Article

12-month Prevalence and Treatment of Mental Disorders in Lebanon: a national epidemiological survey

Harvard University, Cambridge, Massachusetts, United States
The Lancet (Impact Factor: 45.22). 04/2006; 367(9515):1000-6. DOI: 10.1016/S0140-6736(06)68427-4
Source: PubMed

ABSTRACT Mental disorders are believed to account for a large portion of disease burden worldwide. However, no national studies have been undertaken to assess this assumption in the Arab world.
As part of the WHO World Mental Health (WMH) Survey Initiative, a nationally representative psychiatric epidemiological survey of 2857 adults (aged 18 years) was done in Lebanon between September, 2002, and September, 2003, through a study called LEBANON (Lebanese Evaluation of the Burden of Ailments and Needs Of the Nation). 12-month prevalence and severity of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) disorders, and treatment were assessed with the WHO Composite International Diagnostic Interview (CIDI, version 3.0). Information was also obtained for sociodemographics and exposure to traumatic events in the Lebanon wars.
308 (17.0%) of respondents met criteria for at least one 12-month DSM-IV/CIDI disorder, 108 (27.0%) of whom were classified serious and an additional 112 (36.0%) moderate. Nearly half of respondents had a history of exposure to war-related traumatic events. Significantly elevated odds ratios (OR) of mood, anxiety, and impulse-control disorders were associated with two (OR 2.0-3.6) or more (2.2-9.1) war-related traumatic events, resulting in substantially higher proportions of moderate and severe 12-month mental disorders in respondents exposed to multiple war-related traumata (16.8-20.4%) compared with other respondents (3.3-3.5%). Only 47 (10.9%) respondents with 12-month disorders obtained treatment. 85% of people were treated in the general medical sector and the mental-health-care system, and the rest by religious or spiritual advisers, counsellors, herbalists, or fortune-tellers.
Mental disorders are common in Lebanon, with a prevalence equivalent to that in Western Europe. However, the number of individuals with mental disorders who are not receiving treatment is considerably higher in Lebanon than in Western countries.

