, Beirut, Lebanon
| | - Sebastian Burchert
- Department of Education and Psychology, Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Ilja Cornelisz
- Department of Educational and Family Studies, Amsterdam Center for Learning Analytics, Vrije Universiteit, Amsterdam, Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Rabih El Chammay
- National Mental Health Programme, Ministry of Public Health of Lebanon, Beirut, Lebanon
| | - Melissa Harper Shehadeh
- Department of Digital Health and Innovations, World Health Organization, Geneva, Switzerland
| | - Philip Noun
- National Mental Health Programme, Ministry of Public Health of Lebanon, Beirut, Lebanon
| | - Filip Smit
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Chris van Klaveren
- Department of Educational and Family Studies, Amsterdam Center for Learning Analytics, Vrije Universiteit, Amsterdam, Netherlands
| | - Mark van Ommeren
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Edwina Zoghbi
- Country Office for Lebanon, World Health Organization, Beirut, Lebanon
| | - Kenneth Carswell
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
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41
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Naal H, Mahmoud H, Whaibeh E. The potential of telemental health in improving access to mental health services in Lebanon: Analysis of barriers, opportunities, and recommendations. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2020. [DOI: 10.1080/00207411.2020.1863743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Hady Naal
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Hossam Mahmoud
- Cambia Health Solutions, Tufts University School of Medicine, Boston, MA, USA
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42
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The revision of the categories of mood, anxiety and stress-related disorders in the ICD-11: a perspective from the Arab region. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-0017-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The World Health Organization estimates that 75% of patients with mental and substance use disorders in low- and middle-income countries do not have access to the care needed. In the Arab World, approximately 100–140 million people suffer from at least one psychiatric disorder. One main criticism of classification systems has been their lack of cultural sensitivity. The International Classification of Diseases, 11th edition aims to improve clinical utility of psychiatric classification across cultures. Mood, anxiety and stress-related disorders are the most common psychiatric manifestations and the most impacted by cultural factors.
Main body
Relying on rigorous field testing, including in three Arab countries, clinically meaningful changes have been introduced in the International Classification of Diseases 11. These include new disorders such as complex post-traumatic stress disorder and prolonged grief disorder. In classifying mood episodes, the pattern of symptoms over time is emphasized. Disorders associated with anxiety provide the basis for a new grouping separate from obsessive-compulsive-related disorders. Lastly, culture and its impact are incorporated into each diagnostic grouping.
Conclusions
This latest version of the International Classification of Diseases prioritizes addressing gaps in the validity and reliability of psychiatric classification. The methodology adopted in this latest revision is encouraging and opens the way to truly global collaboration on refining psychiatric diagnoses and practice.
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43
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El Hayek S, Bizri M. Beirut blast and mental health in Lebanon: Finding ways out. Asian J Psychiatr 2020; 54:102458. [PMID: 33271737 DOI: 10.1016/j.ajp.2020.102458] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/13/2020] [Accepted: 10/20/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Samer El Hayek
- Department of Psychiatry, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Maya Bizri
- Department of Psychiatry, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
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44
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Arafat SMY, Shoib S, Kar SK, El Hayek S. Psychiatry in Lebanon. Lancet Psychiatry 2020; 7:932. [PMID: 33069308 PMCID: PMC7561311 DOI: 10.1016/s2215-0366(20)30415-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 11/18/2022]
Affiliation(s)
- S M Yasir Arafat
- Department of Psychiatry, Enam Medical College and Hospital, Dhaka 1340, Bangladesh.
