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El Zahran T, Hammoud L, Salam R, Salam Y, Kazzi Z, Tamim H, Hitti E. Sex differences among patients with intentional poisoning presenting to the emergency Department at a Tertiary Care Centre in Beirut, Lebanon. Basic Clin Pharmacol Toxicol 2024. [PMID: 38965652 DOI: 10.1111/bcpt.14039] [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: 02/23/2024] [Revised: 05/07/2024] [Accepted: 05/15/2024] [Indexed: 07/06/2024]
Abstract
Poisoning poses a worldwide public health challenge and recent data from Lebanon in 2020 revealed that over half patients presenting with acute toxicological exposure intentionally poisoned themselves, primarily with suspected suicidal intent. This study aims to assess sex disparities in intentional toxicological exposures among patients presenting to the Emergency Department, at a tertiary care centre in Lebanon. This was a secondary analysis of an existing toxicological database, including patients aged 6 years and older admitted due to acute overdose from March 2015 to August 2022. A total of 444 cases of intentional poisoning were analysed, with 302 (68.0%) women. The primary cause of intentional poisoning was suspected suicide in both sexes, significantly more common in women (85.1% versus 65.5%, P < 0.001). Specific agents exposed to patients varied by sex; sedatives/hypnotics/antipsychotics, antihistamines, and melitracen/flupentixol were significantly more prevalent in women (P < 0.001) while men showed higher prevalence for ethanol (P = 0.02), stimulants, street drugs and opioids (P < 0.001). Our study underscores substantial sex differences in intentional poisoning cases in Lebanon. Women exhibited a higher likelihood of exposures to sedatives/hypnotics/antipsychotics, antihistamines and melitracen/flupentixol, while stimulant drugs, ethanol, and opioids were prevalent in men. Developing proper and effective sex-specific measures may mitigate potential physical and psychological consequences.
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Affiliation(s)
- Tharwat El Zahran
- Department of Emergency Medicine, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Lina Hammoud
- Department of Emergency Medicine, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Rana Salam
- Department of Emergency Medicine, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Youssef Salam
- Department of Emergency Medicine, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Ziad Kazzi
- Department of Emergency Medicine, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Hani Tamim
- Department of Internal Medicine, American University of Beirut Medical Centre, Beirut, Lebanon
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Eveline Hitti
- Department of Emergency Medicine, American University of Beirut Medical Centre, Beirut, Lebanon
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Karam JM, Bitar Z, Malaeb D, Fekih-Romdhane F, Hallit S, Obeid S. Perceived social competencies as moderators: examining the relationship between psychological distress and aggression, hostility, and anger in Lebanese adults. BMC Psychol 2024; 12:212. [PMID: 38632648 PMCID: PMC11025173 DOI: 10.1186/s40359-024-01694-w] [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: 11/03/2023] [Accepted: 03/28/2024] [Indexed: 04/19/2024] Open
Abstract
INTRODUCTION The majority of people experience anger at some point in their lives when confronted with unpleasant situations. In social settings, anger can lead to aggressive and hostile in the absence of adequate social competences. Our study aims to examine the moderating role of perceived social competences in the association between psychological distress and anger expression (trait anger, hostility, physical aggression, and verbal aggression) among a sample of Lebanese adults. METHODS 403 participants above 18 years (the mean age was 24.56 ± 8.46) were enrolled in the cross-sectional study with 73% female participants. The candidates were asked to complete a structured questionnaire including the following scales: (1) Buss-Perry Aggression Questionnaire-Short Form (BPAQ-SF), (2) the Depression Anxiety Stress Scale (DASS-8), (3) Perceived Social Competencies (PSC), and (4) The De Jong-Gierveld Loneliness Scale. RESULTS The interaction psychological distress by perceived social competence was not significantly associated with physical aggression, verbal aggression, or hostility but was significantly associated with anger. After adjusting the results over variables that showed a p <.25 in the bivariate analysis, this association was significant at low (Beta = 0.24; p <.001), moderate (Beta = 0.20; p <.001) and high (Beta = 0.16; p <.001) levels of perceived social competencies, where higher psychological distress was significantly associated with more anger. On another note, with higher perceived social competence, we find a decrease in levels of psychological distress in our sample. CONCLUSION This study provided evidence that perceived social competencies such as communication skills, empathy and prosocial behaviors act as moderators in the association between psychological distress and anger. In future works, investigating and building advanced program in order to develop social competences of individuals might prove important. It is crucial to implement such strategies and projects in schools: this educational setting could be fruitful in a way that social skills could be instilled during childhood and anger-aggressive behaviors could be managed throughout adulthood.
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Affiliation(s)
| | - Zeinab Bitar
- Rennes University, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000, Rennes, France
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, 2010, Manouba, 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, Jounieh, P.O. Box 446, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
| | - Sahar Obeid
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon.
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Nehme A, Moussa S, Fekih-Romdhane F, Hallit S, Obeid S, Haddad G. The mediating role of depression in the association between perceived financial wellbeing and somatization: a study in the context of Lebanon's financial crisis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-15. [PMID: 38598249 DOI: 10.1080/09603123.2024.2341132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 04/05/2024] [Indexed: 04/11/2024]
Abstract
The objectives of this study were to examine the association between financial wellbeing and somatization, in addition to the mediating effect of anxiety, depression and stress. To test such hypotheses, a cross-sectional study was carried out between September and October 2021; 403 participants (264 females; age = 32.76 ± 13.24 years) were recruited. Depression mediated the association between financial wellbeing and somatization. A worse financial wellbeing was significantly associated with more depression, which was associated with more somatization. Moreover, a worse financial wellbeing was significantly and directly associated with more somatization. Our study adds to the narrow body of research revolving around the relationship between financial wellbeing and somatization in Lebanese adults. Understanding that the effects of, depression are aggravated in a country such as Lebanon would help establish more preventative guidelines and mental health awareness campaigns. Identifying the correlates of somatization can also be translated into improved interventions.
