Mental Health of LGBTQ Individuals Who are Arab or of an Arab Descent: A Systematic Review.

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals are at a higher risk of mental illness when compared to their heterosexual and cisgender counterparts. Most research emanates from Western countries, with a paucity of studies in the Arab world. We systematically reviewed studies assessing the mental health of LGBTQ individuals who live in the Arab world or are of Arab descent. Of 261 articles, seven were eligible for analysis. Depression was the most common psychiatric disorder. Suicidal ideations and attempts were frequent in trans women. Post-traumatic stress disorder was also common, with the majority of precipitating traumatic events being related to sexual orientation and/or gender identity. Societal and familial stressors in the Arab culture are major contributors to the increased vulnerability of the LGBTQ community to mental health challenges. Further research is of utmost need while taking into consideration the Arab socio-cultural context.

Predictors of admission to an assertive outreach service for psychosis in Lebanon.

Schizophrenia is a chronic, debilitating mental illness that contributes significantly to the global burden of disease. Assertive outreach treatment for patients with schizophrenia and psychotic disorders has been implemented to improve treatment adherence and outcomes. The suitability of this model of care outside the western context has not been fully established. We describe the characteristics of 45 patients enrolled in the Psychosis Recovery Outreach Program (PROP), a program developed at a leading psychiatric facility in Lebanon. We collected twelve-month data for patients and used logistic regression models to identify predictor variables for enrollment in the service compared to those receiving standard treatment. Patients were mostly males (77.8%), younger than 39 years (80%), of college or higher education (68.2%), and diagnosed with schizophrenia (46.7%) or schizoaffective disorder (48.9%). About one-quarter (22.7%) had a comorbid cannabis use disorder. A majority received more than one oral antipsychotic (75.6%) while half (51.1%) were maintained on a long-acting injectable (LAI) antipsychotic. The following variables were significant predictors of enrollment in PROP: having a comorbid cannabis use disorder (OR 2.83 [1.25 - 6.37]), being prescribed a LAI antipsychotic (OR 9.99 [4.93-20.24]) or more than one oral antipsychotic (OR 4.57 [2.22-9.39]), visiting the emergency department more than once (OR 8.7 [2.64-28.68]), and admission to the psychiatry unit (OR 13.91 [3.17-60.94]). In addition, those following up in PROP were younger and less likely to be in the oldest age group (over 54 years) [OR 0.11 (0.01-0.93)], less likely to be females (OR 0.39 [0.18-0.81]), and less likely to be diagnosed with "other psychotic disorder" as compared to schizophrenia (OR 0.14 [0.03 - 0.62]). Our findings highlight that the assertive outreach model of care is applicable to its target population in the context of psychiatric care in Lebanon, namely young individuals with psychosis, higher comorbidities and a severe course of illness.

Psychological distress experienced by physicians and nurses at a tertiary care center in Lebanon during the COVID-19 outbreak.

The COVID-19 outbreak has had a significant mental health toll on healthcare workers in Lebanon. We examined pandemic-related psychological distress among healthcare workers in a tertiary care medical center. One hundred and fifty participants completed an online questionnaire. About half showed a high risk of acute distress (58.7%) on the GHQ-28, while most (89.3%) scored low/moderate stress on the PSS-10. The IES-R revealed concern for post-traumatic stress in one-third of participants, significantly in nurses (p = 0.008) and those living with vulnerable individuals (p = 0.030). Mental health history did not increase the risk. Our findings highlight the need for early targeted interventions during the pandemic.

Associations between religiosity, aggression and crime: results from the National Survey on Drug Use and Health.

PURPOSE: To explore the association between religiosity, aggression (self- and other-directed) and law-breaking behaviors. METHODS: We used data from the National Survey on Drug Use and Health (NSDUH) in the United States of America across 2008-2014, with a pooled sample of 270,227 adult respondents. We categorized respondents as religious if they considered religious beliefs to be important parts of their lives and/or to be influential in making decisions and/or if they considered it important that friends share their beliefs and/or if they reported attending at least one service over the past 12 months. We used regression models to calculate the odds ratio for committing different forms of aggression and for breaking the law when measuring positively on religiosity and its parameters. RESULTS: More than 85% of our sample qualified as religious. A positive religiosity was correlated with a statistically significant lower risk of self-directed aggression [aOR = 0.83, 95% CI (0.69-0.99)]. Importance of religious beliefs and influence of religious beliefs were inversely correlated to perpetration of self-directed aggression [aOR = 0.81, 95% CI (0.70-0.95)] and [aOR = 0.82, 95% CI (0.70-0.96)], respectively. Positive religiosity was not significantly correlated to lower odds of other-directed aggression. All religiosity parameters were associated with significantly reduced odds of breaking the law, except for infrequent service attendance which was associated with a significantly higher risk of breaking the law [aOR = 1.07, 95% CI (1.03-1.12)]. CONCLUSION: Religiosity has components with a differential impact on aggressive and law-breaking behaviors. Future longitudinal studies are needed to analyze whether religiosity protects against suicidality and promotes pro-social actions.

