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With the well-known serious effects of alcohol and nicotine dependence on adolescents' well-being, and knowing that males are more exposed to violent video gaming, this study was conducted to examine the association between exposure to violent video gaming and alcohol, cigarette, and waterpipe dependence among male Lebanese adolescents.This was a cross-sectional observational study conducted with Lebanese male students (13-17 years old) between October and December 2019. The Video Game Questionnaire was utilized to assess the content of violence in video games. For the assessment of alcohol, cigarette, and waterpipe dependence, the Alcohol Use Disorders Identification Test scale (AUDIT), Fagerström Test for Nicotine Dependence (FTND), and Lebanese Waterpipe Dependence Scale (LWDS) were used, respectively. Log transformation was used for the three addiction scores. Four linear regressions were performed taking the AUDIT, FTND, LWDS, and violent video gaming scores as dependent variables.From the 388 students enroled (mean age= 15.83 ± 1.93 years), 190 (48.8%) were classified as having violent video gaming. Older age (beta=0.049) and more violent video gaming (beta=0.006) were significantly associated with more cigarette dependence. More violent video gaming (beta=0.003) was significantly associated with more waterpipe dependence. Older age (beta=-0.090) was significantly associated with lower alcohol use disorder, whereas more violent video gaming (beta=0.005) was significantly associated with more alcohol use disorder.The study supports an association between higher exposure to violent video game and higher alcohol and smoking dependence among male teenagers in Lebanon. Hence, support and guidance should be implemented to raise awareness and protect teenagers.

This study aimed to evaluate factors and profiles associated with the earlier onset of cigarette/waterpipe smoking and alcohol consumption among Lebanese adolescents in schools.A total of 4000 adolescents (mean age = 15.31 ± 2.01 years) participated in this cross-sectional study. The standardized questionnaire was taken from the Health Behavior in School Children (HBSC) study in different countries (France, Belgium, and the USA) and adjusted to the Lebanese population. K-means clustering analysis was conducted to classify participants into three clusters according to their patterns (surrounded by smokers, surrounded by drinkers, and ease of talking to family members and friends) and Cox regression analyzes were conducted.Participants were divided into three clusters. Cluster 1 (16.75% of participants) included adolescents with the lowest ease of talking to a family member or friend, with the latter smoking and drinking a lot (worst cluster). Cluster 2 (54.95%) included adolescents with moderate ease of talking to a family member and more to friends, surrounded by low-to-moderate smoking and alcohol consumption, particularly for a best friend (positive influence cluster). Finally, cluster 3 (28.30%) included adolescents with low ease of talking to friends, moderate ease of talking to a family member, and low-to-moderate smoking and alcohol consumption (low influence cluster). The results of the Cox regressions (taking the age at onset of smoking cigarettes and waterpipes as the dependent variables) showed that older age at onset of cigarette and waterpipe smoking was significantly associated with female participants and those belonging to clusters 2 and 3 compared to cluster 1. Moreover, a younger age at first alcohol use and getting drunk was significantly associated with living outside Beirut, whereas female gender and belonging to clusters 2 or 3 compared to cluster 1 were significantly associated with older age at first alcohol use and getting drunk.This study identified risk factors (ease of talking as well as smoking and alcohol-drinking status of parents, siblings, and friends) and profiles related to early alcohol and cigarette/waterpipe use. These risk factors and profiles could help implement prevention campaigns to reduce substance use and improve adolescent health.

Objectives Early sexual initiation is known to be associated with deleterious health outcomes. The objective of this study was to evaluate factors (bullying, weight status, smoking and alcohol consumption, peer influence, relations with parents) associated with the initiation of sexual intercourse among Lebanese adolescents in schools. Methods A retrospective cohort was formed using a convenient sampling of Lebanese students (n=1635) in private schools from Beirut and Mount Lebanon. Results Younger age of adolescents at first sexual intercourse was significantly associated with finding it very easy to talk about things that worry them with an older brother, having a best friend who drinks sometimes compared to no drinking, and a best friend who smokes sometimes or every day compared to not smoking. Moreover, older age at the first sexual relationship was significantly associated with female gender (HRa=0.25), as was older age at first time drinking alcohol, first time getting drunk, and smoking cigarettes. Conclusion This study sheds light on some of the factors associated with age at first sexual intercourse in Lebanese adolescents.

To assess: (1) the association between insomnia experienced at admission, sociodemographic and other patients' characteristics and mania; and (2) the variation of insomnia and mania before and after treatment in bipolar patients with manic episodes (type I).Sixty-two patients were interviewed shortly after their admission to the hospital (after 3 to 5 days). The current symptoms experienced by the patients were assessed upon admission and again at discharge from the hospital.A poorer quality of sleep (higher PSQI scores) (Beta=0.590) was significantly associated with higher mania, whereas the intake of SSRIs (Beta=-5.952) and TCAs (Beta=-8.181) was significantly associated with lower mania. Furthermore, highly significant reductions were reported in the PSQI scores (4.96 vs. 2.75, P0.001), ISI scores (8.30 vs. 3.45, P0.001) and YMRS scores (8.60 vs. 3.06, P0.001) between admission to and discharge from the hospital.Insomnia in patients with bipolar disorder type I is associated with mania, with a significant reduction of sleep problems seen during a period of approximately 20 days of hospitalization. Further longitudinal studies are needed to confirm the validity of our results and identify the causes. In the meantime, this research recommends a strategy to improve sleeplessness experienced during inter-episode phases may be helpful in preventing manic episodes in BD.