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Affiliation(s)
- Antonio Nehme
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Sara Moussa
- Faculty of Medicine, University of Balamand, Koura, Lebanon
| | - Feten Fekih-Romdhane
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi Hospital, Manouba, Tunisia
| | - 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
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Georges Haddad
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
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Kaddoura R, Elbejjani M, Tamim H, Mahfoud ZR, Salameh P, Mirza F, Charafeddine L. Building a maternal and child cohort amidst Lebanon's socioeconomic collapse: preliminary results and navigating research challenges. Popul Health Metr 2024; 22:5. [PMID: 38528603 DOI: 10.1186/s12963-024-00325-1] [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: 10/02/2023] [Accepted: 03/05/2024] [Indexed: 03/27/2024] Open
Abstract
The impact of conflict and crisis on maternal and child health underscores the need for reliable research in vulnerable populations. Lebanon, amidst ongoing economic collapse, political instability, and healthcare system strain, offers a case study for exploring these impacts, particularly on preterm babies and their development. This study aims to assess the feasibility of establishing a prospective cohort of mothers and their full-term and preterm babies in Lebanon, examining the association between social determinants, preterm birth, and developmental outcomes amidst the nation's multifaceted crises. The planned cohort involves 50 full-term and 50 preterm mother-baby pairs recruited at birth and followed up to 9-12 months post-birth. Data collection spans social determinants, perceived stress, social support, quality of life, and developmental assessments. Challenges in recruitment, follow-up, and data collection in the context of Lebanon's socio-political and economic turmoil are evaluated, alongside ethical considerations for research in vulnerable populations. Preliminary findings highlight substantial recruitment and follow-up challenges, notably due to population mobility, economic instability, and healthcare access issues. Despite these obstacles, 113 mother-baby pairs have been recruited. Early analysis reveals significant stress and reduced quality of life among mothers, particularly those with preterm infants, against a backdrop of declining birth rates and healthcare worker exodus. Conducting research in crisis settings like Lebanon presents unique methodological and ethical challenges but remains crucial for understanding and improving health outcomes in vulnerable populations. The study underscores the importance of adaptable research designs and ethical diligence in crisis research, highlighting the need for interventions tailored to these contexts. Establishing a mother and child cohort in Lebanon's crisis-ridden setting is faced with many challenges but is essential for guiding future interventions. Research in such contexts is needed to address health disparities and supporting vulnerable populations, emphasizing the need for dedicated funding and innovative research approaches in times of crisis.
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Affiliation(s)
- Rima Kaddoura
- American University of Beirut (AUB), Beirut, Lebanon
| | | | - Hani Tamim
- American University of Beirut (AUB), Beirut, Lebanon
- Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | | | - Pascale Salameh
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- School of Medicine, Lebanese American University, Byblos, Lebanon
- Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, 2417, Nicosia, Cyprus
| | - Fadi Mirza
- Latifa Hospital & Private Practice, Dubai, United Arab Emirates
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Boutros S, Fekih-Romdhane F, Akel M, Hallit S, Obeid S. Path analysis of the role of coping strategies between emotional intelligence and lifestyle habits during COVID-19 lockdown. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-14. [PMID: 38366994 DOI: 10.1080/09603123.2024.2313189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/29/2024] [Indexed: 02/19/2024]
Abstract
The relationship between Emotional Intelligence (EI) and lifestyle choices during the COVID-19 pandemic is obscure and not very well understood. To clarify the mechanisms underlying this relationship, we proposed to test the hypothesis that different coping styles (avoidant and approach) have an indirect effect on the association between EI and many types of lifestyle habits. A cross-sectional study was conducted between December 2020 and January 2021. Our target sample consisted of Lebanese adults from the general population. In path analysis, approach coping mediated the association between EI and different lifestyle habits (rest, nutrition, general physical conditions), but not exercise. Furthermore, avoidant coping did mediate the association between EI and general physical conditions, but not between EI and other lifestyle choices (namely rest, exercise, and nutrition). To conclude, individuals with high EI, and that are users of approach coping strategies to deal with stressors, have increased rest time, healthy nutrition and general physical conditions. This cautiously implies that fostering approach coping may help improve the positive effects of EI on healthy lifestyles during crises such as this pandemic.
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Affiliation(s)
- Sarah Boutros
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Feten Fekih-Romdhane
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry Ibn Omrane, Razi Hospital, Tunis, Tunisia
| | - Marwan Akel
- International Pharmaceutical Federation, The Hague, The Netherlands, Europe
| | - 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
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University (LAU), Jbeil, Lebanon
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Nehme A, Moussa S, Fekih-Romdhane F, Yakın E, Hallit S, Obeid S, Haddad G. Expressive suppression moderates the relationship between PTSD from COVID-19 and somatization and validation of the Arabic version of Patient Health Questionnaire-15 (PHQ-15). PLoS One 2024; 19:e0293081. [PMID: 38271356 PMCID: PMC10810523 DOI: 10.1371/journal.pone.0293081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 10/01/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Lebanese adults have been crippled for years by several crises, including the lately COVID-19 pandemic. These massive civilian traumas have increased the risk of post-traumatic stress disorder (PTSD) in this population. Extensive literature pointed to the association between PTSD and somatization; however, the nature of this relationship remains unknown. We sought to contribute further to work in this area by testing the moderating role of emotion regulation in the relationship between COVID-19- related PTSD and somatization. As a secondary objective, we aimed to examine the psychometric properties of an Arabic translation of the somatization measure Patient Health Questionnaire-15 (PHQ-15) in terms of factorial validity and internal consistency before its use in the present study. METHODS This cross-sectional study was conducted between September and October 2021. A total of 403 Lebanese adults residing in Lebanon were recruited. Eligible participants received an online link to the survey. The Patient Health Questionnaire-15 was used to assess somatization, PTSD Checklist-Civilian Version for PTSD and Emotion Regulation Questionnaire for emotion regulation. RESULTS The results of the exploratory factor analysis (EFA) revealed a three-factor solution explaining 48.79% of the common variance. Confirmatory Factor Analysis results of the three-factor model obtained in the EFA indicated a good fit with a significant CFI of 0.98, TLI 0.98 and a GFI of .97, a RMSEA of .04 [90% CI .01, .06]. Higher PTSD symptoms were associated with somatization. In addition, we found that one specific ER component, i.e. expressive suppression, significantly moderated the relationship between PTSD from the COVID pandemic and somatization. In particular, the interaction PTSD from the COVID-19 pandemic by expressive suppression was significantly associated with somatization; at low, medium and high levels of expressive suppression, higher PTSD from the COVID-19 pandemic was significantly associated with higher somatization scores. As for our secondary objective, findings revealed that the Arabic version of the PHQ-15 exhibited good psychometric properties. In particular, the scale yielded a three-factor structure, and good internal consistency (Cronbach's alpha = 0.87). CONCLUSION The moderating role of expressive suppression on the link between PTSD and somatization presents a novel finding in the field of trauma. Additionally, making a psychometrically sound Arabic version of the PHQ-15 available is a valuable addition to the literature.
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Affiliation(s)
- Antonio Nehme
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Sara Moussa
- Faculty of Medicine, University of Balamand, Koura, Lebanon
| | - Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi Hospital, Manouba, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Ecem Yakın
- Centre d’Études et de Recherches en Psychopathologie et Psychologie de la Santé, Université de Toulouse-Jean Jaurès, UT2J, Toulouse, 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
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Georges Haddad
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
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Al Boukhary R, Hallit R, Postigo A, Malaeb D, Dabbous M, Sakr F, El Khatib S, Fekih-Romdhane F, Hallit S, Obeid S. The effect of gratitude on death anxiety is fully mediated by optimism in Lebanese adults following the 2023 earthquake. BMC Psychol 2024; 12:2. [PMID: 38167169 PMCID: PMC10759689 DOI: 10.1186/s40359-023-01509-4] [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: 10/13/2023] [Accepted: 12/23/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Exploring the levels of death anxiety and factors that can undermine its impact are crucial for the Lebanese nationals. Even though studies have shown various relationships between death anxiety and several factors, very few to no research has been done to show the relationship of death anxiety, gratitude and optimism. Therefore, the objectives of our study were to assess the mediating role of optimism in the association between gratitude and death anxiety, along with investigating the validity and reliability of the Arabic version of the Death Anxiety Scale. METHODS A one-time-point online survey was conducted among Arabic-speaking community adults from the general population of Lebanon (N = 601; mean age 29.91 ± 12.61; 62.7% females). The following scales were used: Scale of Death Anxiety, Optimism-Pessimism Short Scale-2, and Gratitude Questionnaire-Six-Item Form. RESULTS The results of the mediation analysis showed that optimism fully mediated the association between gratitude and death anxiety. Higher gratitude was significantly associated with more optimism; higher optimism was significantly associated with less death anxiety. Finally, higher gratitude was not directly associated with death anxiety. CONCLUSION Our study reveals the relationship between gratitude and death anxiety and the mediating role of optimism. Our results need to be confirmed in a longitudinal study, but point to the importance of assessing optimism in prevention and management of persons with death anxiety.
