Lifetime prevalence of mental disorders in Lebanon: first onset, treatment, and exposure to war.
BACKGROUND
There 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.


RESULTS
The 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).


CONCLUSIONS
About 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.
Karam
Elie G
EG
Department of Psychiatry and Clinical Psychology, Saint George Hospital University Medical Center, Beirut, Lebanon. egkaram@idraac.org
Mneimneh
Zeina N
ZN
Dimassi
Hani
H
Fayyad
John A
JA
Karam
Aimee N
AN
Nasser
Soumana C
SC
Chatterji
Somnath
S
Kessler
Ronald C
RC
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003130:Combat Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006306:Health Surveys; D006801:Humans; D007406:Interview, Psychological; D007861:Lebanon / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D015995:Prevalence; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D011795:Surveys and Questionnaires; D014857:Warfare