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AbuQamar M, Eltayyan D, Kuznetsova I, Dhesi S, Catling J, AL-Dadah R, Saad M, Abuhaiba M. The impact of access to electricity on mental health in conflict-affected territories: An exploratory study in Gaza. Int J Soc Psychiatry 2023; 69:2148-2156. [PMID: 37675921 PMCID: PMC10685693 DOI: 10.1177/00207640231194479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
BACKGROUND Access to affordable and clean energy is an essential component of the Sustainable Development Goals and a determinant of physical and mental health. However, the occupied Palestinian territory, the Gaza Strip, has experienced prolonged issues with electricity, water and gas supplies. This has significantly impacted on daily life and the area is on the verge of disaster. This research focused on the mental health effects of the lack of electricity in Gaza which have not been previously documented. METHODS A cross-sectional analytic approach was adopted. A survey was administrated face-to-face with respondents from 350 participating households. Inferential statistical analysis was used to examine the relationship between the domains of anxiety, depression, wellbeing and electricity supply factors. A multiple linear regression model was also utilised. RESULTS There is a highly statistically significant link between continuity of electricity and level of anxiety (p < .001). The same effect was reported in the level of depression, and a higher level was observed among residents with an intermittent or disrupted electricity supply, with a statistically significant link between the level of depression and continuity of electricity. CONCLUSION Electricity issues, especially when combined with other stressors associated with living in Gaza, lead to serious mental health concerns. Urgent attention must be given to developing sustainable, reliable and affordable energy supplies for short- and long-term health and community development.
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Affiliation(s)
- Mazen AbuQamar
- Faculty of Applied Medical Sciences (FAMS), Al Azhar University-Gaza, Palestinian Territory, occupied
| | - Dalia Eltayyan
- Islamic University of Gaza (IUG), Palestinian Territory, occupied
| | - Irina Kuznetsova
- School of Geography, Earth and Environmental Sciences, University of Birmingham, UK
| | - Surindar Dhesi
- School of Geography, Earth and Environmental Sciences, University of Birmingham, UK
| | | | - Raya AL-Dadah
- Department of Mechanical Engineering, University of Birmingham, UK
| | - Mahmoud Saad
- Department of Mechanical Engineering, University of Birmingham, UK
| | - Mohammad Abuhaiba
- Mechanical Engineering Department, Islamic University of Gaza (IUG), Palestinian Territory, occupied
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Maloney CA, Miller-Graff LE, Wentz B, Cummings EM. Evaluating the Role of Maternal and Paternal Trauma Exposure, Emotional Security, and Mental Health in Predicting Psychological Adjustment among Palestinian Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159288. [PMID: 35954645 PMCID: PMC9368235 DOI: 10.3390/ijerph19159288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 02/06/2023]
Abstract
Previous research has established a strong relationship between family system functioning and child adjustment outcomes. However, within the context of Gaza, an evaluation of both maternal and paternal factors associated with adolescent psychological adjustment has not yet been thoroughly evaluated. The current study examines how maternal and paternal trauma exposure, emotional security, and mental health are related to parent-reported scores of adolescent psychological adjustment, while controlling for adolescent trauma exposure and security in the family. The sample included N = 68 family units living in the Gaza Strip, with two parents and one adolescent surveyed within each unit (adolescent Mage = 14.03 years). The regression model examining maternal factors was significant overall (F = 7.44, R2 = 42.70%, p < 0.001), with increased maternal depression associated with greater adolescent adjustment difficulties (β = 0.31, p = 0.011) and greater maternal emotional security in the family associated with fewer adolescent adjustment difficulties (β = −0.36, p = 0.004). The regression model examining paternal factors was also significant (F = 4.57, R2 = 31.00%, p < 0.001), with increased paternal trauma exposure associated with greater adolescent adjustment difficulties (β = 0.32, p = 0.012). Understanding family-level factors associated with adolescent adjustment is an important step in conceptualizing the mental health needs of conflict-affected youth within the context of Gaza and more broadly.
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Affiliation(s)
- Catherine A. Maloney
- Department of Clinical Psychology, University of Notre Dame, Notre Dame, IN 46556, USA; (L.E.M.-G.); (B.W.); (E.M.C.)
- Kroc Institute for International Peace Studies, University of Notre Dame, Notre Dame, IN 46556, USA
- Correspondence:
| | - Laura E. Miller-Graff
- Department of Clinical Psychology, University of Notre Dame, Notre Dame, IN 46556, USA; (L.E.M.-G.); (B.W.); (E.M.C.)