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Affiliation(s)
- Reem Al Boukhary
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, P.O. Box 446, Lebanon
| | - Rabih Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, P.O. Box 446, Lebanon
- Department of Infectious Disease, Bellevue Medical Center, Mansourieh, Lebanon
- Department of Infectious Disease, Notre Dame des Secours, University Hospital Center, Byblos, Postal code 3, Lebanon
| | - Alvaro Postigo
- Department of Psychology, University of Oviedo, Oviedo, Spain
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Mariam Dabbous
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Fouad Sakr
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- École Doctorale Sciences de la Vie et de la Santé, Université Paris-Est Créteil, Institut Mondor de Recherche Biomédicale, Créteil, France
| | - Sami El Khatib
- Department of Biomedical Sciences, School of Arts and Sciences, Lebanese International University, Bekaa, Lebanon
- Center for Applied Mathematics and Bioinformatics (CAMB), Gulf University for Science and Technology (GUST), Hawally, Kuwait
| | - Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of psychiatry "Ibn Omrane", Razi hospital, 2010, Manouba, 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, Jounieh, P.O. Box 446, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon.
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Fekih-Romdhane F, Fawaz M, Hallit R, Sawma T, Obeid S, Hallit S. Psychometric properties of an Arabic translation of the 10-item Connor-Davidson resilience scale (CD-RISC-10), the 8- and 10-item post-traumatic growth inventory-short form (PTGI-SF) scales. PLoS One 2024; 19:e0293079. [PMID: 38166051 PMCID: PMC10760825 DOI: 10.1371/journal.pone.0293079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/04/2023] [Indexed: 01/04/2024] Open
Abstract
BACKGROUND Given their clinical significance and impact on stress response and their potential malleability, resilience and posttraumatic growth (PTG) should receive greater attention as relevant constructs in clinical and research practice in the Arab context. We aimed through the present study to test the psychometric properties of Arabic translations of the 10-item Connor-Davidson Resilience scale (CD-RISC-10), the 10-item and the 8-item Post-Traumatic Growth Inventory-Short Form (PTGI-SF) in a sample of Lebanese adults from the general population. METHODS Three hundred eighty-seven Arabic-speaking participants (mean age = 26.17; 58.4% females) responded to a self-report web-based questionnaire. The forward and backward translation method was applied with the approval of the original developers of the scales. RESULTS Confirmatory factor analysis indicated that fit of the one-factor model was acceptable, and all indices suggested that configural, metric, and scalar invariance was supported across gender for all the three scales. The CD-RISC-10, the 10-item and the 8-item PTGI-SF yielded a good internal consistency, with a McDonald's ω of .89, .95, and .93, respectively. Higher resilience and higher PTG were significantly and positively associated with greater cognitive reappraisal and lower emotion suppression, supporting convergent validity. CONCLUSION We preliminarily suggest that these Arabic instruments are appropriate for use in Lebanese community adults to assess different positive responses after life crises, identify people with lack or low levels of resilience and growth who might need intervention, and monitor their response to therapy. Further cross-cultural validations should seek to extend their use in broader Arabic-speaking populations and settings.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi Hospital, Manouba, Tunisia
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Mirna Fawaz
- Faculty of Health Sciences Beirut Arab University, Tareek Al Jadida, Afeef Al Tiba, Beirut, Lebanon
| | - Rabih Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Department of Infectious Disease, Bellevue Medical Center, Mansourieh, Lebanon
- Department of Infectious Disease, Notre Dame des Secours University Hospital, Byblos, Lebanon
| | - Toni Sawma
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, 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, Jounieh, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
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Hammoudi Halat D, Hallit S, Younes S, AlFikany M, Khaled S, Krayem M, El Khatib S, Rahal M. Exploring the effects of health behaviors and mental health on students' academic achievement: a cross-sectional study on lebanese university students. BMC Public Health 2023; 23:1228. [PMID: 37365573 DOI: 10.1186/s12889-023-16184-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/23/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND High academic achievement, an important determinant of future success, is known to be influenced by many factors including dietary behavior, lifestyle and mental health, among others. The objectives of the current study were to explore university students' nutritive habits, daily lifestyle, and mental status, and to scrutinize the associations between these factors and students' academic achievement. METHODS A cross-sectional study was conducted among students of a private Lebanese university, using an electronic survey. Diet, eating habits, physical activity, sleep, and smoking were evaluated, and mental health was assessed using a validated Arabic version of the combined Depression, Anxiety, Stress Score (DASS-8). Academic achievement was measured using the Subjective Academic Achievement Scale (SAAS). RESULTS A total of 1677 students participated in the questionnaire. The results of a linear regression taking the SAAS score as the dependent variable, showed that students who have a non-scientific versus scientific major (Beta = 0.53), and having breakfast ≥ 4 days per week compared to less than 2 days (Beta = 0.28) were significantly associated with higher SAAS scores. More psychological distress (Beta = - 0.06) and a higher number of days of eating out (Beta = - 0.07) were significantly associated with lower SAAS scores. CONCLUSIONS This is the first investigation on a Lebanese university students' academic success in relation to lifestyle and mental profiles. Better academic achievement was demonstrated by students having healthier dietary and lifestyle habits, as well as less distressing mental status. Such results, in light of the compounded and unprecedented crises with which Lebanon has been assailed, suggest the need to focus on promoting healthy habits among students in higher education as a possible driver of better academic success.
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Affiliation(s)
- Dalal Hammoudi Halat
- Academic Quality Department, QU Health, Qatar University, Doha, Qatar
- School of Pharmacy, Lebanese International University, Bekaa, 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.
