Abstract
BackgroundSyria 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.MethodsThis 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.ResultsOur 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
This study evaluates mental disorders, post-traumatic stress disorder (PTSD), and the amount of social support among Syrians who remained in Syria as well as the relvevant factors affecting the mental health in war time
19.2% (CI 95%: 17.5–21%) were likely to be well, 19.5% (CI 95%: 17.8–21.3%) had a mild mental disorder, 16% (CI 95%: 14.9–18.1%) had a moderate mental disorder, and 44.7% (CI 95%: 42.6–47.0%) had a severe mental disorder according to Kessler 10 (K10) scale
The social support had a relative weak effect, meaning that resources should be re-allocated to other aspects of care
Summary
Syria 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. Warfare has acute and chronic effects on the community and is considered one of the most mentally stressful events that can be experienced by someone. The aftermath of war is challenging, from shortage of resources such as food, water, fuel and medical equioment, to displacement and disease outbreak [1]. Syria’s deteriorating economy presents a challenge in terms of resource allocation to the health sector as only 1.5 hospital beds and 1.22 physicians were available for every1000 people, making mental medical conditions almost impossible to treat [5]. The economy and health sector are much worse at the time of this study
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