Emerging Psychiatric Themes in Post-COVID-19 Patients on a Psychiatry Consultation-liaison Service.

The need for consultation-liaison psychiatry on COVID-19 wards has substantially increased since the start of the pandemic. In this cross-sectional study, we aimed to summarize the characteristics of patients admitted to the post-COVID-19 ward of the American University of Beirut Medical Center who received a psychiatric consultation. We collected relevant sociodemographic and medical data, information about past psychiatric history, psychiatry consultation details, hospital course, and disposition outcome. We also conducted chi-square and binary logistic regression analyses to assess the association between the different variables and disposition outcome. A total of 52 patients (mean age 57.33 years; equal gender distribution) were seen by the psychiatry consult-liaison team. Most had medical comorbidities and 21.2% required intubation. The most prevalent psychiatric diagnoses were delirium (30.8%), major depressive episode (15.4%), and other anxiety disorder (15.4%). Pharmacological management was implemented in 90.4% of cases and mainly included second-generation antipsychotics (36.5%). Non-pharmacological interventions consisted of those related to delirium and therapy for anxiety. Only intubation was significantly associated with disposition outcome (p = 0.004). This study highlights the various psychiatric themes emerging during the acute and post-acute periods of hospitalization for COVID-19. Hospitalized individuals recovering from the infection should be diligently screened and referred to the psychiatry consultation-liaison team to ensure the implementation of appropriate interventions.

Psychological distress experienced by self-quarantined undergraduate university students in Lebanon during the COVID-19 outbreak.

INTRODUCTION: Quarantine, although essential during contagious outbreaks, has been correlated with poor psychological outcomes in the general population. Such outcomes include low mood, suicide, and post-traumatic stress symptoms. Studies have mostly looked at the mental health of general citizens, healthcare workers, or infected survivors, with limited research targeting university students. This study aimed to understand the psychological distress experienced by self-quarantined undergraduate university students in Lebanon during the COVID-19 outbreak. METHODS: Undergraduate students enrolled at the American University of Beirut were invited to participate in a 47-item online questionnaire. 73 participants completed the questionnaire. Demographic data, data about COVID-19 exposure, stressors during quarantine, understanding the rationale, compliance, and difficulties associated with quarantine, and levels of psychological distress were analysed. RESULTS: 75.3% of the participants were considered as having a high risk of developing acute stress. Undergoing quarantine for more than 14 days, having a chronic medical illness, inadequate access to supplies, and fear of infection were all significantly associated with an increased risk of acute stress. CONCLUSION: Despite being a necessary preventive measure during infectious disease outbreaks, quarantine can be associated with negative psychological effects, particularly in undergraduate students. Providing preventive and effective interventions is of utmost necessity.KEY POINTSDuring COVID-19, three-quarter of students had high risk for acute stress.Females had higher odds of high-risk acute stress compared to males.Having a chronic medical condition was associated with high risk acute stress.Long quarantine and lack of supplies were associated with high risk acute stress.Providing interventions to protect the mental health of students is necessary.

Measles and mumps outbreaks in Lebanon: trends and links.

BACKGROUND: Lebanon has experienced several measles and mumps outbreaks in the past 20 years. In this article, a case-based surveillance of both measles and mumps outbreaks in Lebanon was carried out in an attempt to outline factors contributing to the failure of elimination plans and to provide potential solutions. The relationship between the outbreaks of both diseases was described and explored. METHODS: A retrospective descriptive study of confirmed cases of measles and mumps in Lebanon between 2003 and 2018 collected from the Lebanese Ministry of Public Health Epidemiological Surveillance Unit public database was carried out. The information collected was graphically represented taking into consideration dates of reported cases, age groups affected, and vaccination status. RESULTS: The mean number of measles cases was 150.25 cases/year in the 1-4 years age group, 87 cases/year in individuals aging between 5 and 14, and 63.68 cases/year in those > 14 years old. In the latter group, only 18.05% were unvaccinated. The mean number of mumps cases was 30.4 cases/year in the < 4 year age group and 53.8 cases/year in the 10-19 years age group. During the study period, every spike in measles cases was followed by a similar spike in mumps. 9.66% of measles cases occurred in individuals who received at least 2 doses of the vaccine, 52.26% in the unvaccinated, and 38% in those whose vaccination status was undetermined. CONCLUSIONS: Measles in Lebanon is a disease of the pediatric population, but adults remain at risk. Outbreaks of mumps followed those of measles and were mainly among adolescents. Presence of a large number of Syrian refugees in the country may further complicate the situation. Vaccination activities need to be intensified.