Predicting depressive and anxiety symptoms among Lebanese and Syrian adults in a suburb of Beirut, Lebanon, during concurrent crises: nested cross-sectional study

AI Summary

Prediction models for depressive and anxiety symptoms among Lebanese adults and Syrian refugees/migrants showed good performance in this urban, low-resource setting.
Common predictors included pain limiting activity, debt, feeling unsafe at home, and limited social support for both groups.
Not having legal residency was an additional predictor of depressive symptoms among Syrian refugees or migrants, highlighting need for social protection and financial support.

BMJ Open. 2026 May 11;16(5):e101258. doi: 10.1136/bmjopen-2025-101258.

ABSTRACT

OBJECTIVE: This study aimed to develop prediction models for symptoms of poor mental health among Lebanese adults and adult Syrian refugees or migrants residing in a suburb of Beirut, Lebanon, separately.

DESIGN: Nested cross-sectional study.

SETTING: Sin-El-Fil, a suburb east of Beirut, Lebanon.

PARTICIPANTS: Lebanese and Syrian adults residing in low socio-economic status areas of Sin-El-Fil.

PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome was having depressive symptoms, ascertained through the Patient Health Questionnaire-9 where a total summative score of 10 or more indicated having depressive symptoms. Secondary outcome was having anxiety symptoms, ascertained through the Generalised Anxiety Disorder-7 where a total summative score of 10 or more indicated having anxiety symptoms.

RESULTS: Of 1986 participants, 1322 (66.5%) were Lebanese adults, 664 (33.5%) were Syrian refugees or migrants. Among Lebanese adults and adult Syrian refugees or migrants, 324 (25.3%) and 289 (43.9%) had depressive symptoms, respectively. Having pain that impacts usual activity, having debt, not feeling safe at home and having none or one person to count on in difficult times were common predictors of depressive and anxiety symptoms among Lebanese adults and Syrian refugees or migrants. Not having a legal residency permit was also a predictor of depressive symptoms for Syrian refugees or migrants. Prediction models developed for depressive and anxiety symptoms among both nationalities had good performance measures.

CONCLUSIONS: The predictors of poor mental health included financial, health and social indicators for both Lebanese adults and Syrian refugees or migrants during the concurrent crisis in Lebanon. These models are most applicable in similar urban, crisis-affected and low-resource settings. Findings emphasise the need for social protection and financial support among populations with vulnerabilities.

PMID:42114872 | DOI:10.1136/bmjopen-2025-101258

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