Prevalence of benzodiazepines use during pregnancy in Lebanon.

Pregnancy is a period of heightened risk period for many psychiatric disorders, particularly anxiety disorders. However, there is limited knowledge regarding the usage of psychotropic medications during pregnancy. Over the past decade there has been a notable increase in the use of medications during pregnancy, with benzodiazepines being the primary choice for alleviating anxiety. It is important to note, though, that benzodiazepines have been associated with various risks for both pregnancy and newborns. In Lebanon, to date, there has been no study estimating the prevalence of the use of benzodiazepines during pregnancy. Our study aims to find the prevalence of benzodiazepines use in a population of pregnant women in Hôtel-Dieu Hospital, a tertiary care center in Beirut, and the medical center of Saint-Joseph University and to compare our results to international literature. To accomplish our objectives we administered questionnaires to over two hundred women who had recently given birth in the gynecology department. These forms encompassed inquiries about benzodiazepine consumption, as well as various medical and socio demographic details. In total, we interviewed 225 women who gave birth at the Hôtel-Dieu de France between the months of December 2019 and February 2020 and between the months of February 2021 and October 2021 in the gynecology department. The questionnaires included socio demographic, medical, and psychiatric information as well as questions about the use of benzodiazepines. We found a significantly lower prevalence of benzodiazepine use among these women compared to the figures reported in international literature. The approval of the ethics committee was obtained on December 19, 2019 after making sure that this study raised no ethical objections. (File number: CEHDF 1533).

Effectiveness of a two-stage strategy using the 16-item Prodromal Questionnaire (PQ16/fPQ16) and the Comprehensive Assessment of At Risk Mental States (CAARMS) in the early detection of Ultra High Risk (UHR) patients in Lebanon: a cross-sectional pilot study.

OBJECTIVES: This study aims to identify the prevalence of Ultra High Risk (UHR) adults in a sample of patients in Lebanon and to compare screening and diagnostic tools. METHODS: This is a cross-sectional pilot study which targeted patients aged 17-30 years willingly seeking psychiatric care in a university hospital in Beirut, Lebanon. Participants were invited to fill either the English or the French version of the Prodromal Questionnaire (respectively, PQ16 or fPQ16). The abbreviated version of the "Comprehensive Assessment of At-Risk Mental States" (CAARMS) was then administered to all participants. The latter were subsequently sorted into one of the three UHR groups - vulnerability group, attenuated psychosis (APS), intermittent psychosis (BLIPS) - or were diagnosed as suffering from a psychotic disorder. RESULTS: Thirty-one patients participated in this study. The prevalence of positive screening on the PQ16/fPQ16 and positive diagnosis of UHR on the CAARMS were respectively of 61.29% and 45%. The APS group was the most prevalent (71.42%). A positive psychosis screening on PQ16/fPQ16 was statistically related to a UHR diagnosis on CAARMS (p-value: 0.011 on Chi2 test), OR=8.5 (95% CI: 1.4-50.9; p-value: 0.018). No relation was found between PQ16/fPQ16 results and risk stratification or between the number of "True" responses on PQ16/fPQ16 and the intensity of symptoms on CAARMS. PQ16/fPQ16 statements 5, 9, 11 and 16 predicted a UHR diagnosis on CAARMS (p-value of 0.045, 0.006, 0.045 and 0.045, respectively). CONCLUSION: This two-stage strategy for identifying UHR patients can be adopted in a tertiary health care center.

Positive and negative correlates of suicidal ideations and behaviors in the emergency department of a university hospital in Beirut: A cross-sectional comparative study.

This study aims to identify the prevalence and correlates of current suicidal ideations and past suicidal behaviors among psychiatric emergencies. A cross-sectional comparative study was conducted using the Ask Suicide Screening Questions (ASQ) as a screening tool that targeted all patients presenting for a psychiatric emergency in a university hospital in Beirut during a four-month period. One hundred and three patients of all age groups have been divided into a group of patients with a positive suicidal screening (n=67, 65%), and another one with a negative suicidal screening (n=36, 35%). Suffering from a personality disorder was found to be a positive correlate of suicide screening (OR: 21.6, 95% CI: 2.6-179.0). Female gender (OR: 4.5, 95% CI: 1.6-13.2) and an elevated number of previous hospitalizations were found to be positive correlates of past suicidal attempts. These correlates should be assessed in the emergency room department (ER) to prevent any subsequent suicidal behavior.

Anxiety and sleep quality in a sample of Lebanese healthcare workers during the COVID-19 outbreak.