- Kroc Institute for International Peace Studies, University of Notre Dame, Notre Dame, IN 46556, USA
| | - Bethany Wentz
- Department of Clinical Psychology, University of Notre Dame, Notre Dame, IN 46556, USA; (L.E.M.-G.); (B.W.); (E.M.C.)
| | - Edward Mark Cummings
- Department of Clinical Psychology, University of Notre Dame, Notre Dame, IN 46556, USA; (L.E.M.-G.); (B.W.); (E.M.C.)
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Mesa-Vieira C, Haas AD, Buitrago-Garcia D, Roa-Diaz ZM, Minder B, Gamba M, Salvador D, Gomez D, Lewis M, Gonzalez-Jaramillo WC, Pahud de Mortanges A, Buttia C, Muka T, Trujillo N, Franco OH. Mental health of migrants with pre-migration exposure to armed conflict: a systematic review and meta-analysis. THE LANCET PUBLIC HEALTH 2022; 7:e469-e481. [DOI: 10.1016/s2468-2667(22)00061-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/23/2022] [Accepted: 03/02/2022] [Indexed: 01/08/2023] Open
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Safarini OA, Taya H, Abu Elhija Y, Qadous M, Farhoud A, Thabaleh A, Khayyat A, Nazzal Z, Abuhassan AM, Ghanim N, Mahamid F, Al Ali R, Damiri B. Assessment of the Relationship of Depression With Tobacco and Caffeine Use Among University Students: A Cross-Sectional Study. Cureus 2021; 13:e19098. [PMID: 34868751 PMCID: PMC8627153 DOI: 10.7759/cureus.19098] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background University students are at a higher risk of using cognitive enhancers and psychoactive substances. Depression is associated with a noticeable decline in academic performance and can increase the risk of substance use. Due to sociopolitical issues, the use of cognitive enhancers and psychoactive substances among Palestinians has spread in the last decade. However, depression among tobacco and caffeine users remains underrecognized and neglected. Methodology A self-administrated questionnaire and the Beck Depression Inventory were used to assess the association of depression and the use of cognitive enhancers and psychoactive substances among university students at An-Najah National University in 2020. Results The response rate to the questionnaires was 78.8% (n = 1,051; 38.8% males, 61.2% females). The overall prevalence of depression was high (30.6% males, 34.7% females). The prevalence of cigarette smoking (39.2% males, 3.9% females), waterpipe smoking (43.1% males, 21.6% females), energy drink consumption (59.6% males, 29.7% females), coffee consumption (85.5% for each gender), tea consumption, and chocolate consumption was high, with significant differences in accordance to gender and academic fields. The multinomial logistic regression results revealed that cigarette smokers were more likely to have a higher risk of severe (odds ratio [OR] = 4.5, p = 0.001), moderate (OR = 3.27, p < 0.001), and mild depression (OR = 2.24, p = 0.002) than non-smokers. Severe depression was less prevalent among medical students than health sciences and non-medical students (OR = 0.215, p = 0.015). Moreover, males were less likely to have moderate (OR = 0.5, p = 0.012) and mild (OR = 0.48, p = 0.001) depression than females. Conclusions Overall, the results of this study revealed the high prevalence of depression and the detrimental effects of smoking on students. Moreover, the findings suggest the urgent need to address depression and risk factors among Palestinian university students by educating them about mental health, identifying high-risk students, and offering easily accessible psychological help. Further, it is crucial to broaden the focus of studies to include students from various academic fields instead of focusing on medical students.
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Affiliation(s)
| | | | | | - Marah Qadous
- Medicine, An-Najah National University, Nablus, PSE
| | | | | | | | - Zaher Nazzal
- Community and Family Medicine, An-Najah National University, Nablus, PSE
| | | | - Nesma Ghanim
- Medicine, An-Najah National University, Nablus, PSE
| | - Fayez Mahamid
- Clinical Psychology, An-Najah National University, Nablus, PSE
| | - Rayyan Al Ali
- Forensic Medicine, An-Najah National University, Nablus, PSE
| | - Basma Damiri
- Medicine and Health Sciences, An-Najah National University, Nablus, PSE
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Al-Jabi SW, Sous A, Jorf F, Taqatqa M, Allan M, Sawalha L, Lubadeh E, Sweileh WM, Zyoud SH. Depression among end-stage renal disease patients undergoing hemodialysis: a cross-sectional study from Palestine. RENAL REPLACEMENT THERAPY 2021. [DOI: 10.1186/s41100-021-00331-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Abstract
Background
The impact of end-stage renal disease on the patient’s psychological status necessitates the value of increasing depression awareness. The current study aimed to assess the depression prevalence among Palestinian hemodialyzed patients and its association with patients’ characteristics.
