Publications by authors named "Elie Karam"

Background: Data from the World Mental Health (WMH) surveys on the coverage cascade has underscored the importance of perceived need for seeking treatment of mental disorders. However, little research has focused on treatment contact after adjusting for perceived need. We do so here in analysis of WMH data.

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Background: High unmet need for treatment of mental disorders exists throughout the world. An understanding of barriers to treatment is needed to develop effective programs to address this problem.

Methods: Data on barriers were obtained from face-to-face interviews in 22 community surveys across 19 countries (n = 102,812 respondents aged ≥ 18 years, 57.

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Objective: This study examines the national prevalence of mental health disorders and their associated factors in Lebanon, specifically in the aftermath of the 2020 events, including the catastrophic events of Beirut blast and the concurrent financial meltdown amid the global pandemic.

Methods: Conducted between July and September 2022, the study interviewed a nationally representative sample of 1,000 Lebanese via telephone, using the Computer Assisted Telephone Interview (CATI) system. Gender-specific bivariate and multivariate models were generated for probable posttraumatic stress disorder (PTSD), depression, and anxiety.

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Purpose: Exposure to traumatic events may lead to the development of Acute Stress Disorder (ASD) within the first month post-trauma in some individuals, while others may not exhibit ASD symptoms. ASD was introduced as a potential early indicator to identify those at higher risk of developing Posttraumatic Stress Disorder (PTSD), however, PTSD can occur in some individuals even without prior ASD. Assessing ASD post-trauma can assist in identifying those who would most benefit from intervention to prevent later PTSD, yet the predictive power of ASD varies across studies, with intensity of ASD symptoms and subthreshold PTSD often less considered.

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Objective: To evaluate the sociodemographic characteristics and disease-related factors associated with diagnostic delay in Canadian patients with axial spondyloarthritis (axSpA).

Methods: Data from 542 Canadian patients who participated in the International Map of Axial Spondyloarthritis online survey were analysed. Diagnostic delay was calculated as the difference between age at diagnosis and age at onset of the first symptoms reported by participants.

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Background: To assess gender differences in a large sample of patients included in the International Map of Axial Spondyloarthritis (IMAS) study from around the globe.

Method: IMAS is a cross-sectional online survey (2017-2022) of 5557 unselected axSpA patients from 27 countries. The current analysis assessed differences between males and females for: sociodemographic, health behaviors, disease characteristics, patient-reported outcomes, mental comorbidities, and treatments.

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Background: To assess the prevalence of clinically active disease in axial spondyloarthritis (axSpA) and its associated factors in a large global sample of patients from the International Map of Axial Spondyloarthritis (IMAS) study.

Methods: IMAS is a cross-sectional online survey (2017-2022) of 5557 axSpA patients. Patients were divided between those with active disease (BASDAI ≥4) and without active disease (BASDAI <4).

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Article Synopsis
  • * A retrospective analysis of 248 patient records in Lebanon showed that cancer patients with solid tumors have a significantly higher risk of death and ICU admission due to COVID-19.
  • * The findings highlight the urgent need for tailored healthcare strategies and preventive measures to safeguard immunocompromised cancer patients from severe COVID-19 outcomes.
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Importance: Exposure to war is associated with poor mental health outcomes. Adverse and traumatic experiences can lead to long-lasting DNA methylation changes, potentially mediating the link between adversity and mental health. To date, limited studies have investigated the impact of war on DNA methylation in children or adolescents, hampering our understanding of the biological impact of war exposure.

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Article Synopsis
  • A large-scale, cross-national study examined the impact of removing the "excessiveness" requirement for diagnosing generalized anxiety disorder (GAD) among individuals living in challenging circumstances.
  • Data from over 133,000 adults across various income countries revealed that eliminating this criterion raises the global prevalence of GAD from 2.6% to 4.0%, especially in low- and middle-income countries.
  • Non-excessive worriers, while less severe, exhibit similar socio-demographic traits and impairment levels as excessive worriers, indicating they are significant cases deserving diagnosis and treatment.
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Article Synopsis
  • - The study aimed to evaluate the global diagnostic delay for axial spondyloarthritis (axSpA) and its contributing factors using data from a cross-sectional online survey involving over 5,500 patients from 27 countries.
  • - Analysis of 5,327 patient responses revealed an average diagnostic delay of 7.4 years, with notable differences between regions, the longest delays occurring in South Africa and the shortest in Asia.
  • - Key factors linked to longer diagnostic delays included younger age at symptom onset, being female, receiving a diagnosis from a rheumatologist, seeing multiple healthcare providers before diagnosis, and having a history of uveitis.
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Background: In recent years, the number of forcibly displaced persons has risen worldwide, with approximately 40% being children and adolescents. Most of them are hosted in low- and middle-income countries (LMICs). Many individuals meet the criteria for mental health issues, which can also be exacerbated by a number of risk factors, including low socioeconomic status, displacement, and stressors linked to conflicts in their country or region of origin.

