title: Mental disorders, disability and treatment gap in a protracted refugee setting.
abstract: BACKGROUND
  Studies have shown high levels of distress and mental disorder among people living in refugee camps, yet none has confirmed diagnosis through clinical reappraisal.
  
  
  OBJECTIVE
  To estimate the prevalence of mental disorders, related disability and treatment gap in adult refugees living in the Burj el-Barajneh camp.
  
  
  METHODS
  Randomly selected participants were screened by household representative (n = 748) and individual (n = 315) interviews; clinical reappraisal was performed on a subset (n = 194) of 326 selected participants. Weighted prevalence estimates and 95% confidence intervals were calculated.
  
  
  RESULTS
  The prevalence of current mental disorders was 19.4% (95% CI 12.6-26.2); depression was the most common diagnosis (8.3%, 95% CI 4.4-12.2) and multiple diagnoses were common (42%) among the 88 persons with mental disorder. Lifetime prevalence of psychosis was 3.3% (95% CI 1.0-5.5). Mental disorders were associated with moderate to severe dysfunction (odds ratio = 8.8, 95% CI 4.5-17.4). The treatment gap was 96% (95% CI 92-100).
  
  
  CONCLUSIONS
  A range of mental disorders and associated disability are common in this long-term refugee setting. Combined with an important treatment gap, findings support the current consensus-based policy to prioritise availability of mental health treatment in refugee camps, especially for the most severe and disabling conditions.
authors.affiliation: Augusto E. Llosa, PhD, Epicentre, Paris, France; Zeina Ghantous, MPH, Médecins Sans Frontières, Geneva, Switzerland; Renato Souza, MD, Médecins Sans Frontières, Geneva, Switzerland, and Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Brazil; Fabio Forgione, MSc, Pierre Bastin, MD, Alison Jones, MSc, Annick Antierens, MD, Andrei Slavuckij, MD, Médecins Sans Frontières, Geneva, Switzerland; Rebecca. F. Grais, PhD, Epicentre, Paris, France.
authors.forename: Augusto E
authors.initials: AE
authors.lastname: Llosa
authors.forename: Zeina
authors.initials: Z
authors.lastname: Ghantous
authors.forename: Renato
authors.initials: R
authors.lastname: Souza
authors.forename: Fabio
authors.initials: F
authors.lastname: Forgione
authors.forename: Pierre
authors.initials: P
authors.lastname: Bastin
authors.forename: Alison
authors.initials: A
authors.lastname: Jones
authors.forename: Annick
authors.initials: A
authors.lastname: Antierens
authors.forename: Andrei
authors.initials: A
authors.lastname: Slavuckij
authors.forename: Rebecca F
authors.initials: RF
authors.lastname: Grais
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007861:Lebanon / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D015995:Prevalence; D012036:Refugees / Q000523:psychology*; D055815:Young Adult