Lifetime Prevalence of Mental Disorders in Lebanon: First Onset, Treatment, and Exposure to War

Elie G Karam,John A Fayyad,Zeina N Mneimneh,Ronald C Kessler,Somnath Chatterji,Hani Dimassi,Soumana C Nasser,Aimee N Karam

doi:10.1371/journal.pmed.0050061

Abstract

BackgroundThere are no published data on national lifetime prevalence and treatment of mental disorders in the Arab region. Furthermore, the effect of war on first onset of disorders has not been addressed previously on a national level, especially in the Arab region. Thus, the current study aims at investigating the lifetime prevalence, treatment, age of onset of mental disorders, and their relationship to war in Lebanon.Methods and FindingsThe Lebanese Evaluation of the Burden of Ailments and Needs Of the Nation study was carried out on a nationally representative sample of the Lebanese population (n = 2,857 adults). Respondents were interviewed using the fully structured WHO Composite International Diagnostic Interview 3.0. Lifetime prevalence of any Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) disorder was 25.8%. Anxiety (16.7%) and mood (12.6%) were more common than impulse control (4.4%) and substance (2.2%) disorders. Only a minority of people with any mental disorder ever received professional treatment, with substantial delays (6 to 28 y) between the onset of disorders and onset of treatment. War exposure increased the risk of first onset of anxiety (odds ratio [OR] 5.92, 95% confidence interval [CI] 2.5–14.1), mood (OR 3.32, 95% CI 2.0–5.6), and impulse control disorders (OR 12.72, 95% CI 4.5–35.7).ConclusionsAbout one-fourth of the sample (25.8%) met criteria for at least one of the DSM-IV disorders at some point in their lives. There is a substantial unmet need for early identification and treatment. Exposure to war events increases the odds of first onset of mental disorders.

Highlights

Large-scale psychiatric epidemiologic studies have become increasingly common in industrialized countries in the past decade [1,2,3,4,5] in response to mounting concerns about the prevalence and burden of mental disorders [6,7]
Exposure to war events increases the odds of first onset of mental disorders
War has been linked to a higher risk of mental disorders [12,13,14,15,16], no previous study has comprehensively assessed on a national level the effect of war on the first onset of a broad range of mental disorders during the life span of individuals

Summary

Introduction

Large-scale psychiatric epidemiologic studies have become increasingly common in industrialized countries in the past decade [1,2,3,4,5] in response to mounting concerns about the prevalence and burden of mental disorders [6,7]. In an effort to address these issues, the Institute for Development, Research, Advocacy and Applied Care (IDRAAC) with the Department of Psychiatry and Clinical Psychology at Balamand University and Saint George Hospital University Medical Center conducted the first nationally representative general population survey of mental disorders in Lebanon and the Arab World: the Lebanese Evaluation of the Burden of Ailments and Needs Of the Nation (LEBANON) survey This survey is part of the World Health Organization (WHO) World Mental Health (WMH) Survey Initiative, a series of coordinated, large-scale psychiatric epidemiologic surveys being carried out in over 29 countries in the world [17]. Most people with mental illnesses can lead fulfilling and productive lives with the help of appropriate medical and nonmedical therapies

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Results

Conclusion