Methods
A convenience clustered sampling technique was followed. Sample was collected from ten hemodialysis centers in the West Bank, Palestine, during 3 months in 2015. We used the Beck Depression Inventory-II scale (BDI-II) to evaluate depression among participants. All data were analyzed using Statistical Package for the Social Sciences version 16.0.
Results
Two hundred and eighty-six hemodialyzed patients were interviewed. The mean age (± standard deviation) of the patients was 52.0 ± 14.3 years, and most participants were males 172 (60.1%). Regarding the dialysis characteristics, the median of years of dialysis was 2 years (1–4). The prevalence of depression was 73.1%. Elderly patients (p = 0.001), female (p = 0.036), living in rural areas or camp (p = 0.032), low income (p = 0.041), unemployment (p = 0.001), not doing regular exercise (p = 0.001), and having multi comorbidities (p = 0.001) were significantly associated with more depression scores. The results of binary logistic regression showed that only patients who were living in camps, patients who were previously employed, and patients who were not practicing exercise remained significantly associated with a higher depression score.
Conclusions
This study is the first one confirmed about depression and its prevalence among hemodialyzed patients in the West Bank, Palestine. Compared to other communities, the study found a higher depression prevalence rate. There is a need to offer psychological interviews and non-pharmacological and pharmacological interventions.
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Gibbs A, Abdelatif N, Said N, Jewkes R. Associations between exposures to occupation-related events, depression and intimate partner violence among women in the occupied Palestinian Territories. Glob Public Health 2020; 16:1834-1847. [PMID: 33222619 DOI: 10.1080/17441692.2020.1849349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
War and conflict impact on women's mental health and experiences of intimate partner violence (IPV), including in the occupied Palestinian Territories (oPT). Drawing on a cross-sectional population representative sample (n=534) collected in February 2017 in the oPT, we sought to (i) characterise the patterning of occupation-related events among women (18+) living in the oPT, (ii) to descriptively assess factors associated with this patterning, (iii) to assess the health impacts of occupation-related events by this patterning, specifically experience of IPV and poor mental health, and (iv) to assess the pathways through which occupation-related events are associated with IPV experience. Using Latent Class Analysis we identified three 'classes' of exposure to occupation-related events: 1 in 20 experienced multiple forms directed at themselves, their families and homes, 42.3% reported experiences against family members and their homes, and half reported relatively few direct experiences of occupation-related violence. Group membership was associated with increased past year IPV experience, and depressive symptoms. Using structural equation modelling we demonstrate that experiences of occupation-related events increased IPV experience via two mediated pathways; increased gender inequitable attitudes, and increased depressive symptoms and quarrelling with their husband. Preventing IPV requires addressing occupation-related events as well as transforming gender norms.
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Affiliation(s)
- Andrew Gibbs
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa.,Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Nada Abdelatif
- Biostatistics Research Unit, South African Medical Research Council, Durban, South Africa
| | - Nader Said
- Arab World for Research and Development (AWRAD), Ramallah, Palestine
| | - Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa.,Office of the Executive Scientist, South African Medical Research Council, Pretoria, South Africa.,School of Public Health, University of Witwatersrand, Johannesburg, South Africa
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7
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Contextualizing Cognitions: the Relation Between Negative Post-traumatic Cognitions and Post-traumatic Stress Among Palestinian Refugees. Int J Cogn Ther 2020. [DOI: 10.1007/s41811-020-00066-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AbstractNegative post-traumatic cognitions (PTC) are a relevant factor in the development, persistence, and treatment of post-traumatic stress disorder (PTSD). Palestinian refugees live under challenging circumstances and have negative future prospects, so negative cognitions might be expected to prevail. It is uncertain whether findings on the relation between PTC and PTSD in other (non-refugee) populations can be generalized to the Palestinian refugee context. The first objective was to examine the degree to which endorsement of PTC in this sample differed from the endorsement observed in other samples. The second objective was to investigate whether PTC explain variance in PTSD symptomatology and are predictive of PTSD diagnostic status. In Palestinian refugees (N = 85, 51.8% female), PTSD symptoms and negative cognitions were assessed. One sample t tests and multiple logistic regression analyses were performed. Total PTC scores were significantly higher in the Palestinian sample than in reference samples. Negative cognitions explained significant variance in PTSD symptoms and probable diagnostic status. Findings support the relevance of PTC for PTSD symptoms and diagnosis in a Palestinian refugee sample, in line with the cognitive model for PTSD. This is especially relevant for researchers and clinicians working with refugees in conflict areas.
