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Safiri S, Mousavi SE, Nejadghaderi SA, Noori M, Sullman MJM, Kolahi AA, Shekarriz-Foumani R. The burden of major depressive disorder in the Middle East and North Africa region, 1990-2019. Acta Neuropsychiatr 2024; 36:139-152. [PMID: 37690795 DOI: 10.1017/neu.2023.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) is one of the leading causes of disability. We aimed to report the MDD-attributable prevalence, incidence and years lived with disability (YLDs) in the Middle East and North Africa (MENA) region from 1990 to 2019 by age, sex and socio-demographic index (SDI). METHODS Publicly available data on the burden of MDD were retrieved from the Global Burden of Disease (GBD) study 2019 for the 21 countries in MENA. The counts and age-standardised rates (per 100,000) were presented, along with their corresponding 95% uncertainty intervals. RESULTS In 2019, MDD had an age-standardised point prevalence of 3322.1 and an incidence rate of 4921.7 per 100,000 population in MENA. Furthermore, there were 4.1 million YLDs in 2019. However, there were no substantial changes in the MDD burden over the period 1990-2019. In 2019, Palestine had the highest burden of MDD. The highest prevalence, incidence and YLDs attributable to MDD were found in the 35-39 age group. In 2019, the YLD rate in MENA was higher than the global rate for almost all age groups. Furthermore, there was a broadly negative association between the YLD rate and SDI. CONCLUSION The study highlights the need to prevent the disorder using a multidisciplinary approach and for the provision of cost-effective treatments for those affected, in order to increase their quality of life.
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Affiliation(s)
- Saeid Safiri
- Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Ehsan Mousavi
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Aria Nejadghaderi
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Maryam Noori
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mark J M Sullman
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Shekarriz-Foumani
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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2
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Mattelin E, Paidar K, Söderlind N, Fröberg F, Korhonen L. A systematic review of studies on resilience and risk and protective factors for health among refugee children in Nordic countries. Eur Child Adolesc Psychiatry 2024; 33:667-700. [PMID: 35445318 PMCID: PMC10894096 DOI: 10.1007/s00787-022-01975-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/09/2022] [Indexed: 11/03/2022]
Abstract
The Nordic welfare model is often used as an example for the promotion of health and wellbeing, even in vulnerable groups of children, such as refugees. Nonetheless, there are no published reviews on resilience and/or risk and protective factors for physical and mental health among refugee children living in Nordic countries. In this systematic review, we identified 5181 studies on the topic, screened titles, and abstracts, viewed 632, and finally included 26 studies. These studies described 18 samples with a total of 34,080 individuals ranging in ages 0-18 years. Overall, the studies were of good quality. Nearly all studies assessed adversity. Six studies reported physical health outcomes and all studies mental health outcomes, most often post-traumatic stress disorder and anxiety. None explicitly studied resilience. While we found that age and sex are the most frequently studied risk- and protective factors, findings are inconclusive, since the direction of the associations was different in the different studies. This systematic review indicates that there is still a need for well-designed and -powered studies using clear definitions of key study concepts to examine health outcomes and resilience among refugee children in Nordic countries.