| | - Sheikh Shoib
- Department of Psychiatry, Jawahar Lal Nehru Memorial Hospital, Srinagar, India
| | - Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow, India
| | - Samer El Hayek
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
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45
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Kmeid E, Nacouzi M, Hallit S, Rohayem Z. Prevalence of temporomandibular joint disorder in the Lebanese population, and its association with depression, anxiety, and stress. Head Face Med 2020; 16:19. [PMID: 32887633 PMCID: PMC7650519 DOI: 10.1186/s13005-020-00234-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 09/01/2020] [Indexed: 11/30/2022] Open
Abstract
Background The objectives of this study were to study the prevalence of temporomandibular joint disorder (TMD) and its association with anxiety, depression, and stress among the general Lebanese population as well as in a sample of patients recruited from an otolaryngologist clinic. Methods A cross-sectional study was conducted between September 2018 and December 2019, which enrolled 459 participants from all districts of Lebanon (sample 1) and 37 patients from the otolaryngologist clinic at the Eye and Ear Hospital (sample 2). The temporomandibular disorder screening checklist was used to screen for temporomandibular joint disorder. The Fonseca’s anamnestic index was used to assess for temporomandibular joint disorder related signs and symptoms, as well as for symptoms severity. Results The results showed that 19.7% of the general Lebanese population had TMD, from which 55.9% were female. In contrast, 59.5% of patients in the sample recruited from the clinic were found to have TMD. Higher stress, anxiety, and depression scores were associated with higher temporomandibular disorder severity score (B = 0.23; B = 0.10 and B = 0.10 respectively). Patients in the sample recruited from the clinic had higher mean stress (20.75 vs 11.43), anxiety (12.46 vs 5.78), depression (13.24 vs 6.52), and temporomandibular disorder severity scores (59.5% vs 19.7%) than the general population. Conclusion Temporomandibular joint disorder appears to be associated significantly with depression, anxiety, and stress and remains largely underdiagnosed in the general population.
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Affiliation(s)
- Elio Kmeid
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Mansour Nacouzi
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,Department of otorhinolaryngology, Eye and Ear Hospital, Naccache, Lebanon
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon. .,INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie- Liban, Beirut, Lebanon.
| | - Ziad Rohayem
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon. .,Department of otorhinolaryngology, Eye and Ear Hospital, Naccache, Lebanon.
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46
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Abstract
Lebanon is a medium-income country in the Eastern Mediterranean which has seen a surge in interest in mental health over the past two decades following years of stagnation. The mental health needs of the country at primary care level and for severe psychiatric disorders are underserved. Political instability, chronic underfunding and widespread stigma have all contributed to maintaining a traditional model of private clinics affiliated with inpatient and long-stay psychiatric units. A number of initiatives have recently been launched to cater for patients with psychotic disorders and also to offer partial hospitalization for others with mood-related conditions. In parallel, the Ministry of Public Health,with international funding, has been instrumental in its efforts to standardize care at a national level, particularly for early detection and treatment in primary care settings. The priorities of the national mental health programme are consistent with the global trend in shifting services to the community. Hurdles remain, in line with those facing countries with similar socio-demographics and resources. These include limited third-party coverage of mental health,absence of training opportunities in multidisciplinary community settings and some clinicians' reluctance to update their ways of working. Development of a local workforce, familiar with evidence-based models of care and dedicated to providing a patient-centred approach in the least restrictive settings, is essential for consolidating community carein Lebanon. This would be reinforced by (overdue) legislation and implementation of a mental health law.
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Affiliation(s)
- Joseph El-Khoury
- Department of Psychiatry, American University of Beirut Medical Center
| | - Riwa Haidar
- Department of Psychiatry, American University of Beirut Medical Center
| | - Raghid Charara
- Department of Psychiatry, American University of Beirut Medical Center
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47
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Al‐Habeeb A, Altwaijri YA, Al‐Subaie AS, Bilal L, Almeharish A, Sampson NA, Liu H, Kessler RC. Twelve-month treatment of mental disorders in the Saudi National Mental Health Survey. Int J Methods Psychiatr Res 2020; 29:e1832. [PMID: 32519421 PMCID: PMC7507396 DOI: 10.1002/mpr.1832] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 04/12/2020] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES To estimate treatment rates of 12-month mental disorders in the Saudi National Mental Health Survey (SNMHS). METHODS The SNMHS is a face-to-face community epidemiological survey in a nationally representative household sample of citizens ages 15-65 in the Kingdom of Saudi Arabia (KSA) (n = 4,004). The World Health Organization Composite International Diagnostic Interview (CIDI) was used to produce estimates of 12-month prevalence and treatment of common DSM-IV mental disorders. RESULTS About one eighth (13.7%) of respondents with a 12-month DSM-IV/CIDI disorder received 12-month treatment. The highest proportion of treatment occurred in the general medical sector (53.0%). Close to half (45.2%) of patients received treatment rated at least minimally adequate using standard treatment guidelines. Although serious disorders were significantly more likely to be treated (20.2%) than mild or moderate disorders (8.5-10.7%), no association was found between disorder severity and probability of receiving adequate treatment. Sociodemographic correlates were for the most part nonsignificant. CONCLUSIONS A high level of unmet need for treatment of mental disorders exists in KSA. Further analyses of the SNMHS data might provide insights into modifiable barriers to treatment and policy options to address the problem of unmet need for treatment.