A cross-sectional, survey based study was conducted in order to assess mental health outcomes among healthcare workers in a private university hospital involved in the COVID-19 response in Lebanon. The main objective was to quantify symptoms of anxiety and sleep quality using self-rating scales (the State-Trait Anxiety Inventory (STAI) and Pittsburgh Sleep Quality Index (PSQI) respectively), while identifying factors that might affect those symptoms. A total of 628 healthcare workers completed the survey; 409 (66.2%) were younger than 40 years, and 441 (71.4%) were women. Of all participants, 503 (81.4%) were nurses, 52 (8.4%) were physicians and 63 (10.2%) were residents. Registered nurses, residents, women, and younger participants presented higher scores on both scales than other categories of participants. Among factors related with COVID-19, those associated with higher scores were having relatives affected by the virus (22.2%), being excessively exposed to media (12.9%), and increasing the consumption of substances/alcohol (31.2%) during this period. Factors associated with higher risk of anxiety symptoms after multivariable logistic regression analysis were: female sex, young age, poor sleep quality, and living with elderly. Our findings contribute to the understanding of the psychological wellbeing of health care workers involved in the acute COVID-19 outbreak in Lebanon.

[Nursing profession in Lebanon through a study on professional self-image]. / La profession infirmière au Liban à travers une étude sur l'image de soi professionnelle.

Nursing education in Lebanon has integrated the academic world since 1979, but the profession is experiencing difficulties related to the retention of nurses at work and the lack of attraction to the profession. In this context, a study on the professional self-image was conducted among nurses working in hospitals. The results show that nurses have a positive professional self-image, but they find that their image in society is negative and only 20.4% would recommend this career to their children or their entourage.

First DNA sequence reference library for mammals and plants of the Eastern Mediterranean Region.

The Mediterranean region is identified as one of the world's 36 biodiversity hotspots, with the Earth's most biologically rich yet threatened areas. Lebanon is a hub for Eastern Mediterranean Region (EMR) biodiversity with 9116 characterized plant and animal species (4486 fauna and 4630 flora). Using DNA barcoding as a tool has become crucial in the accurate identification of species in multiple contexts. It can also complement species morphological descriptions, which will add to our understanding of the biodiversity and richness of ecosystems and benefit conservation projects for endangered and endemic species. In this study, we create the first reference library of standard DNA markers for mammals and plants in the EMR, with a focus on endemic and endangered species. Plant leaves were collected from different nature reserves in Mount Lebanon, and mammal samples were obtained from taxidermized museum specimens or road kills. We generated the 12S rRNA sequences of 18 mammal species from 6 orders and 13 different families. We also obtained the trnL and rbcL barcode sequences of 52 plant species from 24 different families. Twenty-five plant species and two mammal species included in this study were sequenced for the first time using these markers.

Ressentimento e os sofrimentos identitários de um jovem xiita / The resentment and Identity Suffering of a Shiite Youth under the bombings in southern Lebanon committed by Israel in 2006 / Resentimiento y los sufrimientos identitarios de un joven chiita / Le ressentiment et la souffrance identitaire d'un jeune chiite sous les bombardements perpétrés par Israël en 2006 dans le sud du Liban

O artigo procura exemplificar o grau de traumatismo sofrido por um jovem nos bombardeios cometidos por Israel em 2006, no sul do Líbano, contra a comunidade xiita. O registro faz parte de 20 histórias de vida colhidas em pesquisas de campo realizadas em cidades afetadas, e pretende-se que exemplifique os efeitos desses eventos na comunidade. Depois de décadas, os integrantes do grupo etno-confessional participam de uma conjuntura nacional de enfrentamentos mortíferos entre suas comunidades. Do outro lado da fronteira, Israel volta a atacá-los. Esse contexto, que os situa em duas frentes de perigo, torna constantes os eventos catastróficos em sua história recente. São analisadas as disposições psíquicas do jovem e o papel da identificação grupal no enfrentamento das situações catastróficas. Será sublinhada a produção do ódio a partir do traumatismo sofrido, para analisar, na conclusão, seu papel na resiliência psíquica e na dinâmica identitária.

The article seeks to exemplify the degree of trauma suffered by a young man in the bombing of the Shiite community committed by Israel in southern Lebanon in 2006. This record is part of twenty life histories collected from field surveys conducted in affected cities, and it is intended to exemplify the effects of these events in the community. The ethno-confessional group participates in a national conjuncture of deadly clashes between their communities, after decades. Across the border, Israel attacks them again. This context that places them in danger, make catastrophic events constant in their recent history. The psychic conditions of the young person and the role of the group identification in the confrontation with the catastrophic situations are analyzed. The surge of hatred from trauma will be highlighted, in order to analyze in conclusion, its role in psychic resilience and in their identity dynamics.