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Affiliation(s)
- Erica Mattelin
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Center for Social and Affective Neuroscience and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Kristina Paidar
- Department of Child and Adolescent Psychiatry, Region Halland, Kungsbacka, Sweden
| | - Natalie Söderlind
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Frida Fröberg
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Laura Korhonen
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
- Center for Social and Affective Neuroscience and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
- Department of Child and Adolescent Psychiatry and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
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3
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Mohammed YY, Abu-Nazel MW, Aly RSI, Shata ZN. The role of adverse childhood experiences in predicting child abuse perpetration among married mothers in Alexandria, Egypt: a cross-sectional study. BMC Womens Health 2024; 24:59. [PMID: 38263083 PMCID: PMC10804716 DOI: 10.1186/s12905-024-02903-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 01/12/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are receiving increased amounts of attention as a critical public health issue. ACEs have a massive impact on future violence victimization and perpetration. They are also associated with lifelong mental and physical health consequences as well as premature mortality. The present study aimed to investigate the role of different ACEs among married mothers in predicting the risk of child abuse perpetration in offspring. METHODS A cross-sectional study was conducted on 350 mothers of children aged 2-12 years attending family health centres in Alexandria. The mothers completed a predesigned interview questionnaire on sociodemographic data and data related to ACEs, spousal violence, and child abuse perpetration. Suitable bivariate and multivariate statistical tests were used to analyse the collected data using version 20.0 of the Statistical Package for Social Sciences (SPSS). RESULTS Two-thirds of mothers (66.3%) reported ever having been exposed to any ACE, and 18.6% of them had experienced 3 or more ACEs. Psychological abuse (46%) and witnessing domestic violence (17%) were the most common. Psychological aggression (95.4%), minor physical assault (79%), and neglect (52%) were the most common forms of child abuse perpetrated by the mothers. The number of ACEs experienced by mothers showed a moderate positive significant correlation with the 5 forms of child abuse examined. Different ACEs, mother's age, socioeconomic status, and current exposure to spousal violence were found to be independent predictors of different forms of child abuse (psychological aggression, neglect, minor physical assault, and severe physical assault). CONCLUSION Different practices of family violence are strongly connected throughout different stages of an individual's life and across generations. Further understanding of the interconnections among forms of violence and addressing them should be prioritized. Additionally, concerted national strategies across all levels and sectors are needed to address this complex problem.
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Affiliation(s)
- Yasmine Yousry Mohammed
- Family Health Department, High Institute of Public Health, Alexandria University, 165 El Horreya Avenue - El Hadara, Alexandria, Egypt.
| | - Mervat Wagdy Abu-Nazel
- Family Health Department, High Institute of Public Health, Alexandria University, 165 El Horreya Avenue - El Hadara, Alexandria, Egypt
| | | | - Zeinab Nazeeh Shata
- Family Health Department, High Institute of Public Health, Alexandria University, 165 El Horreya Avenue - El Hadara, Alexandria, Egypt
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4
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Kanj G, Hallit S, Obeid S. The relationship between childhood emotional abuse and borderline personality disorder: the mediating role of difficulties in emotion regulation among Lebanese adults. Borderline Personal Disord Emot Dysregul 2023; 10:34. [PMID: 37986013 PMCID: PMC10662025 DOI: 10.1186/s40479-023-00241-0] [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: 01/15/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVE The present study investigates the mediating effect of difficulties in emotion regulation in the association between childhood emotional abuse and Borderline Personality Disorder (BPD) among Lebanese adults. METHOD This cross-sectional study, involving 411 participants, was conducted between March and August 2022. Lebanese individuals from all governorates of the country were recruited using the Snowball Sampling technique. Three self-report scales were utilized to complete this research; the 'Difficulties in Emotion Regulation Scale-Brief Version (DERS-16)' which evaluates the difficulties in emotion regulation of individuals, the 'Childhood Trauma Questionnaire-Short Form (CTQ-SF)' which grants a subjective evaluation of the general childhood environment of the participants, as well as the 'Borderline Personality Questionnaire (BPQ)' which measures Borderline Personality Disorder traits, that demonstrate significant convergence with the disorder. RESULTS The results indicate that DERS-16 played an indirect effect role between childhood emotional abuse scores and Borderline Personality Disorder. Higher emotional abuse scores were significantly associated with higher DERS-16 scores, which in turn was significantly associated with higher BPQ scores. Moreover, childhood emotional abuse was directly associated with higher BPQ scores. CONCLUSION This work suggests that, among the different forms of childhood abuse, emotional abuse may have a role in the development of Borderline Personality Disorder. Training on emotion regulation strategies would potentially benefit individuals in preventing BPD development and facilitating therapeutic processes.
