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      Association between parental divorce and mental health outcomes among Lebanese adolescents: results of a national study

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          Abstract

          Background

          In Lebanon, divorce rates have jumped from nearly 7000 in recent years to 8580 in 2017, an increase of 22.5%, with North Lebanon recording the highest number, followed by Beirut, likely resulting in increased behavioral problems in the offspring of divorced parents. Furthermore, one out of two Lebanese adolescents whose biological parents were divorced, separated, or deceased has a psychiatric disorder. More information regarding the impact of divorce on the mental health of Lebanese adolescents is still missing. The objective of this study was to explore the association between divorce and mental health outcomes, particularly depression, anxiety, and suicidal ideation among Lebanese adolescents.

          Methods

          A cross-sectional study conducted between January and May 2019 enrolled 1810 adolescents aged 14 to 17 years, using a simple randomization method to choose schools. A proportionate number of schools was selected from each of the five Lebanese Mohafazat (Beirut, Mount Lebanon, North, South, and Beqaa), based on the list of the Ministry of Education and Higher Education. A total of 18 private schools were approached; two declined, and 16 accepted to participate.

          Results

          The mean age of participants was 15.42 ± 1.14 years, with 53.3% females. After adjustment for the covariates (age, sex, and house crowding index), the results showed that adolescents whose parents are separated compared to living together had more social fear (Standardized Beta (SB = 0.270) and avoidance (SB = 0.188), higher depression (SB = 0.045), and higher suicidal ideation (SB = 0.370).

          Conclusion

          Our findings reveal that teens with divorced parents had higher social fear and avoidance, depression, and suicidal ideation, highlighting the need for adequate prevention programs to support both children and parents during this emotionally difficult period.

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          Most cited references47

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          Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication--Adolescent Supplement (NCS-A).

          To present estimates of the lifetime prevalence of DSM-IV mental disorders with and without severe impairment, their comorbidity across broad classes of disorder, and their sociodemographic correlates. The National Comorbidity Survey-Adolescent Supplement NCS-A is a nationally representative face-to-face survey of 10,123 adolescents aged 13 to 18 years in the continental United States. DSM-IV mental disorders were assessed using a modified version of the fully structured World Health Organization Composite International Diagnostic Interview. Anxiety disorders were the most common condition (31.9%), followed by behavior disorders (19.1%), mood disorders (14.3%), and substance use disorders (11.4%), with approximately 40% of participants with one class of disorder also meeting criteria for another class of lifetime disorder. The overall prevalence of disorders with severe impairment and/or distress was 22.2% (11.2% with mood disorders, 8.3% with anxiety disorders, and 9.6% behavior disorders). The median age of onset for disorder classes was earliest for anxiety (6 years), followed by 11 years for behavior, 13 years for mood, and 15 years for substance use disorders. These findings provide the first prevalence data on a broad range of mental disorders in a nationally representative sample of U.S. adolescents. Approximately one in every four to five youth in the U.S. meets criteria for a mental disorder with severe impairment across their lifetime. The likelihood that common mental disorders in adults first emerge in childhood and adolescence highlights the need for a transition from the common focus on treatment of U.S. youth to that of prevention and early intervention. Copyright © 2010 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
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            Anxiety and anxiety disorders in children and adolescents: developmental issues and implications for DSM-V.

            This review summarizes findings on the epidemiology and etiology of anxiety disorders among children and adolescents including separation anxiety disorder, specific phobia, social phobia, agoraphobia, panic disorder, and generalized anxiety disorder, also highlighting critical aspects of diagnosis, assessment, and treatment. Childhood and adolescence is the core risk phase for the development of anxiety symptoms and syndromes, ranging from transient mild symptoms to full-blown anxiety disorders. This article critically reviews epidemiological evidence covering prevalence, incidence, course, and risk factors. The core challenge in this age span is the derivation of developmentally more sensitive assessment methods. Identification of characteristics that could serve as solid predictors for onset, course, and outcome will require prospective designs that assess a wide range of putative vulnerability and risk factors. This type of information is important for improved early recognition and differential diagnosis as well as prevention and treatment in this age span.
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              Social Phobia

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                Author and article information

                Contributors
                saharobeid23@hotmail.com
                souheilhallit@hotmail.com
                Journal
                BMC Pediatr
                BMC Pediatr
                BMC Pediatrics
                BioMed Central (London )
                1471-2431
                18 October 2021
                18 October 2021
                2021
                : 21
                : 455
                Affiliations
                [1 ]GRID grid.444434.7, ISNI 0000 0001 2106 3658, Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), ; Jounieh, Lebanon
                [2 ]INSPECT-LB: National Institute of Public Health, Clinical Epidemiology, and Toxicology, Beirut, Lebanon
                [3 ]GRID grid.444434.7, ISNI 0000 0001 2106 3658, Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), ; Jounieh, Lebanon
                [4 ]Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
                [5 ]GRID grid.497275.a, Université de Limoges, UMR 1094, Neuroépidémiologie Tropicale, Institut d’Epidémiologie et de Neurologie Tropicale, GEIST, ; 87000 Limoges, France
                [6 ]GRID grid.413056.5, ISNI 0000 0004 0383 4764, University of Nicosia Medical School, ; Nicosia, Cyprus
                [7 ]GRID grid.411324.1, ISNI 0000 0001 2324 3572, Faculty of Pharmacy, Lebanese University, ; Hadat, Lebanon
                Author information
                http://orcid.org/0000-0001-6918-5689
                Article
                2926
                10.1186/s12887-021-02926-3
                8522189
                33397296
                32a44c6f-fe1b-42d8-ba88-3da701e2b58b
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 19 October 2020
                : 23 September 2021
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2021

                Pediatrics
                depression,anxiety,suicidal ideation,divorce,adolescents
                Pediatrics
                depression, anxiety, suicidal ideation, divorce, adolescents

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