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Article Synopsis
  • The objective of the study is to create updated treatment guidelines for managing axial spondyloarthritis (axSpA) in Canada.
  • The recommendations were developed by a diverse panel through a careful process, using existing guidelines and ensuring they fit within the Canadian context, while also considering health equity.
  • A total of fifty-six recommendations were made covering various aspects of axSpA management, including treatment for different stages of the disease and considerations for monitoring and ethics, and these guidelines will be continually updated as new information emerges.
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Background: This study aims to assess the prevalence of poor mental health in axial spondyloarthritis (axSpA) and its associated factors in a large sample of patients from the International Map of Axial Spondyloarthritis (IMAS) study from around the globe.

Methods: IMAS is a cross-sectional online survey (2017-2022) that includes 5557 unselected patients with axSpA worldwide. Mental health was evaluated by the 12-item General Health Questionnaire (GHQ-12) and the cut-off point for poor mental health was set at 3.

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Background: The International Map of Axial Spondyloarthritis (IMAS) is a global initiative aimed to assess the impact and burden of axial spondyloarthritis (axSpA) and identify the unmet needs from the patient's perspective.

Method: IMAS is a collaboration between the Axial Spondyloarthritis International Federation (ASIF), the University of Seville, Novartis Pharma AG and steered by a scientific committee. IMAS collected information through an online cross-sectional survey (2017-2022) from unselected patients with axSpA from Europe, Asia, North America, Latin America and Africa who completed a comprehensive questionnaire containing over 120 items.

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Introduction: To assess differences in the diagnosis journey and access to care in a large sample of patients with axial spondyloarthritis (axSpA) from around the world, included in the International Map of Axial Spondyloarthritis (IMAS).

Methods: IMAS was a cross-sectional online survey (2017-2022) of 5557 unselected patients with axSpA from 27 countries. Across five worldwide geographic regions, the patient journey until diagnosis and healthcare utilization in the last 12 months prior to survey were evaluated.

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Clarifying the mechanisms by which circadian rhythms regulate biology is a central issue in directing life choices in the immediate future and presents an interesting challenge for current scientific research [...

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Individuals with high environmental sensitivity have nervous systems that are disproportionately receptive to both the protective and imperilling aspects of the environment, suggesting their mental health is strongly context-dependent. However, there have been few consolidated attempts to examine putative markers of sensitivity, across different levels of analysis, within a single cohort of individuals with high-priority mental health needs. Here, we examine psychological (self-report), physiological (hair hormones) and genetic (polygenic scores) markers of sensitivity in a large cohort of 1591 Syrian refugee children across two waves of data.

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A syndrome centered on the dysregulation of behavioral rhythms (DBR) is discussed. Recent pandemic brought to observe: (1) Having a DBR affecting sleep patterns, eating habits, and social interactions, before the lockdown period, was a determinant for depressive episodes during the lockdown; (2) In tighter lockdowns, DBR triggered depressive episodes in bipolar patients; (3) DBR in healthcare workers under pressure was a determinant of burnout; (4) DBR influenced the course of chronic diseases by altering immune responses. In addition, it was found that scoring positive on the Mood Disorder Questionnaire (MDQ) was closely associated with the dysregulation of sleep rhythms.

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Background: There is evidence that some childhood trauma increases the risk of the first onset of mental disorders and for the first time into adulthood. There are no studies that assessed whether exposure to war has this delayed long-term effect.

Objectives: To fill this gap by investigating the comparative roles of war and non-war trauma on the first onset of adulthood mood and anxiety disorders.

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For numerous issues of convenience and acceptability, hair hormone data have been increasingly incorporated in the field of war trauma and forced displacement, allowing retrospective examination of several biological metrics thought to covary with refugees' mental health. As a relatively new research method, however, there remain several complexities and uncertainties surrounding the use of hair hormones, from initial hair sampling to final statistical analysis, many of which are underappreciated in the extant literature, and restrict the potential utility of hair hormones. To promote awareness, we provide a narrative overview of our experiences collecting and analyzing hair hormone data in a large cohort of Syrian refugee children ( = 1594), across two sampling waves spaced 12 months apart.

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Healthcare workers (HCWs) were at increased risk for mental health problems during the COVID-19 pandemic, with prior data suggesting women may be particularly vulnerable. Our global mental health study aimed to examine factors associated with gender differences in psychological distress and depressive symptoms among HCWs during COVID-19. Across 22 countries in South America, Europe, Asia and Africa, 32,410 HCWs participated in the COVID-19 HEalth caRe wOrkErS (HEROES) study between March 2020 and February 2021.

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Background: Mental health service providers are increasingly interested in patient perspectives. We examined rates and predictors of patient-reported satisfaction and perceived helpfulness in a cross-national general population survey of adults with 12-month DSM-IV disorders who saw a provider for help with their mental health.

Methods: Data were obtained from epidemiological surveys in the World Mental Health Survey Initiative.

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Children differ substantially in their sensitivity to the quality of their environment. Some are more sensitive and more likely to develop Post-Traumatic Stress Disorder (PTSD) in response to Childhood Adversities (CAs), but might also benefit more from Positive Home Experiences (PHE). The aim of this study is to investigate the role of Environmental Sensitivity (ES), CAs and PHEs in PTSD development in children and adolescents.

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Background: Refugee children are at high risk of mental health problems but face barriers to accessing mental health services, a problem exacerbated by a shortage of mental health professionals. Having trained lay counsellors deliver therapy via telephone could overcome these barriers. This is the first study to explore feasibility and acceptability of telephone-delivered therapy with refugee children in a humanitarian setting.

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