Psychopathology in Children and Adolescents in Lebanon Study (PALS): a national household survey

Abstract

Introduction Psychiatric disorders are among the leading causes of disability in children and adolescents globally. In Lebanon, a country that has endured a prolonged history of conflict and economic and political uncertainty, mental health surveys in children and adolescents have been limited to specific disorders or specific settings or cities. PALS (Psychopathology in Children and Adolescents in Lebanon Study) is the first study to screen a nationally representative sample of children and adolescents for psychiatric disorders and estimate the national prevalence of children and adolescents at risk of having a psychiatric disorder. Methods A nationally representative household sample of 1517 children and adolescents (aged 5 years 0 months to 17 years 11 months) was recruited through a multi-stage stratified proportionate sampling technique between February 2018 and November 2018. Parents and adolescents completed a battery of self-reported scales including the Strengths and Feelings Questionnaire (SDQ), Mood and Feelings Questionnaire (MFQ), Screen for Child Anxiety and Emotional Related Disorders (SCARED), the Peer Relations Questionnaire (PRQ), General Health Questionnaire (GHQ), and Conflict Behavior Questionnaire (CBQ), Child Revised Impact of Events Scale (CRIES), and a demographic/clinical information questionnaire. Logistic regression models were used to examine the correlates of screening positive for psychiatric disorders. Results About a third of children and adolescents (32.7%, n = 497) screened positive for at least one psychiatric disorder, of whom only 5% ( n = 25) reported ever seeking professional mental health help. Academic performance, having a chronic physical illness, higher parental GHQ scores, and involvement in bullying were associated with a higher odds of screening positive for a psychiatric disorder. Higher family income was negatively associated with screening positive for a psychiatric disorder. Conclusion This first national study shows a high prevalence of psychiatric symptoms in Lebanese children and adolescents and an alarming treatment gap. School-based primary prevention programs or screening in primary care settings are key for early detection and management of psychiatric symptoms, and prevention of psychiatric disorders.

Tackling the mental-health crisis in young people

“…In Lebanon, according to one study 10 , just 5% of children with depression sought professional treatment.…”

School‐based psychologists in Lebanese schools: An exploratory analysis of their professional profile

“…This highlights the existence of a wide gap between mental health needs and mental health help seeking in children. In a more recent study examining probable disorders in children and adolescents following the Beirut port explosion, the findings reported high rates for anxiety (64%), PTSD (52%), and depression (33%), yet 61.5% did not seek help (Maalouf, Alrojolah, et al, 2022;Maalouf, Haidar et al, 2022).…”

“…The prior puts them at greater risk for developing mental health problems which raises the need for school psychology services. A national household study conducted between February 2018 and November 2018 investigated psychopathology in a sample of 1517 children and of adolescents in Lebanon, and found that, while 33% of the sample displayed at least one psychiatric disorder, only 5% sought professional help (Maalouf, Alrojolah, et al, 2022; Maalouf, Haidar et al, 2022). This highlights the existence of a wide gap between mental health needs and mental health help seeking in children.…”

Psychometric properties of the Arabic Spence Children’s Anxiety Scale- Parent in a non-clinical sample of Arabic-speaking adults

“…Additionally, a review of multiple studies suggests a global prevalence of about 6.5% for anxiety disorders in children. 4 In Lebanon, a study published in 2022 about mental health issues, in adolescents and children, found that 32.7% of children have a psychiatric disorder, but only 5% were professionally managed 5 .…”

“…According to this study, anxiety is more common in girls (27.41%) than boys (15.6%), and in children aged above 12 years old . 5 Studies showed that most of the clinical presentations involving anxiety are exhibited by physical symptoms. 6,7 Children with anxiety presents somatic symptoms, the most observed ones include restlessness, abdominal pain, palpitations, along with sweating and trembling.…”