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Affiliation(s)
- Gaelle Kanj
- School of Arts and Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
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5
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Karam E, Al Barathie J, Saab D, Karam AN, Fayyad J. First Onset in Adulthood of Mental Disorders: Exposure to War vs. Non-war Childhood Adversities: A National Study. Clin Pract Epidemiol Ment Health 2023; 19:e17450179216651. [PMID: 38655552 PMCID: PMC11037514 DOI: 10.2174/0117450179216651231106072824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/16/2023] [Accepted: 10/24/2023] [Indexed: 04/26/2024]
Abstract
Background There is evidence that some childhood trauma increases the risk of the first onset of mental disorders and for the first time into adulthood. There are no studies that assessed whether exposure to war has this delayed long-term effect. Objectives To fill this gap by investigating the comparative roles of war and non-war trauma on the first onset of adulthood mood and anxiety disorders. Methods A nationally representative sample of 2,857 Lebanese was assessed using the World Health Organization Composite International Diagnostic Interview 3.0. with the onset of exposure to trauma and of first onset of mood and anxiety disorders. Results Non-war childhood traumata especially those belonging to family malfunctioning continue to exert their effect for the first time well beyond their occurrence as they were the most universal predictors for adult onset of both mood and anxiety disorders. War trauma during childhood predicted mood anxiety and mood (anxiety only in males) only below age 18 y. war childhood trauma predicts the first onset of mood and anxiety disorders before age 18 y in females, but only anxiety in males. Conclusion Childhood traumata are not equal in predicting the first onset of mood and anxiety disorders into adulthood. Family malfunctioning looks to carry the longest such risk and war more of shorter immediate effects. This might change though with re-exposure to war in adulthood which might unravel dormant vulnerability.
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Affiliation(s)
- Elie Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, University of Balamand Faculty of Medicine, Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
| | - Josleen Al Barathie
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Dahlia Saab
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Aimee Nasser Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, University of Balamand Faculty of Medicine, Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
| | - John Fayyad
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, University of Balamand Faculty of Medicine, Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
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6
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Al-Hajj S, Pawliuk C, Smith J, Zheng A, Pike I. History of injury in a developing country: a scoping review of injury literature in Lebanon. J Public Health (Oxf) 2021; 43:e24-e44. [PMID: 32323720 DOI: 10.1093/pubmed/fdaa043] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 12/01/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Lebanon, an Eastern Mediterranean country, suffers a large burden of injury as a consequence of conflict and war, political instability, and the lack of policies and safety regulations. This article aims to systematically map and comprehensively describe the injury research literature in Lebanon and, to identify gaps for future research. METHODS MEDLINE, Embase, Eric and SafetyLit, and the grey literature, including conference proceedings, theses and dissertations, government and media reports, were searched without any date or language limits. Data were extracted from 467 documents using REDCap. RESULTS War-related injuries were the most prevalent type of injury in Lebanon, followed by homicide and other forms of violence. While existing literature targeted vulnerable and at-risk populations, the vast majority focused solely on reporting the prevalence of injuries and associated risk factors. There are considerable gaps in the literature dealing with the integration of preventive programs and interventions across all populations. CONCLUSIONS Lebanon, historically and currently, experiences a high number of injuries from many different external causes. To date, efforts have focused on reporting the prevalence of injuries and making recommendations, rather than implementing and evaluating interventions and programs to inform policies. Future injury related work should prioritize interventions and prevention programs.
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Affiliation(s)
- Samar Al-Hajj
- Health Management and Policy Department, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Colleen Pawliuk
- BC Children's Hospital Research Institute, Vancouver, BC V6H3V4, Canada
| | - Jennifer Smith
- BC Injury Research and Prevention Unit, BC Children's Hospital Research Institute, Vancouver, BC V6H3V4, Canada
| | - Alex Zheng
- BC Injury Research and Prevention Unit, BC Children's Hospital Research Institute, Vancouver, BC V6H3V4, Canada
| | - Ian Pike
- BC Children's Hospital Research Institute, Vancouver, BC V6H3V4, Canada.,BC Injury Research and Prevention Unit, BC Children's Hospital Research Institute, Vancouver, BC V6H3V4, Canada.,Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC V6H3V4, Canada
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7
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Haddad C, Darwich MJ, Obeid S, Sacre H, Zakhour M, Kazour F, Nabout R, Hallit S, Tahan FE. Factors associated with anxiety disorders among patients with substance use disorders in Lebanon: Results of a cross-sectional study. Perspect Psychiatr Care 2020; 56:745-752. [PMID: 31793708 DOI: 10.1111/ppc.12462] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 11/23/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Estimate the rate of anxiety disorders (AD) and associated factors among patients with substance use disorder (SUD) in Lebanon. METHODS A cross-sectional study, conducted between April and September 2017, enrolled 57 inpatients with SUD. RESULTS The rate of AD in patients with SUD was 61.4%. The university level of education compared to the primary level of education (ORa = 0.221) was significantly associated with lower anxiety among patients with SUD. Being sexually abused and having a family history of depression tended to significance. PRACTICAL IMPLICATIONS AD is widespread in Lebanon and high rates of anxiety in patients with SUD were found, warranting the implementation of strategic interventions and establishing national policies and legislation for mental health services to provide optimal care.
