Psychiatric Comorbidities in Transsexualism: Study of a Lebanese Transgender Population

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.

Purchase full article [Article in French] at:   http://goo.gl/vJQRE4

By:  Ibrahim C1, Haddad R2, Richa S3.

• 1Hôtel-Dieu de France, faculté de médecine, université Saint-Joseph, Beyrouth, Liban.
• 2Faculté de médecine, université Saint-Joseph, Beyrouth, Liban.
• 3Hôtel-Dieu de France, faculté de médecine, université Saint-Joseph, Beyrouth, Liban; Faculté de médecine, université Saint-Joseph, Beyrouth, Liban. Electronic address: sami.richa@usj.edu.lb.
• Encephale. 2016 Mar 23. pii: S0013-7006(16)00043-9. doi: 10.1016/j.encep.2016.02.011.  

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Torture and Long-Term Health Effects among Lebanese Female Political Prisoners

Lebanese prisoners during the Israeli occupation of Lebanon (1981-1999) were subject to regular torture. We examined the association between torture events and post-traumatic stress and cardiovascular diseases (CVDs) among former women political prisoners. 

We conducted a retrospective survey and performed health check-ups among 108 former women prisoners. Post-traumatic stress disorder (PTSD) was measured through the Clinician-Administered PTSD Scale (CAPS), and CVDs were assessed by physicians' diagnoses. The study was conducted between September 2008 and March 2010. All 67 participants in the study reported having been subjected to a variety of torture events. 

The prevalence of PTSD was 28.4% and that of CVD was 16.42%, respectively. PTSD and CVD were more likely to occur among women who had had longer imprisonment periods, and PTSD specifically was associated with exposure to torture (beating and threatening by rape). CVD was associated with asphyxia with water. Devoutness decreased the risk of PTSD. Torture had adverse long-term effects on prisoners' physiological and psychological health; devoutness played a significant protective role. 

This study highlights the importance of documenting torture events and identifying the indicators of associated morbidity among surviving political prisoners for the provision of additional resources to care.

Purchase full article at:   http://goo.gl/KSjLVn

By:  Ghaddar A1, Elsouri G2, Abboud Z3.

• 1Observatory of Public Policies and Health, Bonmarche Center, Beirut, Lebanon Lebanese International University, Beirut, Lebanon ali.ghaddar@liu.edu.lb.
• 2Observatory of Public Policies and Health, Bonmarche Center, Beirut, Lebanon Lebanese University, Beirut, Lebanon.
• 3Khiam Rehabilitation Center, Beirut, Lebanon.
• J Interpers Violence. 2016 Feb;31(3):500-14. doi: 10.1177/0886260514555865. Epub 2014 Nov 6. 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Substance Use among Lebanese University Students: Prevalence and Associated Factors

Scientific research on use and misuse of substances in Lebanon is scarce. This study aimed to evaluate the rate of use and abuse of substances among Lebanese youth and identify the determinants and risk factors behind these behaviours.

The prevalence of ever consuming alcohol was 20.9%. Cannabis (12.3%) and tranquilizers (11%) had the highest rates of ever use among the drugs, whereas cocaine (3.3%) and hallucinogens (3.6%) had the lowest rates. Smoking cigarettes and waterpipes, going out at night, peer pressure and having no specific leisure time activity were associated with problematic substance use, while a better relationship with parents, reading and working were inversely associated with use. 

There is a high prevalence of substance use among university students in Lebanon. Multidisciplinary support for addicted students is needed to meet their diverse needs.

Via: http://ht.ly/Sdk6I 

By: Salameh P1, Rachidi S2, Al-Hajje A2, Awada S2, Chouaib K3, Saleh N4, Bawab W2.

• 1Laboratoire de recherche clinique et épidémiologique, Faculté de Pharmacie, Université Libanaise, Beyrouth (Liban); École doctorale des Sciences et de Technologie, Université Libanaise, Beyrouth (Liban); Faculté de Santé publique, Université Libanaise, Beyrouth (Liban).
• 2Laboratoire de recherche clinique et épidémiologique, Faculté de Pharmacie, Université Libanaise, Beyrouth (Liban); École doctorale des Sciences et de Technologie, Université Libanaise, Beyrouth (Liban).
• 3École doctorale des Sciences et de Technologie, Université Libanaise, Beyrouth (Liban).
• 4École doctorale des Sciences et de Technologie, Université Libanaise, Beyrouth (Liban); Faculté de Santé publique, Université Libanaise, Beyrouth (Liban).