The objective of this study was to evaluate the impact of the interaction between body dissatisfaction and gender on eating disorders (restrained eating, binge eating, orthorexia nervosa, and emotional eating) among a sample of Lebanese adults.This cross-sectional study, conducted between January and May 2018, enrolled 811 participants selected randomly from all Lebanese Mohafazat. The mean age of the participants was 27.6±11.8 years. The majority were females (66.5%), had a high level of education (73.2%), and low income (77.9%). This study used the following scales: body dissatisfaction subscale of the Eating Disorder Inventory-second version, binge eating scale, Dutch restrained eating scale, orthorexia nervosa scale (ORTHO-15 scale), emotional eating scale, perceived stress scale, Hamilton Anxiety Rating Scale, and Hamilton Depression Rating Scale.Body dissatisfaction was positively correlated to restrained eating (r=0.293, P0.001), emotional eating (r=0.073, P=0.042) and binge eating (r=0.250, P0.001). The interaction between body dissatisfaction and gender was significantly associated with more restrained eating (Beta=0.01, P0.001) and orthorexia nervosa (Beta=-0.09, P0.001), but not with emotional (Beta=-0.43, P=0.103) and binge eating (Beta=-0.08, P=0.358). When stratifying the analysis by gender, the results revealed that higher body dissatisfaction was significantly associated with more restrained eating in both genders, but particularly among women. Body dissatisfaction was significantly associated with higher emotional eating in men only and with higher orthorexia nervosa tendencies and behaviors in females only.The interaction between body dissatisfaction and gender was significantly associated with orthorexia nervosa and restrained eating but not with binge or emotional eating. Higher body dissatisfaction was significantly associated with higher restrained eating, more pronounced in women, while it was significantly associated with higher orthorexia tendencies (lower ORTO-15 scores) in women only. Body dissatisfaction was associated with emotional eating in men only.

Objectives Our aim in this study was to translate the Hamilton Anxiety Rating Scale (HAM-A), State Trait Anxiety Inventory (STAI-A and B) scales to Arabic, linguistically validate them for use in a representative sample of the Lebanese population, and to check the reliability of these Arabic versions. Methods This study is cross-sectional, conducted between November 2017 and March 2018, which enrolled 1332 community dwelling participants using a proportionate random sample from all Lebanese Mohafazat. Results Three factor analyses for the anxiety scales were run over the whole sample (N = 1332). All of the HAM-A, STAI-A and STAI-B items could be extracted from the list. All items from all the scales did not over-correlate to each other (r > 0.9), did not have a low loading on factors ( Conclusion The linguistically validated Arabic versions of these scales can be used to screen for anxiety among the Lebanese populations.

The current study aims to investigate the effect of the interaction between adult attachment styles and alexithymia among participants with alcohol use disorder (AUD). This study is cross-sectional, conducted between November 2017 and March 2018, which enrolled 789 community-dwelling participants. The interaction between alexithymia and secure relationship tended to significance (p = 0.057). Higher interaction between alexithymia and a fearful relationship style (β = 0.04) were significantly associated with higher AUD. The interaction model revealed the importance of stratifying the results according to presence/absence of alexithymia. Being a female and having a secure relationship style were significantly associated with lower AUD in both groups. Being divorced was significantly associated with higher AUD in both groups. Increasing age (β = −1.48), secondary (β = −4.65), and university level of education (β = −6.46) were significantly associated with lower AUD in the non-alexithymic group. Intermediate monthly income (β = 2.69) and being widowed (β = 8.24) were significantly associated with higher AUD in the non-alexithymic group. High monthly income (β = 3.46) was significantly associated with higher AUD in the alexithymic group. The results of this study showed that the consideration of the combination between attachment styles and alexithymia is of significance in the diagnosis and therapy of alcohol use disorders.

Objectives The Hamilton Depression Rating Scale (HDRS) is the most commonly used scale for the evaluation of patients’ treatments for depression. Since the HDRS has never been validated in Lebanon to our knowledge, our primary objective, therefore, is to investigate the correlation, sensitivity, specificity, as well as the reliability and the validity of the Hamilton Depression Rating Scale (HDRS) among Lebanese depressed patients. The secondary objective is to identify sociodemographic factors that would be correlated to depression among our sample. Methods This case-control study, performed between January till May 2017, included 400 patients (200 patients, 200 controls). Results The HDRS scale items converged over a solution of four factors, explaining a total of 58.88% of the variance. A high Cronbach's alpha was found for the full scale (0.862). A stepwise linear regression, using the total HDRS score as continuous variable, showed that a low socioeconomic level, divorced participants and a family history of mental disorders would significantly increase the HDRS total score (Beta = 4.278; Beta = 5.405; and Beta = 3.922) respectively. However, having a university level of education would significantly decrease the HDRS total score (Beta = −4.248, P Conclusion This study shows that the Arabic version of the HDRS has promising psychometric properties, making it a good tool to use for the diagnosis of patients with depression. Depression recognition and treatment in general practice with the aim of improving patient outcome and reducing health care expenditure, is definitely warranted.