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Affiliation(s)
- Chadia Haddad
- Departments of Research, Psychiatry and Psychology, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | | | - Sahar Obeid
- Departments of Research, Psychiatry and Psychology, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
| | - Hala Sacre
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.,Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Maha Zakhour
- Faculty of Sciences, Lebanese University, Fanar, Lebanon
| | - Francois Kazour
- Departments of Research, Psychiatry and Psychology, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Faculty of Sciences, Lebanese University, Fanar, Lebanon.,Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,INSERM U930, équipe 4 "Troubles affectifs", Université François-Rabelais de Tours, Tours, France.,Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Rita Nabout
- Faculty of Sciences, Lebanese University, Fanar, Lebanon
| | - Souheil Hallit
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Fouad E Tahan
- Departments of Research, Psychiatry and Psychology, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Faculty of Sciences, Lebanese University, Fanar, Lebanon
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8
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Karam EG, Fayyad JA, Farhat C, Pluess M, Haddad YC, Tabet CC, Farah L, Kessler RC. Role of childhood adversities and environmental sensitivity in the development of post-traumatic stress disorder in war-exposed Syrian refugee children and adolescents. Br J Psychiatry 2019; 214:354-360. [PMID: 30630553 DOI: 10.1192/bjp.2018.272] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Increased post-traumatic stress disorder (PTSD) rates have been documented in children exposed to war. However, the contribution of childhood adversities and environmental sensitivity to children's responses to adversities and trauma are still far from settled.AimsTo evaluate the relative roles of war, childhood adversities and sensitivity in the genesis of PTSD. METHOD Data on childhood adversities and sensitivity was collected from 549 Syrian refugee children in Lebanon. PTSD symptoms were assessed using the PTSD Reaction Index. RESULTS Although childhood adversities, war events and sensitivity were all significantly related to PTSD in bivariate analyses, multivariate analyses showed that childhood adversities were the most important variable in predicting PTSD. The effect of war on PTSD was found to be dependent on the interplay between childhood adversities and sensitivity, and was most prominent in highly sensitive children with lower levels of adversities; in sensitive children experiencing high levels of adversities, the effects of war exposure on PTSD were less pronounced. CONCLUSIONS When considering the effects of war on PTSD in refugee children, it is important to take account of the presence of other adversities as well as of children's sensitivity. Sensitive children may be more vulnerable to the negative effects of war exposure, but only in contexts that are characterised by low childhood adversities.Declaration of interestNone.
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Affiliation(s)
- Elie G Karam
- Professor of Psychiatry,Department of Psychiatry and Clinical Psychology,Balamand University, St Georges Hospital University Medical Center, Institute for Development, Research, Advocacy and Applied Care (IDRAAC),Lebanon
| | - John A Fayyad
- previously Professor of Psychiatry,Department of Psychiatry and Clinical Psychology,Balamand University, St Georges Hospital University Medical Center,Institute for Development, Research, Advocacy and Applied Care (IDRAAC),Lebanon
| | - Claudia Farhat
- Research Associate,Institute for Development, Research, Advocacy and Applied Care (IDRAAC),Lebanon
| | - Michael Pluess
- Professor in Developmental Psychology,Department of Biological and Experimental Psychology,School of Biological and Chemical Sciences, Queen Mary University of London,UK
| | - Youmna C Haddad
- Instructor,Department of Psychiatry and Clinical Psychology,Balamand University, St Georges Hospital University Medical Center, Institute for Development, Research, Advocacy and Applied Care (IDRAAC),Lebanon
| | - Caroline C Tabet
- Instructor,Department of Psychiatry and Clinical Psychology,Balamand University, St Georges Hospital University Medical Center, Institute for Development, Research, Advocacy and Applied Care (IDRAAC),Lebanon
| | - Lynn Farah
- Social Worker,Department of Social Services,St Joseph University,Lebanon
| | - Ronald C Kessler
- McNeil Family Professor,Department of Health Care Policy,Harvard Medical School,USA
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9
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Grelotti DJ, Gerbasi ME, Eustache E, Reginald Fils-Aimé J, Thérosmé T, Severe J, Raviola GJ, Darghouth S, Legha R, Pierre EL, Affricot E, Alcindor Y, Boyd K, Becker AE, Fawzi MCS. Prevalence of stressful life events and their association with post-traumatic stress disorder among youth attending secondary school in Haiti. Psychiatry Res 2018; 269:369-375. [PMID: 30173043 PMCID: PMC7050197 DOI: 10.1016/j.psychres.2018.08.074] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 05/28/2018] [Accepted: 08/17/2018] [Indexed: 01/03/2023]