- Department of Research, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
| | - Samar Younes
- School of Pharmacy, Lebanese International University, Bekaa, Lebanon
| | - Mira AlFikany
- Department of Biomedical Sciences, School of Arts and Sciences, Lebanese International University, Bekaa, Lebanon
| | - Sanaa Khaled
- Department of Biomedical Sciences, School of Arts and Sciences, Lebanese International University, Bekaa, Lebanon
| | - Maha Krayem
- Department of Biomedical Sciences, School of Arts and Sciences, Lebanese International University, Bekaa, Lebanon
| | - Sami El Khatib
- Department of Biomedical Sciences, School of Arts and Sciences, Lebanese International University, Bekaa, Lebanon
- Center for Applied Mathematics and Bioinformatics (CAMB), Gulf University for Science and Technology (GUST), Hawally, Kuwait
| | - Mohamad Rahal
- School of Pharmacy, Lebanese International University, Bekaa, Lebanon
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Hatem G, Ankouni A, Salhab S, Kteich W, Awada S. Generic drugs use during the COVID-19 pandemic among Lebanese patients using psychotropics: An opportunity for generic drug promotion. JOURNAL OF GENERIC MEDICINES 2023; 19:92-100. [PMID: 38603350 PMCID: PMC9996156 DOI: 10.1177/17411343231162561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
Introduction The Coronavirus disease of 2019 (COVID-19) pandemic has imposed several challenges leading to the shortage of medications due to the disruption of their supply chains. Among others, patients using psychotropics encountered difficulties finding their medication despite the efforts of investing in local production. Encouraging patients to use generic drugs can be an effective strategy to ensure sustainable access to medication. Objectives This study aimed to describe the consumption of psychotropic medications during the COVID-19 pandemic and the willingness together with the reasons for using generic drugs. It also assessed the association between generic drugs and the general characteristics of the patients. Design A cross-sectional study was performed over a period of 4 months (July-October 2021) targeting 128 patients using psychotropic drugs. Results The sample included more women than men with a mean age of 38 years. Antidepressants were the psychotropic medications mostly consumed followed by anti-anxiety medications. Almost 13% of the patients started using psychotropics either through self-prescription or a friend's advice and 73.4% used generic drugs. Fear of dependence, unavailability of the brand drug, and pharmacist's recommendation were the main reported reasons for using generic drugs. Conclusion During the COVID-19 pandemic, the consumption of psychotropics increased due to new prescriptions and self-medication. No differences were noted between using generics and the characteristics of the patients in contrast to previous studies which support the implementation of generic prescription and substitution policies.
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Affiliation(s)
- Georges Hatem
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Ali Ankouni
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Sethrida Salhab
- Faculty of Medicine and Medical Sciences, University of Balamand, El-Koura, Lebanon
| | - Walaa Kteich
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Sanaa Awada
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
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11
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Farah N, Obeid S, Malaeb D, Haddad C, Fekih-Romdhane F, Hallit S. Mediation effect of insomnia symptoms between positive psychotic like experiences and suicidal ideation among Lebanese young adults. BMC Psychiatry 2023; 23:272. [PMID: 37081441 PMCID: PMC10116113 DOI: 10.1186/s12888-023-04778-w] [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: 11/11/2022] [Accepted: 04/12/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Psychotic symptoms reported by healthy individuals in the general population are referred to as psychotic-like experiences (PLEs) and have been proven to increase the risk of suicidal ideation (SI) in these individuals. As it is well established that PLEs and insomnia share a bidirectional association and also that insomnia is linked to SI, we hypothesized that insomnia may represent a mediator underlying the relationship between PLEs and SI. Our aim was to validate this hypothesis among Lebanese young adults. METHODS A total of 3103 young adults (mean age 21.73 ± 3.80 years; 63.6% females) recruited from all Lebanese governorates completed a self-administered online questionnaire. PLEs were assessed using the CAPE-42 scale, SI using the Columbia Suicide Rating Scale, and insomnia using the Insomnia Severity Index). We conducted a mediation analysis using SPSS PROCESS v3.4 model 4 with three pathways. Variables that showed a p < 0.25 in the bivariate analysis were entered in the path analysis. RESULTS A total of 1378 participants (44.4%) had insomnia; 18.8% had SI; 42.5% reported at least one positive PE 'nearly always', and 30.5% reported at least one negative PE with this frequency. The results of the mediation analysis showed that insomnia severity partially mediated the association between positive dimension and SI; higher positive dimension was significantly associated with more insomnia severity, which was, in turn, significantly associated with more SI. Finally, more positive dimension was significantly and directly associated with more SI. CONCLUSION These preliminary findings might encourage the implementation of new preventive measures to reduce SI among PLEs patients. Treating symptoms of insomnia might help reduce the risk of suicide.
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Affiliation(s)
- Nour Farah
- Faculty of Science, Lebanese University, Fanar, Lebanon
| | - Sahar Obeid
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Chadia Haddad
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
- School of Health Sciences, Modern University for Business and Science, Beirut, Lebanon
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
| | - Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi Hospital, 2010, Manouba, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Souheil Hallit
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
- 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.
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12
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McDaid D, Park AL. Making an economic argument for investment in global mental health: The case of conflict-affected refugees and displaced people. Glob Ment Health (Camb) 2023; 10:e10. [PMID: 37854391 PMCID: PMC10579650 DOI: 10.1017/gmh.2023.1] [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: 08/14/2022] [Revised: 12/04/2022] [Accepted: 01/24/2023] [Indexed: 03/06/2023] Open
Abstract
Mental health expenditure accounts for just 2.1% of total domestic governmental health expenditure per capita. There is an economic, as well as moral, imperative to invest more in mental health given the long-term adverse impacts of mental disorders. This paper focuses on how economic evidence can be used to support the case for action on global mental health, focusing on refugees and people displaced due to conflict. Refugees present almost unique challenges as some policy makers may be reluctant to divert scarce resources away from the domestic population to these population groups. A rapid systematic scoping review was also undertaken to identify economic evaluations of mental health-related interventions for refugees and displaced people and to look at how this evidence base can be strengthened. Only 11 economic evaluations focused on the mental health of refugees, asylum seekers and other displaced people were identified. All but two of these intervention studies potentially could be cost-effective, but only five studies reported cost per quality-adjusted life year gained, a metric allowing the economic case for investment in refugee mental health to be compared with any other health-focused intervention. There is a need for more consistent collection of data on quality of life and the longer-term impacts of intervention. The perspective adopted in economic evaluations may also need broadening to include intersectoral benefits beyond health, as well as identifying complementary benefits to host communities. More use can be also made of modelling, drawing on existing evidence on the effectiveness and resource requirements of interventions delivered in comparable settings to expand the current evidence base. The budgetary impact of any proposed strategy should be considered; modelling could also be used to look at how implementation might be adapted to contain costs and take account of local contextual factors.