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8
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Al Zabadi H, Alhroub T, Yaseen N, Haj-Yahya M. Assessment of Depression Severity During Coronavirus Disease 2019 Pandemic Among the Palestinian Population: A Growing Concern and an Immediate Consideration. Front Psychiatry 2020; 11:570065. [PMID: 33424656 PMCID: PMC7785799 DOI: 10.3389/fpsyt.2020.570065] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 11/26/2020] [Indexed: 01/07/2023] Open
Abstract
Background: Aggressive quarantine and lockdown measures were implemented as protective public health actions during the coronavirus disease 2019 (COVID-19) pandemic. Assessing the psychological effects associated with these measures is an important attempt to inform local policymakers in an early stage. Yet little is known about these effects, specifically depression, among the Palestinians. This study aimed to assess the prevalence and predictors of depression among the Palestinian community during this pandemic. Materials and methods: A cross-sectional web-based survey throughout social media (Facebook and Instagram) was carried out using an anonymous online questionnaire. The validated and standardized depression, anxiety, and stress scale (DASS) was used to measure depression severity. A snowball technique recruiting the general public living in Palestine was conducted. Data were collected between 6 and 16 April 2020, which corresponded to the middle interval of strict massive lockdown in Palestine on 22 March to 5 May 2020. Multinomial logistic regression model was developed to predict depression severity. Results: About 2,819 respondents filled out the questionnaire. Depression prevalence was (57.5%; n = 1,621). Out of them, 66% had mild/moderate severity, and 34% had severe/extremely severe degree. Depression severity was negatively associated with age {mild/moderate degree [OR (95% CI) = 0.98 (0.97-0.99)] and severe/extremely severe [OR (95% CI) = 0.96 (0.94-0.97)]} degrees compared with normal degree. Males were significantly less likely to have higher depression than females {mild/moderate degree [OR (95% CI) = 0.69 (0.57-0.85)] and severe/extremely severe [OR (95% CI) = 0.52 (0.40-0.86)]} degree. However, those who reported having inadequate food supply and lesser monthly incomes were more likely to have a higher degree of depression as compared with normal degree. Single persons were significantly more likely to have mild/moderate depression than those in a relationship [OR (95% CI) = 1.31 (1.05-1.64)]. Conclusions: High depression prevalence (57.5%) among the Palestinian community during the COVID-19 pandemic is a growing public health concern. It is essential to provide psychological counseling and treatment during and after the pandemic for the targeted people at high risk (young age/female gender) who were affected psychologically. Strategic long-term policy to address pandemic ramifications, including depression, by implementing comprehensive interventions taking into account socioeconomic disparities, vulnerability, and inequities, is crucial to emerge from this crisis in Palestine.