Abstract
The association between earthquakes and youth post-traumatic stress disorder (PTSD) has been well described, but little is known about the relationship between other stressful life events (SLEs) and PTSD among earthquake-affected youth. This study examines a variety of SLEs, including earthquake, and their association with PTSD among school-going Haitian youth following a major earthquake in 2010. In 2013, we assessed 120 students ages 18-22 for PTSD and other SLEs using a modified Structured Clinical Interview for DSM-IV (SCID)-based interview and the Stressful Life Events Checklist (SLE Checklist). Only 51.7% of participants on the SLE Checklist and 31.7% in the interview endorsed being affected by the earthquake or another disaster. Sexual assault showed the strongest association with PTSD in multivariable logistic regression. Contrary to our hypothesis, exposure to earthquake or another disaster was not significantly associated with current PTSD. In this population, exposure to interpersonal violence may have had a greater impact on PTSD risk than exposure to natural disaster. These data underscore the need to examine and reduce both acute and chronic stressors among disaster-affected youth.
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Affiliation(s)
- David J. Grelotti
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA,Correspondence to David J. Grelotti, MD, Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, MC 0603, La Jolla, CA 92093.
| | - Margaret E. Gerbasi
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Eddy Eustache
- Mental Health and Psychosocial Services, Zanmi Lasante, Mirebalais, Haiti
| | | | - Tatiana Thérosmé
- Mental Health and Psychosocial Services, Zanmi Lasante, Mirebalais, Haiti
| | - Jennifer Severe
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Giuseppe J. Raviola
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Sarah Darghouth
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Rupinder Legha
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA
| | - Ermaze L. Pierre
- Mental Health and Psychosocial Services, Zanmi Lasante, Mirebalais, Haiti
| | - Emmeline Affricot
- Mental Health and Psychosocial Services, Zanmi Lasante, Mirebalais, Haiti
| | - Yoldie Alcindor
- Mental Health and Psychosocial Services, Zanmi Lasante, Mirebalais, Haiti
| | | | - Anne E. Becker
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Mary C. Smith Fawzi
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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10
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Naal H, El Jalkh T, Haddad R. Adverse childhood experiences in substance use disorder outpatients of a Lebanese addiction center. PSYCHOL HEALTH MED 2018; 23:1137-1144. [DOI: 10.1080/13548506.2018.1469781] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Hady Naal
- Department of Psychology, Haigazian University, Beirut, Lebanon
| | - Tatiana El Jalkh
- Department of Life and Earth Sciences, Faculty of Sciences, Lebanese University, Beirut, Lebanon
| | - Ramzi Haddad
- Department of Psychiatry, Saint Joseph University, Beirut, Lebanon
- Department of Psychiatry, Lebanese University, Beirut, Lebanon
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11
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Tarabah A, Badr LK, Usta J, Doyle J. Exposure to Violence and Children's Desensitization Attitudes in Lebanon. JOURNAL OF INTERPERSONAL VIOLENCE 2016; 31:3017-3038. [PMID: 26013396 DOI: 10.1177/0886260515584337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Children exposed to multiple sources of violence may become desensitized, increasing the possibility of them imitating the aggressive behaviors they watch and considering such behavior as normal. The purpose of this article is to assess the association between exposure to various types of violence (including war) and desensitization in Lebanese children. A cross-sectional design with 207 school-aged children assessed exposure to violence using three surveys: (a) violence in the media (the Media Preference survey), (b) exposure to violence (the KID-SAVE survey), and (c) desensitization attitudes (the Attitude Toward Violence-Child Version). Children were between 8 and 12 years old, 56% were males, and 70%were from middle socioeconomic status (SES) backgrounds. Seventy-six percent of children reported being exposed to violence, with more exposure in males and in the lower SES group. Impact, however, was greater on girls. The predictors of attitude toward violence were "Frequency" of exposure, "Impact" of exposure, and the amount of violence viewed on television. Children are massively exposed to violence in Lebanon resulting in desensitization, which may habituate them to accept violence as normal and put them at risk for imitating violent behaviors.