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Affiliation(s)
- David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - A-La Park
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
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13
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Bitar Z, Elias MB, Malaeb D, Hallit S, Obeid S. Is cyberbullying perpetration associated with anxiety, depression and suicidal ideation among lebanese adolescents? Results from a cross-sectional study. BMC Psychol 2023; 11:53. [PMID: 36829238 PMCID: PMC9951827 DOI: 10.1186/s40359-023-01091-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 02/20/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND As cyberbullying is a new area of investigation, results worldwide point to the prevalence of cyberbullying perpetration. This study aimed to assess the association between cyberbullying perpetration, anxiety, depression and suicidal ideation among Lebanese adolescents. METHODS This cross-sectional study was conducted between May and June 2021 and included a sample of adolescents aged between 13 and 16 years old, recruited from private schools chosen in a convenient way from all Lebanese districts. A total of 520 students accepted to participate in our study. To collect data, a questionnaire was shared by google form including: Cyber Bully/Cyber victim questionnaire; Lebanese Anxiety Scale; and Patient Health Questionnaire for Adolescents. RESULTS The results of the linear regressions, taking anxiety and depression as dependent variables, showed that female gender, having kind of hard and very/extremely hard influence of problems on daily work, sexual cyberbullying in cyberspace, embarrassing and inserting malicious content in cyberspace and older age were significantly associated with more anxiety and depression. Having kind of hard influence of problems on daily work compared to not at all, higher anxiety, higher depression and higher household crowding index (lower socioeconomic status) were significantly associated with higher odds of having suicidal ideation in the last month. CONCLUSION Cyberbullying perpetration and its associated factors reported in this study are significant enough to call for early detection and prevention strategies for Lebanese adolescents. At the school level, effective programs implemented in the school years are needed, aiming to develop social/emotional control, and conflict resolution skills as they might decrease engagement in cyberbullying perpetration among adolescents. Preventive interventions are needed to reduce the engagement of Lebanese adolescents in cyberbullying perpetration.
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Affiliation(s)
- Zeinab Bitar
- grid.460789.40000 0004 4910 6535Faculty of medicine, Paris-Saclay University, Le Kremlin-Bicêtre, France
| | - Marie-Belle Elias
- grid.444434.70000 0001 2106 3658School of Arts and Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Diana Malaeb
- grid.411884.00000 0004 1762 9788College of Pharmacy, Gulf Medical University, P.O. Box 4184, Ajman, United Arab Emirates ,grid.444421.30000 0004 0417 6142School of Pharmacy, Lebanese International University, Beirut, 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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14
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Fekih-Romdhane F, Malaeb D, Loch AA, Farah N, Stambouli M, Cheour M, Obeid S, Hallit S. Problematic Smartphone Use Mediates the Pathway from Suicidal Ideation to Positive Psychotic Experiences: a Large Cross-Sectional, Population-Based Study. Int J Ment Health Addict 2023:1-18. [PMID: 36820017 PMCID: PMC9930705 DOI: 10.1007/s11469-023-01028-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/07/2023] [Indexed: 02/17/2023] Open
Abstract
The present study followed the newly hypothesized "suicidal drive for psychosis" suggesting that psychosis may be consequential to suicidal ideation (SI) and behavior and attempted to explain parts of the pathway between these variables. To this end, we aimed to test whether problematic smartphone use (PSU) has an indirect mediating effect in the cross-sectional relationship between SI and positive psychotic experiences (PEs). Lebanese community young adults (N=4158; 64.4% females; mean age 21.91±3.79) have been invited to participate to a cross-sectional, web-based study in the period from June to September 2022. After adjusting for potential confounders (i.e., the living situation, marital status, household crowding index, economic pressure, cannabis use, other drugs use, and past history of mental illness other than psychosis), we found that higher levels of suicidal ideation was significantly associated with greater PSU, which was also positively and significantly associated with more positive PEs. Finally, greater suicidal ideation was significantly and directly associated with more positive PEs. Our findings suggest that SPU may be regarded as a potential target for prevention and intervention in psychosis. Clinicians, educators, and school administrators ought to give greater attention to PSU among vulnerable young people who present with SI.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi Hospital, 2010 Manouba, Tunisia
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Alexandre Andrade Loch
- Laboratorio de Neurociencias (LIM 27), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Cientifico e Tecnológico, Sao Paulo, Brazil
| | - Nour Farah
- Faculty of Science, Lebanese University, Fanar, Lebanon
| | - Manel Stambouli
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi Hospital, 2010 Manouba, Tunisia
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Majda Cheour
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi Hospital, 2010 Manouba, Tunisia
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - 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
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
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15
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Moghnieh L. Global Mental Health in South Lebanon: Psychoeducation, Translation, and Culture. Med Anthropol 2023; 42:105-119. [PMID: 36228082 DOI: 10.1080/01459740.2022.2129023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In this article I examine the unintended consequences of global mental health reform in postwar South Lebanon. I follow the integration of mental health in primary health care centers. Three key tensions emerge: First, integrating mental health led to separating mental health from socioeconomic conditions. Second, culture was simultaneously conceived as a barrier to therapy and a local context requiring adaptation. Third, the use of personality disorders as psychological interpretations of social life resulted in psychologizing gender and class. The article contributes to growing ethnographic research on global mental health and calls for attention to structural competence in similar settings.SECOND LANGUAGE ABSTRACTفي هذا المقال، أستكشف العواقب غير المقصودة لإصلاحات الصحة النفسية العالمية في جنوب لبنان بعد الحرب. أتابع دمج الصحة النفسية في مراكز الرعاية الصحية الأولية. تظهر هنا ثلاث معضلات رئيسية: أولاً ، أدّى دمج الصحة النفسية إلى فصلها عن الظروف الاجتماعية والاقتصادية المحيطة بها. ثانيًا، تم تصوير مفهوم الثقافة كحاجز أمام العلاج النفسي من جهة وكسياق محلي يتطلب تكيفا وترجمة. ثالثًا، أدى استخدام تشخيصات اضطرابات الشخصية كتفسيرات نفسية للحياة الاجتماعية إلى نفسنة الجنس والطبقة. يساهم المقال الى البحوث الإثنوغرافية المتنامية حول الصحة النفسية العالمية ويدعو إلى الاهتمام بالكفاءة الهيكلية للصحة النفسية في بيئات مماثلة .
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Affiliation(s)
- Lamia Moghnieh
- English Germanic and Romance Studies Department, University of Copenhagen, Copenhagen, Denmark
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16
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Nehme A, Barakat M, Malaeb D, Obeid S, Hallit S, Haddad G. Association between COVID-19 symptoms, COVID-19 vaccine, and somatization among a sample of the Lebanese adults. Pharm Pract (Granada) 2023; 21:2763. [PMID: 37090451 PMCID: PMC10117341 DOI: 10.18549/pharmpract.2023.1.2763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/03/2022] [Indexed: 04/25/2023] Open
Abstract
Objectives Long COVID syndrome, the poorly defined illness, has been increasingly mentioned in recent studies yet is still poorly understood especially when it comes to precipitating and modulating factors, the high prevalence of mental health problems associated with the COVID-19 pandemic has brought to light the hypothesis of the existence of a psychological component associated with the persistence of symptoms and if vaccination may serve as a modulating factor. This study aims to examine the prevalence of somatization disorders and association between persistent COVID-19 symptoms and COVID-19 vaccine with somatization among a sample of the Lebanese general population. Methods A cross-sectional study was carried out between September and October 2021. The snowball sampling technique was picked to choose a sample that addressed all Lebanese Mohafazat. Patient Health Questionnaire-15 (PHQ-15) was used to assess somatization. Results A total of 403 participants was enrolled in this study, with a mean age of 32.76 ± 13.24 years, 108 (26.8%) had medium somatization symptoms (PHQ-15 scores ≥10). Having persistent COVID symptoms (β=2.15) was significantly associated with more somatization, whereas the intake of COVID vaccine (β=-1.17) was significantly associated with less somatization. Conclusion Long lasting COVID-19 symptoms were closely related to somatization, although the administration of the COVID-19 vaccine was associated with less somatization. However, further studies are needed to provide a better understanding of the relationship between long COVID and somatization, on one hand, and the modulating factors on the other hand.