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Affiliation(s)
| | - Yasmin A. Altwaijri
- King Salman Center for Disability ResearchRiyadhSaudi Arabia
- Biostatistics, Epidemiology and Scientific Computing DepartmentKing Faisal Specialist Hospital and Research CentreRiyadhSaudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine King Saud UniversityRiyadhSaudi Arabia
| | - Abdullah S. Al‐Subaie
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine King Saud UniversityRiyadhSaudi Arabia
- Edrak Medical CenterRiyadhSaudi Arabia
| | - Lisa Bilal
- King Salman Center for Disability ResearchRiyadhSaudi Arabia
- Biostatistics, Epidemiology and Scientific Computing DepartmentKing Faisal Specialist Hospital and Research CentreRiyadhSaudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine King Saud UniversityRiyadhSaudi Arabia
| | - Amani Almeharish
- Biostatistics, Epidemiology and Scientific Computing DepartmentKing Faisal Specialist Hospital and Research CentreRiyadhSaudi Arabia
| | - Nancy A. Sampson
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
| | - Howard Liu
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
| | - Ronald C. Kessler
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
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48
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Altwaijri YA, Al-Habeeb A, Al-Subaie AS, Bilal L, Al-Desouki M, Shahab MK, Hyder S, Sampson NA, King AJ, Kessler RC. Twelve-month prevalence and severity of mental disorders in the Saudi National Mental Health Survey. Int J Methods Psychiatr Res 2020; 29:e1831. [PMID: 33245602 PMCID: PMC7507007 DOI: 10.1002/mpr.1831] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 04/12/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To estimate 12-month prevalence and severity of mental disorders in the Saudi National Mental Health Survey (SNMHS). METHODS The SNMHS is a face-to-face community epidemiological survey in a nationally representative household sample of citizens aged 15 to 65 in the Kingdom of Saudi Arabia (KSA) (n = 4,004). The World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) was used to estimate 12-month prevalence of common DSM-IV mental disorders. RESULTS Twelve-month prevalence of any DSM-IV/CIDI disorder is 20.2%. Most common are anxiety disorders (12.3%) followed by mood (6.8%), disruptive behavior (5.4%), eating (3.2%), and substance use (1.9%) disorders. The proportion of 12-month cases rated serious (39.0% of all cases) is high across virtually all disorders relative to the proportions found in CIDI surveys in other high-income countries. Younger people have significantly elevated odds of mood and disruptive behavior disorders and serious disorders. Women have significantly elevated odds of anxiety and mood disorders and serious disorders. Previously married people have significantly elevated odds of most disorder classes and serious disorders. CONCLUSIONS Both 12-month prevalence and severity of DSM-IV/CIDI disorders are high in Saudi Arabia compared to other high-income countries that carried out comparable surveys.
