COVID-19 outbreak in a psychiatric hospital: what makes it worse?

BACKGROUND: Psychiatric patients could be at risk of worse outcomes from COVID-19 than the general population. The primary objective of the present study was to describe the symptoms and clinical characteristics of COVID-19 patients living in long-term hospital for mental illness in Lebanon. The secondary objective was to evaluate the factors related to COVID-19 disease severity among these patients. METHODS: A retrospective observational study was conducted from September 2020 to January 2021 at the Psychiatric Hospital of the Cross. The total number of COVID-19 patients in the infected floors is 410 out of 548. The outcome variable was the severity of COVID-19 illness classified into five categories: asymptomatic, mild, moderate, severe and critically ill. RESULTS: The rate of infection in the affected floors was 74.81%. Almost half of the patients were asymptomatic (49.3%), 43.4% had hyperthermia and only 28.0% had tachycardia and 25.1% developed hypoxia. The multivariate regression analysis showed that higher temperature (ORa = 6.52), lower saturation (ORa = 0.88), higher BMI (ORa = 1.12), higher CRP (ORa = 1.01), being a female (ORa = 4.59), having diabetes (ORa = 8.11) or COPD (ORa = 10.03) were significantly associated with the increase of the COVID-19 severity. CONCLUSIONS: The current study showed that a high rate of infection from COVID-19 was detected in a psychiatric hospital with the majority having asymptomatic to mild symptoms. Female psychiatric patients, desaturation, increase inflammation and comorbidities such as diabetes and COPD were associated with the severity of COVID-19 among psychiatric patients. Future studies are needed to better understand the causal relation of the factors with severity and long term effects or sequelae of the disease.

Association of problematic internet use with depression, impulsivity, anger, aggression, and social anxiety: Results of a national study among Lebanese adolescents.

IMPORTANCE: Several studies conducted worldwide (mostly in Western countries) highlighted the negative effects of problematic internet use, particularly among adolescents aged 12 to 17, including depression, impulsivity, aggression, and social fear and avoidance. In Lebanon, literature on the prevalence and impact of problematic internet use among adolescents is limited. OBJECTIVE: This study aim was to study the association between problematic internet use and depression, impulsivity, anger, aggression and social phobia among Lebanese adolescents. METHODS: A cross-sectional study was performed on 1103 young adolescents (14-17 years), recruited from October 2017 till April 2018. The Internet Addiction Test (IAT) was used to evaluate the level of problematic internet use. Data were analyzed using the MANCOVA analysis. The main independent variable of interest was the IAT, while the dependent variables included the psychological scales. RESULTS: The multivariate analysis taking the psychological scales as the dependent variables and the problematic internet use (IAT score) as an independent variable, showed that problematic internet use was associated with higher depression, impulsivity, aggression, anger, hostility and social anxiety. INTERPRETATION: Problematic internet use has become an important health issue that should not be overlooked, particularly because of the increased use of the internet by adolescents. Educational programs on early exposure to the internet should be developed.

Phubbing and temperaments among young Lebanese adults: the mediating effect of self-esteem and emotional intelligence.

BACKGROUND: The rapid increasing rate of mobile and internet users in Lebanon, predisposes us to a high dependency on smartphones, leading to more phubbing. Phubbing has been found associated with many psychological factors. Thus, the main objectives of this study was (1) to evaluate the association between phubbing and temperaments, and (2) assess the mediating effect of self-esteem and emotional intelligence in the association between phubbing and temperaments among a sample of Lebanese adults. METHODS: A cross-sectional study, carried out between August and September 2020, enrolled 461 participants aged between 18 and 29 years old. Participants were recruited from all districts/governorates of Lebanon (Beirut, Mount Lebanon, North Lebanon, South Lebanon, and Bekaa) using the snowball technique. The Generic Scale of Phubbing, Rosenberg Self-Esteem Scale, Schutte Self Report Emotional Intelligence Test and TEMPS-M were used to assess phubbing, self-esteem, emotional intelligence and temperaments respectively. RESULTS: Our results showed that higher depressive temperament (B = 1.21) was significantly associated with more phubbing, whereas higher self-esteem (B = - 0.32) was significantly associated with less phubbing. Regarding the mediating effect, self-esteem partially mediated the association between depressive temperament and phubbing (21.02%), whereas emotional intelligence had no mediating effect on the association between temperaments and phubbing. CONCLUSION: A strong correlation between phubbing and temperaments has been found in our study with a partial mediating effect of self-esteem in this association. Our findings might be a first step for raising awareness to develop the etiquette of using smartphones by providing media education to families, and good media usage habits.