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Affiliation(s)
- Antonio Nehme
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
| | - Muna Barakat
- Department of Clinical Pharmacy and therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, 11931, Jordan.
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates.
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon.
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
| | - Georges Haddad
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Psychiatry Departments, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
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17
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Rachidi M, Hatem G, Hatem M, Zein S, Rachidi S, Awada S. Impact of the COVID-19 pandemic on the consumption patterns of psychotropic drugs and predictors of limited access to medication. THE JOURNAL OF MEDICINE ACCESS 2023; 7:27550834231163706. [PMID: 37051188 PMCID: PMC10086612 DOI: 10.1177/27550834231163706] [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: 11/04/2022] [Accepted: 02/27/2023] [Indexed: 04/14/2023]
Abstract
Background Despite the efforts of the health system to improve access to medications during the coronavirus disease of 2019 (COVID-19) pandemic, such as online consultations, encouraging generic prescriptions, and other measures to limit the storage of medication, psychotropic patients faced significant challenges in accessing their medications. Objectives This study aimed (1) to compare the consumption of psychotropics before and during the pandemic, (2) to assess the association between having difficulties finding the medications and the general characteristics of the patients, and (3) to assess the predictors of these difficulties. Design A case-control study was performed in which 128 patients (cases) were recruited during the pandemic (July-October 2021), and 256 patients (controls) using psychotropics before the pandemic were matched for age and sex. Methods Data were collected using a uniform survey given to patients using psychotropics and filled out at their time and place preferences. Results More patients used antipsychotics and anti-anxiety medications before the pandemic, while antidepressants were used more during the pandemic. Almost half of the patients reported facing difficulties finding their medications in both time frames. Before the pandemic, these difficulties were noted per increase in age and being employed and were less faced if patients had medical assistance or lived in the north of Lebanon. However, more patients reported having difficulties accessing their medication during the pandemic, with no significant differences. Conclusion The consumption of psychotropic drugs was higher among cases. All patients faced challenges in accessing their medication throughout the pandemic, while older and employed patients had more limitations before the pandemic. Further investigations exploring viable solutions are recommended in order to maintain sustainable access to treatment.
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Affiliation(s)
- Maya Rachidi
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Georges Hatem
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- Faculty of Medicine, University of Porto, Porto, Portugal
- Georges Hatem, Faculty of medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.
| | - Melissa Hatem
- Faculty of Medicine and Medical Sciences, University of Balamand, El-Koura, Lebanon
| | - Salam Zein
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Samar Rachidi
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Sanaa Awada
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
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18
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Youssef D, Abboud E, Abou-Abbas L, Hassan H, Youssef J. Prevalence and correlates of burnout among Lebanese health care workers during the COVID-19 pandemic: a national cross-sectional survey. J Pharm Policy Pract 2022; 15:102. [PMID: 36527056 PMCID: PMC9756668 DOI: 10.1186/s40545-022-00503-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has harshly burdened the healthcare systems. Health care workers (HCWs) are at substantial risk of infection and confronted several stressors as well leading them to experience burnout. This study aimed to assess the prevalence of burnout among Lebanese health HCWs and to identify its associated factors. METHODS A cross-sectional online survey was conducted between the first of November and the end of December 2020 among Lebanese HCWs working in all active hospitals operating across the country. Data were collected using an Arabic, anonymous, self-reported questionnaire comprising four sections: (a) basic sociodemographic characteristics, (b) exposure to COVID-19 covariates, (c) occupational factors, and (d) the measurements including the Copenhagen Burnout Inventory (CBI). CBI subscale cut-off score of 50 was used to assess the prevalence of burnout among HCWs. Multinomial logistic regression analyses were performed to examine the factors associated with the different aspects of burnout. RESULTS Out of the 1751 respondents, personal burnout (PB) was detected in its moderate and high-level aspects among 86.3% of Lebanese HCWs. Moderate and high levels of work-related burnout (WB), and client-related burnout (CB) hit 79.2% and 83.3% of HCWs, respectively. HCWs who were females, married, physicians, having a poor health status and specific living conditions (dependent child, elderly at home, family member with comorbidities, and a low income) were more likely to exhibit a high level of PB compared to no/low burnout level. Moreover, frontline HCWs, those infected by COVID-19 or those having a colleague infected by COVID-19, and those exhibiting a high perception of threat were more prone to experience a high-level PB rather than a low/no burnout. Working in a public hospital, extensive working hours, and insufficient sleeping hours were also found positively associated with high PB. However, older age and altruism were negatively associated with high PB compared to no/low PB among HCWs. As for WB, similar factors were found either positively or negatively associated with a high level of WB except health status and living conditions factors (dependent child or family member). As for CB, older age of HCWs (> 30 years) and altruism were negatively associated with high CB compared to no/low burnout level. However, working in the frontline, high threat perception, extensive working hours, insufficient sleeping hours, and low income were positively associated with high CB among HCWs compared to no/low burnout. CONCLUSION The prevalence of burnout among Lebanese HCWs during the pandemic was significant and alarming. Enacting and implementing preventive policies and effective interventions are urgently needed to cultivate wellness among HCWs.
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Affiliation(s)
- Dalal Youssef
- grid.412041.20000 0001 2106 639XBordeaux Research Center for Population Health, Institut de Santé Publique, d’épidémiologie et de Développement (ISPED), Bordeaux University, Bordeaux, France ,grid.490673.f0000 0004 6020 2237Clinical Trial Program, Ministry of Public Health, Beirut, Lebanon ,grid.490673.f0000 0004 6020 2237Preventive Medicine Department, Ministry of Public Health, Beirut, Lebanon
| | - Edmond Abboud
- grid.490673.f0000 0004 6020 2237Ministry of Public Health, Beirut, Lebanon
| | - Linda Abou-Abbas
- grid.411324.10000 0001 2324 3572Neuroscience Research Center, Lebanese University, Faculty of Medical Sciences, Beirut, Lebanon
| | - Hamad Hassan
- grid.490673.f0000 0004 6020 2237Ministry of Public Health, Beirut, Lebanon
| | - Janet Youssef
- Al Zahraa Hospital University Medical Center, Beirut, Lebanon
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Awad E, Fawaz M, Hallit S, Obeid S. The moderating effect of emotion regulation in the association between coping strategies and resilience in Lebanese adults. BMC Psychol 2022; 10:296. [PMID: 36494760 PMCID: PMC9734639 DOI: 10.1186/s40359-022-01019-9] [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: 09/02/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To evaluate the psychometric properties of the Coping Strategies Inventory-Short Form and investigate the relationship between coping strategies and resilience, taking into consideration the moderating role of emotion regulation. METHODS This cross-sectional study was carried out between May and July 2022. A total of 387 participants was recruited through convenience sampling through several areas in Lebanon governorates. The data was collected through an online questionnaire containing the following sections: sociodemographic information about the participants, Connor-Davidson Resilience Scale (CD-RISC), Emotion Regulation Questionnaire and Coping Strategies Inventory-Short Form. RESULTS The confirmatory factor analysis results confirmed the four-factor structure of the Coping Strategies Inventory-Short Form, with no measurement invariance across gender. In individuals with high problem-focused engagement and emotion-focused engagement, lower expressive suppression was significantly associated with more resilience. In individuals with high problem-focused disengagement, having high expressive suppression was significantly associated with less resilience. CONCLUSION The current study provides novel and distinct findings regarding the relationship between emotion regulation, coping strategies and resilience in all of their dimensions. Furthermore, the present results provide insight on how a population under extreme stress receives and reacts to its reality.