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Affiliation(s)
- Hamzeh Al Zabadi
- Public Health Department, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Thair Alhroub
- Medicine Department, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Noor Yaseen
- Medicine Department, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Maryam Haj-Yahya
- Medicine Department, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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Blanner Kristiansen C, Kjær JN, Hjorth P, Andersen K, Prina AM. Prevalence of common mental disorders in widowhood: A systematic review and meta-analysis. J Affect Disord 2019; 245:1016-1023. [PMID: 30699843 DOI: 10.1016/j.jad.2018.11.088] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/27/2018] [Accepted: 11/12/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Widowed people have a high risk of common mental disorders, however no summary estimates of the prevalences exist. The aim of this study was to conduct a systematic review and meta-analysis of the prevalence of common mental disorders in widowed people in the community. METHODS MEDLINE, Embase and PsycInfo were searched for papers reporting on prevalence of common mental disorders and widowhood. Eligible studies were included in random effects meta-analyses of the prevalence of depression and anxiety disorders. Subgroup analyses were performed on method of assessment of depression and age and sex. RESULTS The literature search identified 13,781 titles of which 42 were eligible for meta-analysis. The pooled prevalence of depression in studies using a screening scale was 40.6% (33.6%-47.6%) (n = 30). For studies using full diagnostic criteria the pooled prevalence of depression was 19.2% (13.4%-25.0%) (n = 12). Subgroup analyses of age (≥ or < 65) and sex did not show any differences regarding depression. Five studies reported the prevalence of anxiety disorders. The pooled prevalence estimate was 26.9% (8.1%-45.7%). LIMITATIONS The prevalence estimates in this study are summary estimates of prevalences from existing literature. Although the reporting bias assessment showed no evidence, there could be some reporting bias, as studies might only present results if there is a high prevalence. CONCLUSIONS Widowed people have a high prevalence of depression and anxiety disorders. The high prevalence of depression was independent of age and sex. The study identifies a population group at high risk needing special attention in clinical practice.
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Affiliation(s)
- Christina Blanner Kristiansen
- Department of Psychiatry - Odense. Mental Health Services in the Region of Southern Denmark, Denmark; Institute of Psychiatry, Psychology & Neuroscience at King's College London, Department of Health Service and Population Research, Social Epidemiology Research Group, London, UK; Department of Clinical Research, University of Southern Denmark, Denmark.
| | - Jesper Nørgaard Kjær
- Psychiatric Research Academy, Department of Affective Disorders, Aarhus University Hospital, Risskov, Denmark
| | - Peter Hjorth
- Institute for Regional Health, Region of Southern Denmark, Odense, Denmark; Centre for Psychiatric Nursing and Health Care Research, Region of Southern Denmark, Denmark
| | - Kjeld Andersen
- Department of Psychiatry - Odense. Mental Health Services in the Region of Southern Denmark, Denmark; Department of Clinical Research, University of Southern Denmark, Denmark
| | - A Matthew Prina
- Institute of Psychiatry, Psychology & Neuroscience at King's College London, Department of Health Service and Population Research, Social Epidemiology Research Group, London, UK
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10
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Nonsuicidal self-injury among adolescents and young adults with prolonged exposure to violence: The effect of post-traumatic stress symptoms. Psychiatry Res 2018; 270:510-516. [PMID: 30347378 DOI: 10.1016/j.psychres.2018.10.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 08/14/2018] [Accepted: 10/08/2018] [Indexed: 01/02/2023]
Abstract
Less is known about nonsuicidal self-injury (NSSI) among adolescents and young adults living in areas under prolonged political violence. This study aims to explore the frequencies of NSSI as well as the severity of post-traumatic stress symptoms (PTSS), depression, anxiety, and sleep problems among 889 Palestinian adolescents and young adults. The participants completed self-report questionnaires assessing NSSI, PTSS, depression, anxiety symptoms, and sleep difficulties. The results found that 13.8% of the total sample are frequently engaging in some form of NSSI behavior. Moreover, 43.1% exhibited severe symptoms of PTSD, and almost one-third of the sample reported severe symptoms of depression (30.1%); more than two-thirds of the sample (68.4%) experience sleep difficulties. Those who engage in NSSI were found to be at higher risk for sleep problems, depression, and PTSS. Avoidance/numbing, as well as hyperarousal symptoms clusters of PTSS, were significantly associated with NSSI above and beyond depressive symptoms. These results suggest that NSSI is frequently a sequelae of prolonged exposure to trauma and violence, and highlight the importance of routine assessment of this behavior. It is crucial to be familiar with the association between PTSS, sleep difficulties, and NSSI in a clinical setting to implement programs focusing on preventing these domains.
