The impact of lockdown and other stressors during the COVID-19 pandemic on depression and anxiety in a Lebanese opportunistic sample: an online cross-sectional survey.

Lockdown measures were taken since February 2020 in Lebanon, a country already going through a socio-economic crisis, to fight the new coronavirus pandemic. The aim of this study is to evaluate the psychological impact of the lockdown in Lebanon. A cross-sectional, online survey was conducted during the lockdown period in order to punctually assess depression, anxiety symptoms as well as eating and substance use disorders using self-rating scales (the DASS-21, SCOFF and CAGE-AID respectively), while identifying factors that might affect those outcomes. Overall, 1133 participants completed the questionnaire. The DASS-21 score was positively correlated with the impact of lockdown on participants' lifestyle and lockdown duration. A highest effect on DASS-21 score was related to the intensity of other stressful life events that have happened during the last 3 months. Linear regression analysis also showed that age, monthly income, professional status, the SCOFF and CAGE-AID scores, the intensity of the lockdown's impact on lifestyle and having been through other stressful life events unrelated to the lockdown per se, were risk factors affecting significantly the DASS-21 score. Lockdown, as well as other stressful life event that have happened during the last 3 months, were therefore associated with higher depression, anxiety, and stress symptoms. These findings may guide future policy making strategies in order to prevent mental health problems in case of a pandemic concomitant with other critical stressors.

Syrian refugee young adults as community mental health workers implementing problem management plus: Protocol for a pilot randomized controlled trial to measure the mechanisms of effect on their own wellbeing, stress and coping.

This pilot randomized controlled trial protocol aims to (1) assess the impact on the wellbeing of Syrian refugee young adults (18-24 years) of being a community mental health worker (CMHW) implementing WHO's evidence-based psychosocial intervention - Problem Management Plus (PM+) - with adults in their community, and (2) identify the mechanisms associated with the outcomes of enhanced wellbeing and coping, and reduced stress among these CMHWs. Over 108 million people have been forcibly displaced as of the end of 2022. Mental health consequences of these displacements are significant, yet human resources for health are not sufficient to meet the needs. A large proportion of refugee populations are youth and young adults (YA). Evidence indicates their engagement in supporting their communities leads to their own enhanced wellbeing and that of their community. This trial trains Syrian refugees to serve their communities as CMHW (n=19) or tutors (n=19) and compare wellbeing, stress and coping outcomes between these two groups and a control group (n = 40). We will also assess 7 mechanisms as potential pathways for the interventions to influence outcomes. Surveys will assess outcomes and mechanisms, hair samples will measure stress cortisol. The primary analysis will use a Bayesian Hierarchical Model approach to model the trajectories of the mechanisms and primary study endpoints over time for individuals in each of the arms. Our results will elucidate critical mechanisms in which engagement of young adults to support their community enhances their own wellbeing. Trial registration: National Institutes of Mental Health, NCT05265611, Registered prospectively in 2021. Lebanon clinical trials registry #: LBCTR2023015206, Registered in 2023.

Trauma exposure and PTSD prevalence among Yazidi, Christian and Muslim asylum seekers and refugees displaced to Iraqi Kurdistan.

BACKGROUND: There is unreliable, and negligible information on the mental health and trauma-exposure of asylum-seekers and displaced refugees in the Iraqi Kurdistan region. OBJECTIVES: To evaluate how responsible the ethno-religious origins are, for the prevalence of trauma exposure and post-traumatic stress disorder (PTSD) in displaced Iraqi asylum-seekers and refugees residing in the Iraqi Kurdistan region. METHODS: Structured interviews with a cross-sectional sample of 150 individuals, comprised of three self-identified ethno-religious groups (50 participants in each): Christians, Muslims, and Yazidis. RESULTS: 100% prevalence of trauma exposure and 48.7% of current PTSD among refugees, 70% PTSD rate of Yazidi participants, which is significantly higher (p < 0.01) compared to 44% of Muslim participants and 32% of Christian participants. These findings were corroborated using the self-rated PTSD, DSM-5 Checklist, with more severe PTSD symptom scores (p < 0.001) obtained among Yazidis (43.1; 19.7), compared to Muslims (31.3; 20.1) and Christians (29.3; 17.8). Self-rated depressive symptoms (Patient Health Questionnaire-9) were also higher (p < 0.007) among Yazidis (12.3; 8.2) and Muslims (11.7; 5.9), compared to Christians (8.1; 7).