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Affiliation(s)
- Emmanuelle Awad
- grid.411323.60000 0001 2324 5973Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Mirna Fawaz
- grid.18112.3b0000 0000 9884 2169Faculty of Health Sciences, Beirut Arab University, Tareek Al Jadida, Afeef Al Tiba, 1105 Beirut, Lebanon
| | - Souheil Hallit
- grid.444434.70000 0001 2106 3658School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon ,grid.512933.f0000 0004 0451 7867Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon ,grid.411423.10000 0004 0622 534XApplied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Sahar Obeid
- grid.411323.60000 0001 2324 5973Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
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Rija A, Islam Z, Bilal W, Qamar K, Gangat SA, Abbas S, Mirha HT, Mohanan P, Rahmat ZS, Shaeen SK, Djedid SNK, Essar MY, Kashyap R. The impact of violence on healthcare workers' mental health in conflict based settings amidst COVID‐19 pandemic, and potential interventions: A narrative review. Health Sci Rep 2022; 5:e920. [PMCID: PMC9638051 DOI: 10.1002/hsr2.920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 09/27/2022] [Accepted: 10/17/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Aiman Rija
- Faculty of Medicine, Dow Medical College Dow University of Health Sciences Karachi Pakistan
| | - Zarmina Islam
- Faculty of Medicine, Dow Medical College Dow University of Health Sciences Karachi Pakistan
| | - Wajeeha Bilal
- Faculty of Medicine, Dow Medical College Dow University of Health Sciences Karachi Pakistan
| | - Khulud Qamar
- Faculty of Medicine, Dow Medical College Dow University of Health Sciences Karachi Pakistan
| | - Shazil Ahmed Gangat
- Faculty of Medicine, Dow Medical College Dow University of Health Sciences Karachi Pakistan
| | - Samina Abbas
- Faculty of Medicine, Dow Medical College Dow University of Health Sciences Karachi Pakistan
| | - Hania Tul Mirha
- Department of Medicine CMH Lahore Medical College Lahore Pakistan
| | | | - Zainab Syyeda Rahmat
- Faculty of Medicine, Dow Medical College Dow University of Health Sciences Karachi Pakistan
| | - Sean Kaisser Shaeen
- Faculty of Medicine, Dow Medical College Dow University of Health Sciences Karachi Pakistan
| | | | | | - Rahul Kashyap
- Critical Care Medicine Mayo Clinic Rochester Minnesota USA
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21
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Karam J, Haddad C, Sacre H, Serhan M, Salameh P, Jomaa L. Financial Wellbeing and Quality of Life Among a Sample of the Lebanese Population: The Mediating Effect of Food Insecurity. Front Nutr 2022; 9:906646. [PMID: 35967774 PMCID: PMC9364834 DOI: 10.3389/fnut.2022.906646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/12/2022] [Indexed: 11/30/2022] Open
Abstract
Background Lebanon is undergoing multiple overlapping crises, affecting the food security, financial well-being, and quality of life (QOL) of its residents. Objective The primary objective was to assess the food insecurity (FI) status of a sample of the Lebanese population. The second objective was to explore factors related to QOL parameters and evaluate the mediating effect of food security between financial well-being and QOL. Methods The study was cross-sectional and enrolled 412 participants recruited online using the snowball sampling technique. The survey included questions related to sociodemographic and economic characteristics of Lebanese households and validated scales to assess FI, QOL measures, financial well-being, and fear of COVID-19. Results Almost 43% of the study participants reported being food insecure, with 31% experiencing mild FI, 10% moderate FI, and 1.5% severe FI. Compared to food-insecure participants, food secure participants had a significantly higher income (58.5% vs. 39.2%, p < 0.001), a university education level (96.6% vs. 88.1%, p = 0.002), an average perceived financial status (83.9% vs. 65.9%), higher financial well-being scores (5.14 vs. 3.19, p < 0.001), and lower crowding index (0.94 ± 0.4 vs. 1.09, p = 0.002). Multivariate analysis showed that FI was not associated with physical (Beta = −1.48, 95% CI: −3.10; 0.13) and mental (Beta = −1.46, 95% CI −3.68; 0.75) QOL, after adjusting for other demographic and socioeconomic correlates. This association remained non-significant when introducing the financial well-being variable to the model. Mediation analyses showed that the FI variable mediated the association between financial well-being and physical QOL (Beta = 0.19, 95% CI: 0.02; 0.36), but not the mental QOL (Beta = −0.02, 95% CI: −0.20; 0.14). Conclusion Food insecurity was prevalent in our study sample, and it mediated the association between financial well-being and physical, but not mental, QOL parameters. These findings call for evidence-based policies and programs to help improve the food security and well-being of Lebanese households amidst these unprecedented circumstances.
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Affiliation(s)
- Joanne Karam
- Nutrition Department, Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie (INSPECT-LB), Beirut, Lebanon.,School of Health Sciences, Modern University of Business and Science, Beirut, Lebanon
| | - Chadia Haddad
- Nutrition Department, Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie (INSPECT-LB), Beirut, Lebanon.,School of Health Sciences, Modern University of Business and Science, Beirut, Lebanon.,Research Department, Psychiatric Hospital of the Cross, Beirut, Lebanon
| | - Hala Sacre
- School of Health Sciences, Modern University of Business and Science, Beirut, Lebanon
| | - Mireille Serhan
- Department of Nutritional Sciences, Faculty of Health Sciences, University of Balamand, Koura, Lebanon
| | - Pascale Salameh
- School of Health Sciences, Modern University of Business and Science, Beirut, Lebanon.,Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus.,School of Medicine, Lebanese American University, Byblos, Lebanon.,Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Lamis Jomaa
- Department of Human Sciences, College of Health and Sciences, North Carolina Central University, Durham, NC, United States.,Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
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22
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Bizri M, Ibrahim N, Beyrouthy C, Yamout D, Tamim H, Abiad J, Ghazeeri G. Psychometric properties of the Arabic version of Connor-Davidson Resilience Scale in a sample of Lebanese women. PLoS One 2022; 17:e0269700. [PMID: 35704645 PMCID: PMC9200348 DOI: 10.1371/journal.pone.0269700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/25/2022] [Indexed: 11/19/2022] Open
Abstract
Purpose Resilience is defined as the ability to face adversities with positive outcomes. Various scales have been utilized, including 25-item Connor-Davidson Resilience Scale (CD-RISC), to evaluate resilience among populations. Resilience research is scarce, particularly in Lebanon as no such scales have been validated. Thus, in the present work, we aimed to assess the psychometric properties of the Arabic version of CD-RISC. Patients and methods The study was conducted at the Women’s Health Center at the American University of Beirut Medical Center among Lebanese women presenting to the obstetrics and gynecology clinics. Internal validity of the Arabic CD-RISC was examined. Pearson’s correlation coefficients between the scores of the Arabic version of CD-RISC and the other related constructs (Rosenberg Self-Esteem Scale, Dispositional Hope Scale, Life Orientation Test, and Positive and Negative Affect Schedule) were assessed to evaluate its divergent and convergent validity. We collected responses from a total of 63 Lebanese women. Results The studied scale displayed a high internal consistency. Adequate correlation coefficients were manifested by the significant positive moderate to strong and negative moderate correlations between the Arabic CD-RISC and the other related constructs. Conclusion This is the first study to validate the Arabic version of the CD-RISC in a sample of Lebanese women. The findings of this study provide evidence that the Arabic version of CD-RISC is a reliable and valid tool for the evaluation of resilience among Lebanese women.
