POS-738 ASSESSMENT OF DEPRESSION, ANXIETY, SUICIDALITY AND POST-TRAUMATIC STRESS DISORDER IN LEBANESE PATIENTS ON HEMODIALYSIS FOLLOWING THE BEIRUT EXPLOSION

ABSTRACT

Introduction: On the 4thof August 2020, Beirut witnessed a major blast in its port that led to 214 dead and more than 6500 injured. Saint George Hospital University Medical Center (SGHUMC) facing the port was subject to severe damage and was non-functional for around a month after the explosion. A considerable number of patients, and staff members present in the hospital at the time of the explosion were injured and subject to physical and psychological trauma, including patients who were undergoing their hemodialysis shift at the time of the blast. The purpose of this study was to assess the prevalence of depression, anxiety, suicidality, and post-traumatic stress disorder (PTSD) in this vulnerable population of end-stage renal disease patients. Methods: A cross-sectional study was conducted in March and April 2021 among patients aged 18 years and older, undergoing hemodialysis on a chronic basis at the outpatient unit of SGHUMC. The Arabic version of the Hospital Anxiety and Depression Scale (HADS) was used to screen for anxiety and depressive disorders, while the PTSD Checklist for DSM-5 (PCL-5) was used to screen for PTSD. Suicidality was assessed by direct questions about passive death wishes, suicidal thoughts, plans and attempts. Other measures included age, sex, marital status, education, socioeconomic status, smoking, alcohol and substance use, malnutrition risk assessment, comorbid medical diseases, past psychiatric history, history of severe COVID-19 infection and assessment of the exposure to the Beirut blast. Results: 42 patients (mean age 66.1;SD 11.2 years) were included in the assessment of whom 45.2% were female. 69% were married, 31% had a high school level of education or above while 16.6% had earned a university degree. 59.5% were smokers and 40.5% were alcohol users while 2.4% reported alcohol misuse. In addition, 2.4% reported active drug use. 66.7% belonged to a middle socioeconomic status (SES) and 9.5% to a high SES. Around 7% were hospitalized for COVID-19 infection. Two thirds suffered from moderate to severe malnutrition according to the GLIM criteria. Around 40% had cardiovascular disease and one fourth had thyroid problems. Only 12% had previously consulted a mental health professional. Anxiety and depression screening rates were found to be significantly high, reaching 54.8% and 57.1% using cut-offs of 6 and 7 respectively on the HADS. 9.5% of the patients reported being in the hospital at the time of the blast and 7.1% reported being injured. In addition, 23.8% had a close family member either injured or deceased because of the blast. 33.3% of our population screened positively for PTSD using a cut-off of 23 on the PCL-5. 26.2% had passive death wishes and 7.1% had suicide plans, however no one had attempted it. Conclusions: In an urban dialysis unit, affected by a major blast and the COVID-19 pandemic, depression, anxiety, and PTSD were found to be highly prevalent (figure 1), urging the need for a prompt psychiatric evaluation in similar settings and early intervention strategies aiming at improving the physical and mental well-being in this vulnerable population. No conflict of interest