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12
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McLafferty M, Armour C, O'Neill S, Murphy S, Ferry F, Bunting B. Suicidality and profiles of childhood adversities, conflict related trauma and psychopathology in the Northern Ireland population. J Affect Disord 2016; 200:97-102. [PMID: 27130959 DOI: 10.1016/j.jad.2016.04.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 03/24/2016] [Accepted: 04/16/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND Over 30 years of conflict in Northern Ireland (NI) has impacted on the population's mental health. However, childhood adversities may add to the psychological impact of conflict. The aims of the study were to assess co-occurrence across childhood adversities, conflict related traumas, and psychological health, then explore demographic variations between identified classes, and examine the impact of class membership on suicidal ideation and behaviour. METHOD Data was obtained from the Northern Ireland Study of Health and Stress, a representative epidemiological study which used the CIDI to assess psychopathology and related risk factors in the NI population (N=4340, part 2 n=1986; response rate 64%). RESULTS Latent Class Analysis uncovered 4 discrete profiles; a conflict class (n=191; 9.6%), a multi-risk class endorsing elevated levels of childhood adversities, conflict related traumas and psychopathology (n=85; 4.3%), a psychopathology class (n=290; 14.6%), and a low risk class (n=1420; 71.5%). Multinomial logistic regression analysis revealed that individuals who grew up during the worst years of the Troubles were more likely to have experienced multiple traumas and psychopathology. Individuals in the multi-risk class were more than fifteen times more likely to endorse suicidal ideation and behaviour. LIMITATIONS The main limitations are that the study may not be fully representative of the NI population due to the exclusion criteria applied and also the possible misclassification of conflict related events. CONCLUSIONS The findings indicate that treatment providers should be cognisant that those with wide ranging adversity profiles are those also likely to be reporting psychological distress and suicidality.
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Affiliation(s)
- Margaret McLafferty
- School of Psychology, Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland, United Kingdom.
| | - Cherie Armour
- School of Psychology, Ulster University, Coleraine Campus, Cromore Road, Coleraine, Northern Ireland, United Kingdom
| | - Siobhan O'Neill
- School of Psychology, Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland, United Kingdom
| | - Sam Murphy
- School of Psychology, Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland, United Kingdom
| | - Finola Ferry
- School of Psychology, Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland, United Kingdom
| | - Brendan Bunting
- School of Psychology, Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland, United Kingdom
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Coêlho BM, Andrade LH, Borges G, Santana GL, Viana MC, Wang YP. Do Childhood Adversities Predict Suicidality? Findings from the General Population of the Metropolitan Area of São Paulo, Brazil. PLoS One 2016; 11:e0155639. [PMID: 27192171 PMCID: PMC4871559 DOI: 10.1371/journal.pone.0155639] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 05/02/2016] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Childhood adversities have been associated with a number of medical and psychiatric outcomes. However, the reported effects that specific childhood adversities have on suicidality vary across studies. METHOD This was a cross-sectional, stratified, multistage area probability investigation of a general population in Brazil, designated the São Paulo Megacity Mental Health Survey. The World Mental Health Composite International Diagnostic Interview was applied in 5037 individuals ≥ 18 years of age, in order to assess 12 different adversities occurring during childhood and/or adolescence, as well as to look for associations between those adversities and subsequent suicidality in different age strata. RESULTS Over half of the respondents reported at least one childhood adversity. Only physical abuse was consistently associated with suicide attempts in all subsequent life stages (OR = 2.1). Among adults 20-29 years of age, the likelihood of a suicide attempt was correlated with parental divorce, whereas suicidal ideation was associated with prior sexual abuse. Among adults over 30 years of age, physical illness and economic adversity emerged as relevant childhood adversities associated with suicide attempts, whereas sexual abuse, family violence, and economic adversity were associated with suicidal ideation. CONCLUSION Childhood adversities, especially physical abuse, are likely associated with unfavorable consequences in subsequent years. For suicidality across a lifespan, the role of different childhood adversities must be examined independently.