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11
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Alduraidi H, Waters CM. Depression, Perceived Health, and Right-of-Return Hopefulness of Palestinian Refugees. J Nurs Scholarsh 2017; 50:163-171. [PMID: 29193636 DOI: 10.1111/jnu.12363] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE Displacement is traumatic and often an unwanted social change that can lead to a loss of identity and socioeconomic, physical, and psychological livelihood. The purpose of the study was to describe the association of perceived health and right-of-return hopefulness to depressive symptom severity in Palestinian refugees, taking into consideration gender and poverty. DESIGN The descriptive, correlational study was framed within a socioecological lens. Data collection occurred between October 2015 and November 2015 in Amman, Jordan, which hosts the most Palestinian refugees in the world. The participants in the sample (N = 177) had a mean age of 36.9 years. METHODS Participants responded to the Patient Health Questionnaire for depressive symptom severity, the RAND-36 perceived health item, and a statement about hopefulness to return to Palestine. Descriptive, correlation, and logistic and linear regression analyses were computed. FINDINGS Results showed that 43% of participants had moderate to severe depressive symptoms, 42% lived in poverty, and 20% had fair or poor health; yet, 60% were hopeful about returning to Palestine. Participants who had better perceived health and right-of-return hopefulness were less likely to have symptoms of major depression. Perceived health was the only factor-not gender, poverty, or right-of-return hopefulness-that explained the variance in depressive symptoms. CONCLUSIONS Palestinian adult refugees in Jordan exhibited symptoms of major depression that were associated with poorer perceived health and less hopefulness about repatriation to Palestine. CLINICAL RELEVANCE Nurses with community or mental health specialization can play a major role by systematically screening refugees for depression using worldwide, evidence-based tools and by advocating for policies that can improve the health and living conditions of refugees.
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Affiliation(s)
- Hamza Alduraidi
- Assistant Professor, Community Health Nursing Department, The University of Jordan, School of Nursing, Amman, Jordan
| | - Catherine M Waters
- Alpha Eta, Professor and Sally Bates Endowed Chair in Community Nursing and Health Disparities, Department of Community Health Systems, University of California, San Francisco, School of Nursing, San Francisco, CA, USA
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12
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Marie M, Hannigan B, Jones A. Mental health needs and services in the West Bank, Palestine. Int J Ment Health Syst 2016; 10:23. [PMID: 26981151 PMCID: PMC4791766 DOI: 10.1186/s13033-016-0056-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 03/07/2016] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Palestine is a low income country with scarce resources, which is seeking independence. This paper discusses the high levels of mental health need found amongst Palestinian people, and examines services, education and research in this area with particular attention paid to the West Bank. METHODS CINAHL, PubMed, and Science Direct were used to search for materials. RESULTS AND CONCLUSION Evidence from this review is that there is a necessity to increase the availability and quality of mental health care. Mental health policy and services in Palestine need development in order to better meet the needs of service users and professionals. It is essential to raise awareness of mental health and increase the integration of mental health services with other areas of health care. Civilians need their basic human needs met, including having freedom of movement and seeing an end to the occupation. There is a need to enhance the resilience and capacity of community mental health teams. There is a need to increase resources and offer more support, up-to-date training and supervision to mental health teams.
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Affiliation(s)
- Mohammad Marie
- />College of Medicine and Health Sciences, Annajah National University, 7, Rafedia, Nablus, West Bank, Palestine
| | - Ben Hannigan
- />School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Eastgate House, 35-43 Newport Road, Cardiff, CF24 0AB UK
| | - Aled Jones
- />School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Eastgate House, 35-43 Newport Road, Cardiff, CF24 0AB UK
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Coldiron ME, Llosa AE, Roederer T, Casas G, Moro MR. Brief mental health interventions in conflict and emergency settings: an overview of four Médecins Sans Frontières - France programs. Confl Health 2013; 7:23. [PMID: 24182311 PMCID: PMC3829376 DOI: 10.1186/1752-1505-7-23] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 10/24/2013] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Mental health problems, particularly anxiety and mood disorders, are prevalent in the setting of humanitarian emergencies, both natural and man-made disasters. Evidence regarding best strategies for therapeutic interventions is sparse. Médecins Sans Frontières has been providing mental health services during emergencies for over two decades, and here we compare data from four programs. PROGRAM OVERVIEW In China, 564 patients were followed for an average of 7 sessions after a major earthquake. The most common diagnoses were PTSD and other anxiety disorders. Between program entry and exit, the median global assessment of functioning increased from 65 to 80. At program entry, 58% were considered moderately, markedly or severely ill; a proportion which fell to 14% at program exit. In Colombia in the setting of chronic violence, 2411 patients were followed for a median of two sessions. Anxiety disorders and major depression were the most common diagnoses, and 76% of patients were moderately or severely ill at program entry. 91% had symptomatic improvement at program exit. In Gaza, 1357 patients were followed for a median of 9 sessions; a majority was under age 15. PTSD and other anxiety disorders were the most common diagnoses, and 91% were moderately or severely ill at entry. 89% had improved symptoms at program exit. In the West Bank, the 1478 patients had similar characteristics to those enrolled in Gaza. 88% were moderately or severely ill at entry; 88% had improved at exit. DISCUSSION AND EVALUATION It was feasible to implement brief yet effective mental health interventions in a wide variety of humanitarian contexts - post-natural disaster, during acute violent conflict and during chronic violent conflict. The most common diagnoses were PTSD, other anxiety disorders and mood disorders. The use of local specially-trained counselors who were focused on coping skills and improving functionality over a brief time period, likely contributed to the symptomatic improvement seen in a large majority of patients across the four sites. CONCLUSIONS Mental health is an essential part of a health care response to humanitarian emergencies. In a variety of settings, we show the positive results of brief interventions. Further research is needed to improve and evaluate mental health interventions in crises.
