Up to 140 million people in the Arab world may be suffering from one or more psychiatric disorders, a major collaborative study has found.

The UAE University (UAEU) and Harvard University’s Programme on Refugee Trauma jointly conducted the research, which surveyed 90 psychiatrists and primary care doctors from 17 Arab countries. Based on the feedback from doctors, the research was able to identify some of the main factors that contributed towards psychological trauma, with the death of a close relative or friend among the main causes.

“The study highlights the need to develop awareness and training programmes for health workers in Arab communities to identify and properly treat traumatised individuals with special focus on primary care settings. This is expected to have significant effects on the sense of health and wellbeing for patients,” said Dr Osama Tawakol Osman, associate professor, Department of Psychiatry and Behavioural Sciences at UAEU, and one of the lead researchers.

“It is also important to enhance the educational curricula in medical schools and in residency training programmes… One essential skill is to respectfully empathise with the patients to help them recognise what happened to them and positively change the narrative to focus on areas of strength rather than dwell on what is wrong with them,” he added.

“It is estimated that as many as 100–140 million people in the Arab world suffer from one or more psychiatric disorders. Violence, war, political and social instability, and change have all played a role in increasing the regional prevalence of trauma. The physical and psychological consequences of trauma are disabling to individuals, families, and communities,” he said, highlighting the important need for doctors in the region to be able to handle the issue.

“The negative effects of these conditions have spread through social networks and across generations. Maternal mental health issues, for example, are associated with negative physical, developmental, and psychological outcomes in their offspring, who in turn may develop an increased risk of mental health disorders which then persist and worsen in adulthood,” he added.

Explaining some of the main factors behind psychological trauma, Osman said they ranged from domestic violence to the effects of war.

“Traumas frequently reported by their patients were attributed to recent death of a close relative or friend (62.3 per cent), domestic violence (41.4 per cent), divorce/separation (72.1 per cent), serious traffic accident (45.6 per cent), sexual assault/rape (20.3 per cent), child abuse (20.3 per cent), psychological effects of war (30.9 per cent), victims of crime (15.9 per cent), refugees/internally displaced persons (20.6 per cent),

“[Other causes were due to] physical effects of war (19.1 per cent), torture (13.2 per cent), elderly abuse (11.6 per cent), psychological effects of a natural disaster (7.4 per cent), physical effect of a natural disaster (7.2 per cent), and child soldiers (4.3 per cent).

“Psychiatrists had significantly more patients with the following traumatic experiences: divorce/separation, recent death of a close relative or friend and domestic violence,” he added.

Osman also said that one of the main challenges in treating psychological trauma was the social and cultural stigma attached to it, with many people choosing to keep their condition secret out of fear or shame.

“Trauma related psychological symptoms are frequently hidden because of societal stigma that may erroneously consider psychiatric symptoms a weakness of faith.

“The feelings of guilt and shame and the lack of awareness with the related symptomatology delay help seeking. Many experts will refer to consequences of psychological trauma as the invisible wounds,” he added.

Reporting by Sami Zaatari

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