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Affiliation(s)
- Bruno Mendonça Coêlho
- Section of Psychiatric Epidemiology – LIM-23, Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, SP, Brazil
- * E-mail:
| | - Laura Helena Andrade
- Section of Psychiatric Epidemiology – LIM-23, Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Guilherme Borges
- División de Investigaciones Epidemiológicas y Sociales, Instituto Mexicano de Psiquiatría (IMP), México, D.F., Mexico
| | - Geilson Lima Santana
- Section of Psychiatric Epidemiology – LIM-23, Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Maria Carmen Viana
- Department of Social Medicine Post-Graduate Program in Public Health, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | - Yuan-Pang Wang
- Section of Psychiatric Epidemiology – LIM-23, Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, SP, Brazil
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14
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Karam G, Itani L, Fayyad J, Karam A, Mneimneh Z, Karam E. Prevalence, Correlates, and Treatment of Mental Disorders among Lebanese Older Adults: A National Study. Am J Geriatr Psychiatry 2016; 24:278-86. [PMID: 26880613 DOI: 10.1016/j.jagp.2015.10.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 09/23/2015] [Accepted: 10/05/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Data on the mental health of older adults in the Middle East is lacking. Prevalence of mental disorders in Lebanese older adults (age: 60+ years) as well as accounts of their attitude towards seeking professional help for mental disorders were investigated. The results of older adults were compared to a younger age group (18-59 years). DESIGN Cross-sectional nationally representative study, using data from the Lebanese Evaluation of the Burden of Ailments and Needs of the Nation. SETTING Community-based epidemiologic survey. PARTICIPANTS Community-dwelling adults (N = 2,857) in Lebanon. MEASUREMENTS Mental disorders were evaluated using the World Health Organization Composite International Diagnostic Interview. RESULTS The lifetime and 12-month prevalences of having "any mental disorder" in older adults (N = 593) were 17.4% and 10.6%, respectively, and were significantly lower than the prevalence in younger adults (25.7% and 18.5%, respectively). Female sex, low household income, social disability, and exposure to war trauma were significant correlates of 12-month mental disorders in older adults. Of those with a 12-month mental disorder, 16.0% sought professional help for their condition in the past year. CONCLUSIONS As shown in other epidemiologic studies, the prevalence of mental disorders in Lebanon was lower in older adults as compared to younger adults. Several factors in epidemiologic studies, however, may contribute to the underdiagnosis of mental disorders in older adults. No significant differences in attitude towards mental health services were found between older and younger age groups. The importance of interventions that improve the social relationships of older adults is highlighted.
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Affiliation(s)
- Georges Karam
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care , Beirut, Lebanon.
| | - Lynn Itani
- Institute for Development Research Advocacy and Applied Care , Beirut, Lebanon
| | - John Fayyad
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care , Beirut, Lebanon
| | - Aimee Karam
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care , Beirut, Lebanon
| | - Zeina Mneimneh
- Institute for Social Research, University of Michigan , Ann Arbor, MI, USA
| | - Elie Karam
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care , Beirut, Lebanon
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Abstract
Millions of people across the world have been displaced or live in exile and/or as refugees largely as a consequence of wars, acts of terrorism, and catastrophic natural disasters. There are serious psychological consequences as a result of these extremely difficult life circumstances. Adults often can express their needs and have them be heard, whereas children are unable to do so. The children may be provided food, shelter, and clothing and have their medical needs attended to, but their emotional and psychological needs go unrecognized and unmet, with dire and monumental long-term consequences.
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Affiliation(s)
- Paramjit T Joshi
- Department of Psychiatry & Behavioral Sciences, Children's National Medical Center, George Washington University School of Medicine, 111 Michigan Avenue Northwest, Floor 2.5 West, Suite 700, Washington, DC 20010, USA.
| | - John A Fayyad
- Faculty of Medicine, St George Hospital, University Medical Center, Balamand University, Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
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