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Affiliation(s)
| | | | | | - German Casas
- Médecins Sans Frontières, 8 rue Saint-Sabin, 75011 Paris, France
- Los Andes University, School of Medicine, Cr 7 N. 117-15, Bogota, Colombia
| | - Marie-Rose Moro
- Médecins Sans Frontières, 8 rue Saint-Sabin, 75011 Paris, France
- Hôpital Cochin, Maison des adolescents, Université de Paris 5, 97 Boulevard de Port Royal, 75670 Paris cedex 14, France
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Llosa AE, Casas G, Thomas H, Mairal A, Grais RF, Moro MR. Short and longer-term psychological consequences of Operation Cast Lead: documentation from a mental health program in the Gaza Strip. Confl Health 2012; 6:8. [PMID: 23092553 PMCID: PMC3492006 DOI: 10.1186/1752-1505-6-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 10/18/2012] [Indexed: 11/18/2022] Open
Abstract
UNLABELLED BACKGROUND There is growing recognition of the psychological impact of adversity associated with armed conflict on exposed civilian populations. Yet there is a paucity of evidence on the value of mental health programs in these contexts, and of the chronology of psychological sequelae, especially in prolonged conflicts with repeated cycles of extreme violence. Here, we describe changes in the psychological profile of new patients in a mental health program after the military offensive Cast Lead, in the context of the prolonged armed conflict involving the Gaza Strip. METHODS This study analyses routinely collected program data from a Médecins Sans Frontières mental health program in the Gaza Strip spanning 2007-2011. Data consist of socio-demographic as well as clinical baseline and follow-up data on new patients entering the program. Comparisons were made through Chi square and Fisher's exact tests, univariate and multivariate logistic and linear regression. RESULTS PTSD, depression and other anxiety disorders were the most frequent psychopathologies, with 21% having multiple diagnoses. With a median of nine sessions, clinical improvement was recorded for 83% (1122/1357), and more common for those with separation anxiety, acute and posttraumatic disorders as principal diagnosis (855/1005), compared to depression (141/183, p<0.01). Noted changes proximal to Operation Cast Lead were: a doubling in patient case load with a broader socio-economic background, shorter interval from an identified traumatic event to seeking care, and a rise in diagnoses of acute and posttraumatic stress disorders. Sustained changes included: high case load, more distal triggering events, and increase in diagnoses of other anxiety disorders (especially for children 15 years and younger) and depression (especially for patients 16 years and older). CONCLUSION Evolving changes in patient volume, diagnoses and recall period to triggering events suggest a lengthy and durable effect of an intensified exposure to violence in a context of prolonged conflict. Our findings suggest that mental health related humanitarian relief in protracted conflicts might need to prepare for an increase in patients with changing profiles over an extended period following an acute flare-up in violence.
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Affiliation(s)
| | - Germán Casas
- School of Medicine, Los Andes University, Carrera 7 N 116-05, Bogotá, Colombia
- Médecins Sans Frontières, 8 rue Saint Sabin, Paris, 75011, France
| | - Hélène Thomas
- Medecins Sans Frontieres, El Hajaj Ibn Youssuf Street, Shufat Main road, Jerusalem
| | - Angels Mairal
- Medecins Sans Frontieres, El Hajaj Ibn Youssuf Street, Shufat Main road, Jerusalem
| | | | - Marie-Rose Moro
- Médecins Sans Frontières, 8 rue Saint Sabin, Paris, 75011, France
- Cochin Hospital, Université Paris Descartes, Unité INSERM 669, Paris, 75014, France
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