Suicidality in the Arab World: Results from an Online Screener.

Suicide in the Arab World is grossly understudied. This study sought to understand suicidality among Arabic-speaking individuals visiting an online depression screener. A large sample (N = 23,201) from the Arab World was recruited online. 78.9% (n = 17,042) reported suicidality (thoughts of death or suicide, or a suicide attempt) and 12.4% reported a suicide attempt in the past 2 weeks. Binary logistic regressions indicated that women tended to report more suicidality, and that suicidality tended to decline with age (all ps < 0.001), across all levels of suicidality. Comparing countries with n ≥ 1000 (Algeria, Egypt, Jordan, Morocco, and Saudi Arabia), several 3-way (gender * age * country) and 2-way interactions indicated that some countries departed from the usual pattern of responses. For instance, in Algeria, neither gender nor age differences were observed in reported attempts. Women and younger adults in the Arab World may be at higher risk of suicidality. Differences between and within countries warrant further exploration.

Factor analysis of depression symptoms across five broad cultural groups.

INTRODUCTION: Core symptoms of depression are likely universal, however cultural groups differ in their experience of the condition. The purpose of this study was to examine differences and similarities of depression symptom groupings between broad cultural groups. METHOD: 6,982 adults took part in an online multilingual depression screening study, and completed an 18-item major depression screener. Participants were categorized into five broad cultural groups by language and country of residence: Spanish speakers from Latin America (n = 3,411); English speakers from Southeast Asia (n = 1,265); Russian speakers from the former Soviet bloc (n = 642); English speakers from English-speaking Western countries (n = 999); and Chinese speakers from China (n = 665). Principal components analysis with promax rotation was used. RESULTS: Both similarities and noteworthy differences in symptom clustering between groups were observed. For instance, though suicide-related items formed a separate cluster for most cultures, for the Latin-American group, worthlessness loaded with suicidality. Changes in appetite and changes in weight tended to load on different factors (except for Chinese and Russian groups). Hypersomnia tended to load with psychomotor agitation, and core depression symptoms tended to load with physical symptoms (except for the Russian group). LIMITATIONS: Depression was assessed by a self-report measure aligned to DSM-IV. CONCLUSION: The analysis contributes to a nuanced understanding of depression manifestations of various cultures, which may inform culturally sensitive clinical practice.

The ICD-11 classification of gender incongruence of adolescence and adulthood: adequacy among transgender people in Lebanon.

The aim of this study was to evaluate the adequacy of the then proposed International Classification of Diseases version 11 (ICD-11) diagnostic guidelines for Gender Incongruence of Adolescence and Adulthood in a sample of transgender people accessing multi-disciplinary health care services at specialised organisations in Lebanon. The cross-sectional study reported here was part of the ICD-11 field test studies that took place in several countries. Twenty-eight Arab transgender adults residing in Lebanon were recruited after giving consent to participate in a structured interview with a mental health professional. The questions asked of them consisted of the following: socio-demographic data; medical history related to gender identity; experiences of gender incongruence; psychological distress; rejection; violence; and functional impairment. Results showed that Arab transgender individuals living in Lebanon report being the victims of violence, abuse, discrimination and rejection from family, peers and society in general. As a result, they develop psychological distress that is better explained by the social context in which they live, rather than by their transgender identity. Reformulating ICD-10 Transsexualism as Gender Incongruence of Adolescence and Adulthood in ICD-11 and moving this diagnosis out of the chapter on mental disorders chapter would be favourable to the Lebanese sample.

Common and Country-Specific Characteristics Associated With Suicidality in the Arab Region.

OBJECTIVE: To explore the prevalence of recent (previous 2 weeks) suicide attempts and estimates of likelihood of future suicide attempts as well as demographic characteristics associated with such attempts among residents of the Arab region looking for depression information online. METHODS: Google Ads were used to recruit 1,003 Arabic-speaking adults mostly from February 2014 to June 2014 to take part in a depression and suicidality screening study using a self-report questionnaire based on DSM-IV diagnostic criteria. RESULTS: Of the eligible participants (N = 900), 10.6% reported a suicide attempt in the previous 2 weeks, and 16.1% indicated a likelihood of making a suicide attempt in the following month. Men, those declining to state their sexual orientation, those from lower subjective social status (SSS), and unemployed individuals had higher odds of reporting a past suicide attempt (P = .001, P = .002, P < .001, P = .023, respectively). Younger individuals, those less religious, those with past suicide attempt, and those with lower SSS had higher odds of a likelihood of a future suicide attempt (P = .03, P = .02, P < .001, P = .001, respectively). Comparing the 4 countries with highest number of participants (Algeria, n = 148, Egypt, n = 260, Morocco, n = 118, and Saudi Arabia, n = 99), lower SSS was associated with higher odds of an attempt for Algeria, Morocco, and Saudi Arabia, but not for Egypt (P = .002). Lower religiosity was related to higher odds of estimates of future suicide for Algeria, Egypt, and Saudi Arabia, but not for Morocco (P = .014). CONCLUSIONS: Suicidality among residents of Arab-speaking countries warrants further exploration. Common predictors of risk may be less relevant for some populations.​.

Selected psychiatric problems among college students in two Arab countries: comparison with the USA.

BACKGROUND: Psychiatric problems among college students on USA campuses are common. Little is known about similar problems in developing countries, particularly the Arab region. The goal of this study was to assess the frequency of selected psychiatric problems among college students in two Arab countries: Qatar and Lebanon, and to compare them to the USA. METHODS: The Healthy Minds Study, an online confidential survey of common psychiatric symptoms designed for college campuses was used. We used the Patient Health Questionnaire-9 (PHQ-9) to screen for major depression, the Generalized Anxiety Disorder-7 (GAD-7) to screen for generalized anxiety and the SCOFF questionnaire to screen for eating disorders. Comparisons were made using ANOVA, Chi-Square tests and logistic regressions. RESULTS: A total of 1841 students participated in the study. The rates of depression (PHQ-9 ≥ 12), generalized anxiety (GAD-7 ≥ 10) and eating disorders (SCOFF≥3) at the combined Arab universities were 34.6, 36.1 and 20.4% respectively. The corresponding rates in the USA were: 12.8, 15.9 and 6.8% (p < 0.001 for all measures). The impact of psychiatric problems on functioning in general and academic performance in particular was more severe in the Arab countries compared to the USA (p < 0.001). Independent predictors of psychiatric problems in general included location, female gender, financial difficulties and poor grades. Being religious had a protective association with mental health. CONCLUSION: The rates of depression, anxiety and eating disorders were significantly higher among college students in Qatar and Lebanon compared to the USA. Additional research is needed to determine whether these results reflect methodological limitations or true differences in psychopathology across these populations. If replicated, the results indicate that the psychiatric problems on college campuses in the USA are a microcosm of a global problem that needs global solutions.