El articulo trata de ejemplificar el grado de traumatismo sufrido por un joven en los bombardeos contra la comunidad chií cometidos por Israel en el sur del Líbano en 2006. Este registro forma parte de veinte historias de vida recogidas a partir de investigaciones de campo realizadas en ciudades afectadas, y se pretende que ejemplifique los efectos de estos eventos en la comunidad. El grupo etno confesional participa después de décadas de una coyuntura nacional de enfrentamientos mortíferos entre sus comunidades. Al otro lado de la frontera, Israel vuelve a atacarlos nuevamente. Este contexto que los sitúa en dos frentes de peligro, vuelve constantes los acontecimientos catastróficos en su historia reciente. Se analizan las disposiciones psíquicas del joven y el papel de la identificación grupal en el enfrentamiento con las situaciones catastróficas. Se subrayará la producción del odio a partir del traumatismo sufrido, para analizar en la conclusión su papel en la resiliencia psíquica y en su dinámica identitaria.

L'article cherche à illustrer le degré de traumatisme subi par un jeune homme lors des bombardements contre la communauté chiite commis par Israël dans le sud du Liban en 2006. Ce registre fait partie de vingt histoires de vie recueillies lors de recherches sur le terrain, menées dans les villes touchées, dans le but d'expliquer les effets de ces événements sur la communauté. Depuis des décennies, les membres du groupe ethno-confessionnel participent d'une conjoncture nationale d'affrontements meurtriers entre leurs communautés. De l'autre côté de la frontière, Israël les attaque à nouveau. Ce contexte qui les place sur deux fronts de danger rend constants les événements catastrophiques dans leur histoire récente. On analyse les dispositions psychiques du jeune et le rôle de l'identification du groupe dans la défense contre les situations catastrophiques. Ce sera souligné la production de la haine à partir du traumatisme subi, pour analyser, dans la conclusion, son rôle dans la résilience psychique et dans sa dynamique identitaire.

Is menarche occuring earlier among Lebanese girls?

BACKGROUND: Early menarche is associated with increased risks for several diseases such as cardiovascular diseases and breast cancer. This analysis aimed at generating evidence on a historical trend towards younger age at menarche among Lebanese girls. METHODS: A secondary analysis was conducted on data consolidated from three serial cross-sectional national surveys of women in Lebanon (2007, 2009 and 2012). A total of 6150 women were included in order to study the association between date of birth intervals and age at menarche. RESULTS: The mean age at menarche was 13.06 years, with a peak of the distribution at age 12. Women born before 1950 had a significantly higher mean age at menarche (13.21) compared to those born in 1970 and thereafter (12.95). A stratified analysis showed that women living outside the metropolitan Greater Beirut (GB) area were characterized by an older mean age at menarche (13.11) in all date of birth intervals compared to those in GB (12.89). However, age at menarche declined more significantly over the last two decades among women outside GB, compared to those living in GB. CONCLUSIONS: Epidemiological figures emerging from this study confirm that trends in Lebanon are in line with a global pattern of decreasing age at menarche. Urban-rural differences suggest that higher caloric content of diet and consequent early overweight, more evident in urban areas, are likely determinants of younger menarche. Evidence from this study calls for an urgent implementation of comprehensive multisectoral obesity prevention in children in Lebanon.

Blood donations mode: Assessment of the Lebanese model.

Voluntary non-remunerated donations remain the cornerstone for a safe and sustainable blood supply. According to the World Health Organization and other international scientific committees, all nations must switch their system of blood collection to voluntary non-remunerated donation. Several other types of blood donations still exist nowadays that will be discussed. Lebanon, similarly to other developing countries, is struggling to achieve 100% voluntary non-remunerated donations for the many existing social, demographic, cultural and economic problems. Replacement donations remain the predominant type, which creates huge burden on both hospital blood banks and patient families. Despite the limited resources, some improvements have been made recently in this field and Lebanon seems to be on the road of achieving 100% voluntary non-remunerated blood donation as requested by the World Health Organization. The Lebanese experience is worth sharing so that neighbouring countries facing similar problems could benefit from it.

Cervical cancer screening among Lebanese women.

BACKGROUND: Cervical cancer is a very common malignancy amongst women worldwide. Pap smear is an effective and inexpensive screening test in asymptomatic women. The aim of this paper was to assess the prevalence of Pap smear screening for cervical cancer among Lebanese women and to determine associated sociodemographic and psychosocial characteristics. METHODS: This national survey included 2255 women, selected by multi-stage random cluster sampling across Lebanon. A questionnaire about practices and perceptions related to cervical cancer screening was developed based on the "Health Belief Model". RESULTS: The weighted national prevalence of "ever-use" of the Pap smear for screening purposes was 35%. Most important determinants of screening behavior were: residence within Greater Beirut, higher socio-economic status and educational attainment, marriage status, presence of a health coverage, awareness of Pap smear usefulness, knowing someone who had already done it, and a balance between perceived benefits and perceived barriers to Pap smear screening. CONCLUSION: Regular information campaigns regarding the availability and effectiveness of the test should be devised, targeting in priority the sexually vulnerable women in Lebanon. Moreover, healthcare providers should be encouraged to discuss with their patients the opportunity of obtaining a Pap smear.