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Affiliation(s)
- Maya Bizri
- Department of Psychiatry, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nour Ibrahim
- Department of Psychiatry, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Christine Beyrouthy
- Department of Obstetrics and Gynecology, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Dahlia Yamout
- Department of Psychiatry, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hani Tamim
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Jude Abiad
- Faculty of Sciences, Boston University, Boston, MA, United States of America
| | - Ghina Ghazeeri
- Department of Obstetrics and Gynecology, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- * E-mail:
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23
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Moussa S, Malaeb D, Obeid S, Hallit S. Correlates of Positivity Among a Sample of Lebanese University Students. Front Psychol 2022; 13:880437. [PMID: 35548518 PMCID: PMC9084318 DOI: 10.3389/fpsyg.2022.880437] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background People say it is hard to stay truly positive in Lebanon. Studies showed that 63% of Lebanese young adults are highly dissatisfied with their country. In fact, young adults are the most vulnerable population to stressors in Lebanon since their future is at stake and it is their time to shape their lives in a country that cripples them. This study aimed to assess factors (flourishing, religious coping, experiences in life, and the economic burden) associated with positivity among a sample of Lebanese university students despite the various stressors they are facing on top of the economic collapse and the COVID-19 pandemic. Methods This cross-sectional study was conducted between November and December 2021. A total of 333 participants (219 females and 114 males; mean age = 22.95 ± 4.79 years) was recruited through convenience sampling and snowball technique through several areas in Lebanon's governorates. A linear regression taking the positivity score as the dependent variable was adopted and all variables that showed a correlation > │0.24│ in absolute value were entered in the final model as independent. Results A linear regression taking the positivity score as the dependent variable showed that more positive experiences in life (Beta = 0.49; 95% CI 0.35-0.62), more flourishing (Beta = 0.10; 95% CI 0.05-0.14), living in rural area compared to urban (Beta = 3.06; 95% CI 2.02-4.11), and female gender (Beta = 1.56; 95% CI 0.50-2.61) were significantly associated with more positivity (Nagelkerke R 2 of the model = 45.8%). Conclusion This study demonstrated that the youth's positivity is strongly affected by age, gender, residency, and the country they live in that will both directly and indirectly shape their life experiences and their ability to flourish and prosper. Along with all the efforts done to help during this collapse and alleviate the stress that young adults are enduring, follow-up studies are still needed to determine accurate coping techniques that pushes these young adults to think positively in a country where negativity reigns and all else fails.
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Affiliation(s)
- Sara Moussa
- Faculty of Medicine, University of Balamand, Koura, Lebanon
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Sahar Obeid
- Department of Social and Education Sciences, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon.,Department of Psychology, College of Humanities, Effat University, Jeddah, Saudi Arabia.,Department of Research, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
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24
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Cherro M, El-Khoury J. Lebanon facing an exodus of psychiatrists when they are most needed. Asian J Psychiatr 2022; 71:103081. [PMID: 35311671 DOI: 10.1016/j.ajp.2022.103081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/09/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Michele Cherro
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
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25
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Brown FL, Bosqui T, Elias J, Farah S, Mayya A, Abo Nakkoul D, Walsh B, Chreif S, Einein A, Meksassi B, Abi Saad R, Naal H, Ghossainy ME, Donnelly M, Betancourt TS, Carr A, Puffer E, El Chammay R, Jordans MJD. Family systemic psychosocial support for at-risk adolescents in Lebanon: study protocol for a multi-site randomised controlled trial. Trials 2022; 23:327. [PMID: 35436976 PMCID: PMC9014280 DOI: 10.1186/s13063-022-06284-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/05/2022] [Indexed: 11/10/2022] Open
Abstract
Background Adolescents growing up in communities characterised by adversity face multiple risk factors for poor mental health and wellbeing. There is currently a scarcity of research on effective approaches for preventing and treating psychological distress in this population, particularly in humanitarian settings. The powerful impact of the home environment and family support is well known; however, approaches targeting the family are seldom developed or evaluated in such settings. We developed a brief family systemic psychosocial support intervention to be delivered through existing child protection systems with non-specialist facilitators. This paper outlines the study protocol for a randomised controlled trial of the intervention in Lebanon. Methods We will conduct a single-blind hybrid effectiveness-implementation multi-site RCT comparing the locally developed systemic family intervention to a waitlist control group for families residing in vulnerable regions in North Lebanon and Beqaa governorates (including families of Syrian, Palestinian, and Lebanese backgrounds). Outcomes on a range of family, adolescent, and caregiver measures will be assessed at baseline (T0) and post-intervention (T1), and at a 3-month follow-up for the treatment arm (T2). Families will be eligible for the trial if they are identified by implementing organisations as being medium-to-high risk for child protection concerns and have one or more adolescent aged 12–17 who demonstrates significant psychological distress on a self-report brief screening tool. Families will be randomly assigned to a treatment or a waitlist control condition. Families in the waitlist condition will receive a group version of the programme after completion of the study, to allow us to assess feasibility, acceptability, and preliminary indications of intervention effects of this modality. The primary outcome is reduction in overall adolescent-reported psychological distress over time, with post-intervention (T1) as the primary endpoint. Secondary adolescent-reported outcomes include family functioning, psychosocial wellbeing, and emotional regulation difficulties. Secondary caregiver-reported outcomes include parenting style, family functioning, psychological distress, and emotional regulation difficulties. Discussion This trial will provide the first assessment of the effectiveness of the family systemic psychosocial support intervention for use in Lebanon, with important implications for the use of systemic, low-cost, non-specialist interventions for this age range. Trial registration Local registry: National Mental Health Program, Ministry of Public Health, Lebanese Republic. Registered on 19 October 2021 Lebanese Clinical Trial Registry LBCTR2021104870. Registered on 13 October 2021 Global registry: ISRCTN ISRCTN13751677. Registered on 1 November 2021
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