Download full-text

Full-text

Available from: Zeina Mneimneh, May 01, 2014
0 Followers
 · 
102 Views
  • Source
    • "Several issues need clarification in relation to the universality of the IED pattern. Inconsistencies have emerged in the prevalence of IED across countries, with lifetime rates varying from 1.8% to 9% (Al-Hamzawi et al., 2012; Fincham et al., 2009; Karam et al., 2006; Yoshimasu and Kawakami, 2011). In addition, although most inquiries report a higher prevalence of IED amongst males (Fincham et al., 2009; Karam et al., 2008), a study in post-conflict Timor-Leste found that women had double the rate of the disorder (12%) of men (6%) (Rees et al., 2013). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Questions remain about the nosological status of Intermittent Explosive Disorder (IED) as a universal diagnosis. Cross-cultural studies are needed to establish whether IED symptoms form a coherent pattern and are distinguishable from other related symptom constellations. A study amongst a refugee population also allows further inquiry of the relationship between exposure to potentially traumatic events (PTEs) and other adversities with the IED constellation. In the present study amongst West Papuan refugees residing in Port Moresby, Papua New Guinea, we apply culturally adapted interview modules to assess symptoms of IED, post-traumatic stress disorder (PTSD), and depression, as well as the potentially traumatic events (PTEs) of conflict and ongoing adversity in the post-migration environment. Latent class analysis yielded a PTSD class (23%), a posttraumatic depressive class (14%), an IED class (12%), and a low/no symptom class (49%). Compared to the low/no-symptom class, the PTSD class had high levels of exposure to all PTE domains including childhood-related adversities, witnessing murder, human rights trauma, and traumatic losses, as well as ongoing adversity relating to displacement and separation from families, safety concerns, and lack of access to basic needs and health care. The posttraumatic depression class had greater exposure to traumatic losses and childhood-related adversities, higher levels of stress relating to material loss and deprivation, as well as to displacement and separation from families. In contrast, the IED class was distinguished only by the ongoing stress of displacement and separation from families in the homeland. Our findings provide support for the phenomenological distinctiveness of IED symptoms in this transcultural setting. Although not exclusive to IED, conditions of long-term displacement and separation appear to be a source of ongoing anger and explosive aggression amongst this population.
    Journal of Affective Disorders 02/2015; 177C:86-94. DOI:10.1016/j.jad.2015.02.009 · 3.71 Impact Factor
  • Source
    • "Recent history reveals the contribution of wars and major societal trauma to the short-and long-term health status of children and young people worldwide (Betancourt and Khan 2008, Masten and Narayan 2012). Children living in the context of armed conflict are likely to suffer an increase in both mental health and social problems as evidenced by studies from areas such as Jammu and Kashmir (De Jong et al. 2006), Mozambique (Richman 1993), Sri Lanka (Somasundaram 2004), the Gaza Strip (Thabet et al. 2002), Kosovo (Jones 2003), Bosnia (Husain et al. 2008) and Lebanon (Karam et al. 2006). In these contexts, assistance to children informed by psychosocial perspectives provides incentive for greater focus on preventive and primary care services (De Jong 2002; Tolfree 1996; Jordans et al. 2008, 2009; Patel et al. 2008) and the importance of community-based interventions alongside clinical interventions (IASC 2007). "
    [Show abstract] [Hide abstract]
    ABSTRACT: There is an absence of education regarding psychosocial issues in Iraqi paediatric training programmes. The aim of this study is to examine current knowledge and perspectives around these topics and to explore potential development in these programmes. 56 paediatric trainers and students at the Child Central Teaching Hospital, a hospital affiliated to the Al-Mustansyria medical college in Baghdad, responded to a questionnaire to evaluate knowledge and perspectives regarding psychosocial approaches to child and adolescent health as delivered presently via academic training and used in professional practice. The majority of the respondents reported having no training in psychosocial interventions. Using a scale from 0 ('not relevant') to 10 ('very important'), psychosocial issues were rated 7.1 in their relevance to everyday paediatric practice. On a scale of 0 ('very poor') to 10 ('totally adequate'), respondents rated formal current psychosocial training at 2.5. It is concluded that incorporating psychosocial approaches in paediatric training will lead to a broader base of knowledge in children's health and contribute to the promotion of multidisciplinary practice in Iraq.
    Medicine Conflict and Survival 03/2013; 29(1):45-56. DOI:10.1080/13623699.2013.765196
  • Source
    • "the country (e.g., civil war) and their effects on psychopathology. While clinical psychological research in Lebanon has mainly focused on mental disorders and indicators (e.g., Karam et al. 2006) and while these studies are somewhat useful, they are mainly focused on pathologies and do not elucidate how the Lebanese people and communities cope, deal and live with experiences of violence and suffering in their everyday life and in everyday situations. Studies on subjective well-being and happiness can highlight other ways of adaptations and strengths that may emerge from experiences of violence. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The present study evaluated the subjective happiness of Lebanese college youth using a multi-item rather than a single-item subjective happiness measure. An Arabic translation of the Subjective Happiness Scale (SHS) was administered to 273 Lebanese college youth from state- and private-run higher institutions of learning, as was the Arabic Adult Parental Acceptance-Rejection Questionnaire (Arabic PARQ). The reliability and validity of the Arabic SHS was tested in terms of factor analysis, internal consistency, and correlation with Arabic PARQ scores, as was the factorial invariance and relation of the scale across age, sex, marital status, birth order, and college campus. The Arabic SHS showed a reliable unitary structure similar to those found in other cultures, and factorial invariance across sex, marital status, birth order and college campus. While age, sex, marital status and birth order were independent of happiness scores, college students attending the private university reported greater happiness than those from the state-run academic setting. It was concluded that the Lebanese Arabic SHS is a reliable and valid measure of global subjective happiness, its factor structure is similar across other translated versions of the scale, and its scores are independent of age, sex, marital status and birth order.
    Social Indicators Research 11/2012; 109(2). DOI:10.1007/s11205-011-9895-5 · 1.40 Impact Factor
Show more