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NEW ORLEANS -- People living abroad may experience anxiety, depression, and even post-traumatic stress disorder (PTSD) when disastrous events occur in their home countries, according to a survey study that followed up with Lebanese expatriates after the deadly explosion in Beirut in August 2020.

Among over 1,000 participants, 41.2% screened higher than the threshold for anxiety and depression, and 57.5% scored higher than the threshold for PTSD, using the Hopkins Symptom Checklist, reported Gaëlle Rached, MD, MSc, a postdoctoral fellow at Northwestern University in Chicago, during the American Psychiatric Association annual meeting.

Mental health effects were greater among women and younger people, noted Rached, who witnessed the Beirut explosion firsthand. She lost her home, and members of her family were injured.

"Expatriates already are under stressful living conditions, living abroad with no social support," she told 番茄社区app. "And very little is known about the mental health of expatriates, let alone in the context of traumatic events such as the Beirut explosion."

"In disaster, the attention naturally goes towards the most immediate victims, so people who are impacted physically," she noted. "However, expats still had a home in Lebanon, still had family there, and they, too, are impacted."

This population was especially important to study because an estimated 14 million Lebanese people are living abroad, which is greater than the domestic population, Rached said.

"I felt very emotional hearing about their experience, as expatriates, of the blast," she added. "They were at home. They heard about the blast from social media. And they tried reaching out to their families. They weren't able to reach them. The lines weren't connecting. They spent hours trying to reach them and imagining the worst. When we started talking about our experiences, we realized that the experiences are similar."

These preliminary findings show that psychiatrists should consider these factors when treating patients who may be experiencing distant traumatic events in this way, said session moderator Howard Liu, MD, MBA, chair of the psychiatry department at the University of Nebraska Medical Center in Omaha.

"I think we have to be trauma informed," he noted. "It's not just about looking at the biological correlates of illness ... but also looking at the environment in which people live, work, and are in therapy, or in treatment."

This research helps raise awareness of the need for more access to trauma and mental health support around the world, Liu added. "There's really a huge shortage of psychiatrists around the world, particularly those from countries that have been impacted by trauma."

Rached and colleagues surveyed more than 1,000 individuals from Lebanon (mean age 31), who were living abroad in August 2020, about their experiences in the weeks and months following the explosion. The survey was shared using email and social media, including WhatsApp, Facebook, Instagram, Twitter and LinkedIn, beginning in March 2021.

Most of the participants were currently living in France, the U.S., Canada, or the United Arab Emirates. In total, 670 participants were deemed eligible for anxiety and depression screening and 268 were deemed eligible for PTSD screening.

Most participants reported that close friends and family had experienced physical impact and losses from the explosion, and a majority reported feeling helpless or anxious after the event.

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