Abstract

AimsSyria has experienced war since 2011, leaving over 80% under the poverty line and millions displaced. War and its retaliations have significantly impacted the mental health of Syrians. This study evaluates the post-traumatic stress disorder (PTSD), and the severity of the mental distress caused by war and other factors such as low social support. This study also evaluates other variables and compares the findings with those of multiple studies on Syria and refugees.MethodThis is a cross-sectional study that included people who lived in Syria in different governorates. Online surveys were distributed into multiple online groups and included the Kessler 10 (K10) scale which screens for anxiety and depression, the Screen for Posttraumatic Stress Symptoms (SPTSS) tool, the Multidimensional Scale of Perceived Social Support, and questionnaires on demographic and war-related factors.ResultOur study included 1951 participants, of which, 527 (27.0%) were males and 1538 (78.8%) between the age of 19 and 25. Among participants, 44% had likely severe mental disorder, 27% had both likely severe mental disorder and full PTSD symptoms, 36.9% had full PTSD symptoms, and only 10.8% had neither positive PTSD symptoms nor mental disorder on the K10 scale. Around 23% had low overall support. Half of the responders were internally displaced, and 27.6% were forced to change places of living three times or more due to war. Around 86.6% of the responders believed that the war was the main reason for their mental distress. Those with high SPTSS and K10 scores were found to take more days off from work or school due to negative feelings and having somatic symptoms. Moreover, the number of times changing places of living due to war, educational level, and being distressed by war noise were the most prominent factors for more severe PTSD and mental distress. No differences in PTSD and mental disorder prevalence were noted in participants living in different governorates or among different types of jobs. A strong significant correlation (r = 0.623) was found between SPTSS and K10 scores.ConclusionThe conflict in Syria has left the population at great risk for mental distress which was higher compared to Syrian refugees elsewhere. Many measures with an emphasis on mental health are needed to help the people against a long-term avoidable suffering.

Highlights

  • It is not clear as to what the placebo response in treatment-resistant depression (TRD) patients is or whether it differs across treatment modalities

  • Searches were conducted on MEDLINE and PsychInfo from inception to January 24, 2020

  • Secondary outcomes included moderators assessed via meta-regression and response and remission rate

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Summary

Introduction

Weissman[1], Jewel Karbi[1], Tya Vine[2], Louise S. Razza[5], Daniel Blumberger[4] and Zafiris J Daskalakis7 1University of Toronto, Department of Psychiatry; 2McMaster University; 3Nutrition and Food, Nova Scotia Health Authority; 4University of Toronto, Department of Psychiatry, Centre for Addiction and Mental Health; 5Department of Internal Medicine, Faculty of Medicine, University of Sao Paulo, Laboratory of Neurosciences (LIM-27), Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Department and Institute of Psychiatry, Faculdade de Medicina, Universit; 6Centre for Addiction and Mental Health, University of Toronto, Department of Psychiatry and 7Department of Psychiatry, University of California San Diego *Corresponding author. The placebo response in depression clinical trials is a major contributing factor for failure to establish the efficacy of novel and repurposed treatments. It is not clear as to what the placebo response in treatment-resistant depression (TRD) patients is or whether it differs across treatment modalities.

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