[Psychiatric comorbidities in transsexualism: Study of a Lebanese transgender population]. / Les comorbidités psychiatriques dans le transsexualisme : étude sur une population de transgenres libanais.

INTRODUCTION: The question of whether gender dysphoria is associated with psychiatric comorbidity has been addressed in several studies. Several cohort studies have shown that psychiatric comorbidity is one of the main features of poor prognosis following sex change therapy. Gender dysphoria is rare, with an estimated prevalence of 0.001% to 0.002% globally. The literature shows a high prevalence of psychiatric comorbidities in people with gender dysphoria, and that they are more common in male to female transsexuals. Data on long-term mortality show that transsexuals present a 51 % increase in mortality compared to the general population. This is mainly attributed to a six-fold increase in the number of suicides and a higher rate of psychiatric disorders and risky behaviors leading to HIV infection and substance abuse. PURPOSE: Assess psychiatric comorbidity in a population of Lebanese transgender individuals and compare it to the general population. The hypothesis of our study is that the Lebanese transgenders suffer from more psychiatric comorbidities than the general population. Our second objective was to determine the specific mental health needs of this population in order to adapt our services to their medical needs and their specific concerns. METHODS: Our objective was to acquire 20 transgender participants and 20 control subjects. We chose a snowball sampling method. The evaluation consisted of three questionnaires including a general demographic questionnaire, the MINI 5.0.0 Arabic version for axis I disorders and the SCID-II for axis II disorders. RESULTS: The mean age of both groups was 23.55 years. Fifty-five percent (n=11) transgender participants had active suicidal thoughts against 0 % in controls. Within the group of transgender, 45 % (n=9) had a major depressive episode, 5 % (n=1) had a generalized anxiety disorder, 5 % (n=1) had a posttraumatic stress disorder and 10 % (n=2) had a major depressive episode with comorbid posttraumatic stress disorder. We noted a significant difference between the two groups regarding the presence of suicidal ideation (P=0.000) and the presence of axis I disorders (P=0.039). DISCUSSION: In our study, we noted demographic and economic characteristics specific to the population of transgender individuals. We found a significant difference in the level of education, economic status and household composition. Transgender individuals suffer from more psychiatric pathologies compared to the general population. This may be due to social and familial discrimination and ostracism. These results demonstrate the vulnerability of this population. An awareness program for mental health professionals is essential in order to adapt care to the specific needs of this population. A list of non "transphobic" mental health professionals should be established.

Soins psychiatriques et vécu infirmier au Liban.

Psychiatric care and nurse's experience in Lebanon. Psychiatry in Lebanon has developed significantly over the last decade, both in terms of care, university training and research. This article presents the specificities of psychiatric care and the experience of the nurses working in this discipline at Beirut's Hôtel-Dieu de France hospital.

[Choosing the best panel of aeroallergen prick-tests for patients in Lebanon with rhinitis and asthma: A retrospective study of 2350 patients]. / Choix du meilleur panel de prick-tests pour explorer une rhinite ou un asthme au Liban : une étude rétrospective sur 2350 patients.

INTRODUCTION: The aim of this study was to evaluate the profile of skin prick-test reactivity to different aeroallergens in patients with rhinitis and asthma in Lebanon and its geographic variation within the country. It was also to suggest a minimal panel of allergens that should be used to detect sensitized patients. METHODS: All patients who underwent skin prick-testing, because of rhinitis and/or symptoms suggesting asthma, between 2004 to 2011 in the hôtel-Dieu de France university hospital of Beirut, were studied. The total number of patients was 2350 and all were tested with the same panel of 24 aeroallergens. A further series of 208 patients were added because Cupressaceae antigens were not included in the initial series. RESULTS: The overall rate of sensitization to any allergen was 75.6%. A battery of eleven allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia, Parietaria, grass, Salicaceae, oak, Oleaceae, dog, cat, and cockroaches) was found to identify sensitized patients with a sensitivity of 96% and a negative predictive value of 90%. Cupressaceae should be added to this battery in view of the results of the additional series. The Bekaa region had a unique profile of sensitization. CONCLUSION: Twelve allergens are able to detect almost all sensitized patients suffering from respiratory symptoms in Lebanon.