Objectives: Sociocultural factors and personality traits play key roles in determining dietary behaviors. Orthorexia nervosa (ON), the pathologic obsession with healthy eating, is increasingly receiving scientific attention. However, mechanisms and risk factors are not completely understood. The aims of this study were to compare the prevalence of orthorexic eating attitudes among adults in Germany and Lebanon, and to examine the relationship with primary facets of personality and maladaptive personality traits. Methods: The German sample comprised 391 adults, of which 314 were women (80.3%) and the mean age was 27 y. The Lebanese sample comprised 519 adults, of which 283 were women (56%) and the mean age was 36 y. In addition to sociodemographic data, participants completed the Dusseldorf Orthorexia Scale (DOS), the Teruel Orthorexia Scale (TOS), the Big Five Inventory, and the Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Results: Generally higher levels of healthy orthorexia among women and higher levels of ON according to the TOS-ON and DOS scores were found in Lebanon. In the Lebanese sample, 8.4% presented a high risk for ON, whereas this was true for only 4.9% of the German sample. Some associations between DOS/TOS scores and personality traits appeared but coefficients were generally low. Hierarchical multiple regression showed that the negative association between ON and the traits agreeableness and negative affectivity was clearly evident in the Lebanese sample but less so in the German sample. Age, body mass index, marital status, and subjective social status were not relevant moderators of effects. Comparison by country indicated higher prevalence of pathologic healthful eating and ON in the Lebanese sample compared with the German group. Personality traits, but not sociodemographic variables, partly contributed to this difference. Conclusion: The present results suggested the importance of sociocultural factors in the development of eating pathologies and proposed specific personality traits as important associated factors.

Resume Les schemas « precoces » identifies par Young sont pertinents en clinique du sujet âge. Ils representent des modeles ou des themes importants et envahissants pour l’individu, constitues de souvenirs, d’emotions, de pensees et de sensations corporelles. L’objectif de notre recherche consiste dans l’etude du niveau d’activation des schemas cognitifs dysfonctionnels specifiques au troisieme âge en fonction des milieux de vie (maison de retraite et domicile) des personnes âgees, a savoir, les schemas de carence affective, d’abandon, de mefiance, d’exclusion, de dependance, de vulnerabilite et de surcontrole emotionnel. Le « Questionnaire de Schemas de Young », dans sa forme courte, a ete realise chez 80 personnes âgees dont 40 vivant en maison de retraite et 40 a domicile avec au moins une personne. Les personnes vivant en maison de retraite, comparees aux sujets vivant a domicile ont plus d’activation des schemas de carence affective (22,5 % vs 7,5 %), d’abandon (15 % vs 0 %), de mefiance (32,5 % vs 2,5 %), d’exclusion (7,5 % vs 0 %) et de surcontrole emotionnel (25 % vs 2,5 %). Ces resultats sont significatifs sur cinq des sept schemas etudies, excepte les schemas de dependance et de vulnerabilite dont le niveau d’activation ne differe pas entre les deux groupes de l’echantillon. L’activation de ces schemas precoces chez les sujets en maison de retraite serait liee a un manque de support familial et emotionnel.

Resume Introduction La schizophrenie est associee a des troubles cognitifs et sociaux varies qui handicapent fortement les patients dans leur vie quotidienne. Le traitement de la schizophrenie repose sur une approche biopsychosociale qui comporte l’utilisation d’antipsychotiques, associes a un programme de remediation cognitive. Le programme integratif de therapies psychologiques (IPT) a la particularite d’associer une approche psychosociale a la remediation cognitive. Ce programme se compose de six sous-programmes. Chaque sous-programme est subdivise en plusieurs etapes. Les interventions therapeutiques se situent sur un axe qui procede du cognitif vers le social, du simple vers le complexe et d’un style d’animation directif vers la discussion ouverte centree. Methode Quarante-huit patients repondant au diagnostic de schizophrenie ont ete evalues a l’aide de la Brief Cognitive Rating Scale et de la Morning Rehabilitation Status Scale. Resultats L’evaluation apres trois mois montre une amelioration des troubles cognitifs. Il n’existait pas de differences significatives quant aux performances sociales etant donne que le groupe experimental n’a pas encore suivi tous les modules d’entrainement des habiletes sociales. Discussion L’IPT semble constituer une intervention therapeutique efficace, en association avec les antipsychotiques. Ce programme permet ainsi aux patients souffrant de schizophrenie une adaptation socioprofessionnelle et par consequent une qualite de vie satisfaisante.