Construction of the Lebanese Anxiety Scale (LAS-10): a new scale to assess anxiety in adult patients.

Objective: The study objectives were (1) to create a new 10-item scale, the 'Lebanese Anxiety Scale' (LAS-10), inspired by the diagnostic criteria of DSM-5, and the HAM-A and STAI scales and (2) to evaluate the performance of this new scale on a sample of Lebanese individuals.Methods: This cross-sectional study enrolled 1332 community dwelling participants between November 2017 and March 2018.Results: In sample 1, the participants' mean age was 28.08 years (63.9% females). The LAS items converged over a solution of two factors that had an Eigenvalue over 1, explaining a total of 51.97% of the variance (αCronbach=0.857). The optimal cut-off between healthy controls and anxious patients was 13.50 according to the ROC curve. The sensitivity and specificity were good at this cut-off (77.5% and 70.8%, respectively). The area under the curve was high: 0.811 [0.778-0.845]; p < .001. The positive predicted value of the LAS-10 score in sample 1 was 26.9%, whereas the negative predicted value was 95.2%.Conclusion: The results of the present study show that the LAS-10 is a tool that can be used in clinical practice and research to screen for anxiety.KEY POINTSThe positive predicted value of the LAS-10 score was 26.9%.Its negative predicted value was 95.2%.People with scores above 13.5 be referred to a health care professional for further assessment.The LAS-10 is a tool can be used in clinical practice and research to screen for anxiety.Future studies are needed to validate the LAS-10 in other countries.

Interaction between anxiety and depression on suicidal ideation, quality of life, and work productivity impairment: Results from a representative sample of the Lebanese population.

PURPOSE: To assess the association between the interaction of anxiety and depression on the suicidal ideation, quality of life (QOL), and work productivity/impairment in Lebanon. DESIGN: Cross-sectional. METHODS: 1487 participants were enrolled between November 2017 and March 2018. RESULTS: The interaction of anxiety and depression (ß = .101), higher depression alone (ß = .021), higher anxiety traits (STAI-B) (ß = .007) were associated with higher suicidal ideation. Higher depression (ß = 1.177), having more anxiety traits (STAI-B) (ß = .485) and higher anxiety (STAI-A) (ß = .298) were associated with higher activity impairment. Higher depression, higher anxiety traits and state, were associated with lower mental and physical QOL. PRACTICE IMPLICATIONS: Screening for anxiety and depression can help clinicians improve patients' QOL and work productivity and decrease the suicidal ideation risk.

Internet Addiction Among Lebanese Adolescents: The Role of Self-Esteem, Anger, Depression, Anxiety, Social Anxiety and Fear, Impulsivity, and Aggression-A Cross-Sectional Study.

The study objective was to evaluate the association between depression, anxiety, social anxiety and fear, impulsivity, and aggression and Internet addiction (IA) among Lebanese adolescents. This cross-sectional study, conducted between October 2017 and April 2018, enrolled 1103 young adolescents aged between 13 and 17 years. The Internet Addiction Test (IAT) was used to screen for IA. The results also showed that 56.4% of the participants were average Internet users (IAT score ≤49), 40.0% had occasional/frequent problems (IAT scores between 50 and 79), and 3.6% had significant problems (IAT scores ≥80) because of Internet use. The results of a stepwise regression showed that higher levels of aggression (ß = 0.185), depression (Multiscore Depression Inventory for Children) (ß = 0.219), impulsivity (ß = 0.344), and social fear (ß = 0.084) were associated with higher IA, whereas an increased number of siblings (ß = -0.779) and a higher socioeconomic status (ß = -1.707) were associated with lower IA. Uncontrolled use of the Internet can be associated with addiction and other psychological comorbidities.