Prevalence of depression symptoms and associated sociodemographic and clinical correlates among Syrian refugees in Lebanon

Abstract

Background Since the outbreak of the Syrian war in 2011, close to 6 million Syrian refugees have escaped to Syria’s neighbouring countries, including Lebanon. Evidence suggests rising levels of mental health disorders among Syrian refugee populations. Yet, to the best of our knowledge, large-scale studies addressing the mental health of adult Syrian refugees in Lebanon are lacking. We examined the prevalence of depression symptoms, which represent a common and debilitating mental health disorder among Syrian refugee populations in Lebanon, along with their sociodemographic and clinical correlates. Methods A cross-sectional survey design was conducted as part of a collaborative project-“Sijilli”- led by the Global Health Institute at the American University of Beirut (Beirut, Lebanon) across 4 informal tented settlements for refugees (Beirut, Bekaa, North, South) in Lebanon among adult Syrian refugees (≥18), over a period extending from 2018 to 2020. The survey inquired about participants’ sociodemographic and clinical characteristics, and screened participants for symptoms of depression through sequential methodology using the Patient Health Questionnaire (PHQ-2 and PHQ-9). Results A total of 3255 adult Syrian refugees were enrolled in the study. Of those refugees, 46.73% (n = 1521) screened positive on the PHQ-2 and were therefore eligible to complete the PHQ-9. In the entire sample (n = 3255), the prevalence of moderate to severe depression symptoms (PHQ-2 ≥ 2 and then PHQ-9 ≥ 10) was 22% (n = 706). Further analyses indicate that being ≥45 years of age (OR 1.61, 95% CI 1.13–2.30), a woman (OR 1.34, 95% CI 1.06–1.70), widowed (OR 2.88, 95% CI 1.31–6.32), reporting a neurological (OR 1.73, 95% CI 1.15–2.60) or a mental health condition (OR 3.98, 95% CI 1.76–8.97) are major risk factors for depression. Conclusion Our study suggests that an estimated one in four Syrian refugees in Lebanon shows moderate to severe depression symptoms, and our findings have important public health and clinical implications on refugee health. There is a need to enhance screening efforts, to improve access and referral to mental health services, and to improve post-migration factors among Syrian refugees in Lebanon.

“I Go up to the Edge of the Valley, and I Talk to God”: Using Mixed Methods to Understand the Relationship between Gender-Based Violence and Mental Health among Lebanese and Syrian Refugee Women Engaged in Psychosocial Programming

“…There is a strong demand for consistent and culturally appropriate mental health care that engages the local community while incorporating psychosocial medical care [41,42], especially considering that social and familial networks are disrupted throughout conflict and displacement [11]. Programming should place an emphasis on access, taking into account gendered roles' influence on daily lives of the women (e.g., need for childcare), and the need for clarity about who programs are for and associated costs, if any, as this was the primary supportive factor in service seeking listed among the survey group, and was a primary barrier among qualitative discussion respondents.…”

Effects of a WHO-guided digital health intervention for depression in Syrian refugees in Lebanon: A randomized controlled trial

“…As a result, they are at risk of mental disorders, such as depression, anxiety, and post-traumatic stress [ 7 ]. It has been estimated that 22% of displaced, war-affected Syrians in Lebanon suffer from moderate to severe depressive symptoms [ 8 ].…”

Mental health outcomes in Syrian refugees: A systematic review

“…Forty-two studies focused on major depressive disorder or depressive symptoms (Acarturk et al, 2018, 2021; Ahmad et al, 2021; Böge et al, 2020; Borho et al, 2020; Braun-Lewensohn et al, 2019; Cheung Chung et al, 2018; Chung & Shakra, 2022; Chung et al, 2017, 2021; Chung, AlQarni et al, 2018; Chung, Shakra et al, 2018; Demir et al, 2020; Euteneuer & Schäfer, 2018; Fuhr et al, 2019; Gammouh et al, 2015; Georgiadou et al, 2018, 2020; Javanbakht et al, 2019; Mahmood et al, 2019; Marwa, 2016; McGrath et al, 2020; Mohammad et al, 2018; M’zah et al, 2019; Naal et al, 2021; Naja et al, 2016; Oda et al, 2021; Okenwa-Emegwa et al, 2019; Poole et al, 2018; Rizkalla & Segal, 2018, 2019; Röhr et al, 2020; Schlechter et al, 2021; Sengoelge et al, 2019; Sevinc et al, 2021; Sim et al, 2018; Stevenson et al, 2019; Tekeli-Yesil et al, 2018; Tinghög et al, 2017; Uygun, 2021; Woltin et al, 2018; Yalim, 2021). The most used instrument was the Hopkins Symptom Checklist 25-items (HSCL-25), and the prevalence of positive screening results ranged from 34.7% to 59.4%.…”