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Affiliation(s)
- Yasmin A Altwaijri
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine , King Saud University, Riyadh, Saudi Arabia.,King Salman Center for Disability Research, Riyadh, Saudi Arabia.,Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist, Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Abdulhameed Al-Habeeb
- National Center for Mental Health Promotion, Ministry of Health, Riyadh, Saudi Arabia
| | - Abdullah S Al-Subaie
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine , King Saud University, Riyadh, Saudi Arabia.,Edrak Medical Center, Riyadh, Saudi Arabia
| | - Lisa Bilal
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine , King Saud University, Riyadh, Saudi Arabia.,King Salman Center for Disability Research, Riyadh, Saudi Arabia.,Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist, Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Majid Al-Desouki
- Psychiatry Unit, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Mona K Shahab
- King Salman Center for Disability Research, Riyadh, Saudi Arabia.,Clinical Epidemiology, Leiden University Medical Center; Faculty of Social and Behavioural Sciences, Clinical Psychology Department, Leiden University, Leiden, The Netherlands.,i-psy interculturele psychiatrie, Parnassia Groep, The Hague, The Netherlands
| | - Sanaa Hyder
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine , King Saud University, Riyadh, Saudi Arabia.,King Salman Center for Disability Research, Riyadh, Saudi Arabia.,Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist, Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Nancy A Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Andrew J King
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
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49
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Chatterji S. The Saudi National Mental Health Survey: Filling critical gaps in methodology and data in mental health epidemiology. Int J Methods Psychiatr Res 2020; 29:e1852. [PMID: 32945556 PMCID: PMC7507492 DOI: 10.1002/mpr.1852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 06/02/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- Somnath Chatterji
- Department of Data and Analytics, World Health Organization, Geneva, Switzerland
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50
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Chahine M, Salameh P, Haddad C, Sacre H, Soufia M, Akel M, Obeid S, Hallit R, Hallit S. Suicidal ideation among Lebanese adolescents: scale validation, prevalence and correlates. BMC Psychiatry 2020; 20:304. [PMID: 32539735 PMCID: PMC7296775 DOI: 10.1186/s12888-020-02726-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 06/09/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND In addition to the unstable political situation, Lebanon had experienced a cycle of wars, local armed conflicts, terrorist attacks, and crises (lack of clean water, recurrent power failure, and waste mismanagement, in addition to the growing number of unemployed people, as the number of Syrian refugees has dramatically increased, and led to competition for jobs with locals. All these factors make the Lebanese population prone to mental disorders, particularly suicide, without clear management policies. This study aims to validate the Columbia-Suicide Severity Rating Scale (CSSRS), and determine the prevalence of suicidal ideation and associated factors among a Lebanese nationally representative sample of adolescents from 9th to 12th grades. METHODS Participants were 1810 adolescents who enrolled in this cross-sectional study (January-May 2019), using a proportionate random sample of schools from all Lebanese Mohafazat. The Columbia-Suicide Severity Rating Scale was used to screen for suicidal ideation. RESULTS The results showed that 28.9% had some type of suicidal ideation [95% CI 26.7-31.1%]. The CSSRS items converged on a one-factor solution, accounting for a total of 85.40% of the variance (αCronbach = 0.966). Higher psychological abuse (Beta = 0.041), child physical abuse (Beta = 0.030), alcohol dependence (Beta = 0.062), social fear (Beta = 0.028), victimization/bullying score (Beta = 0.028), impulsivity (Beta = 0.028) and internet addiction (Beta = 0.010) scores were significantly associated with higher suicidal ideation. Same applies to adolescents whose parents are separated compared to living together (Beta = 0.992) and in females compared to males (0.311). On another hand, a higher age (Beta = - 0.182) was significantly associated with lower suicidal ideation. CONCLUSION This study provides insights about suicidal ideation among Lebanese adolescents and related risk factors, such as child psychological and physical abuse, alcohol use disorders, social fear, bullying and victimization, impulsivity, and internet addiction.
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Affiliation(s)
- Melissa Chahine
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- Faculty of Medicine, Lebanese University, Hadat, Lebanon
| | - Chadia Haddad
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
- Université de Limoges, UMR 1094, Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, GEIST, 87000, Limoges, France
| | - Hala Sacre
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Michel Soufia
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
- Faculty of Medicine, Lebanese University, Hadat, Lebanon
| | - Marwan Akel
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Sahar Obeid
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Rabih Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon.
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