Predicting Depressive and Anxiety Symptoms Among Lebanese and Syrian Adults in a Suburb of Beirut during the Concurrent Crises: A Population-Based Study

BackgroundPeople living in low socioeconomic conditions are more prone to depression and anxiety. This study aimed to develop and internally validate prediction models for depressive and anxiety symptoms in Lebanese adults and Syrian refugees residing in a suburb of Beirut, Lebanon. MethodsThis was a population-based study among COVID-19 vulnerable adults in low socioeconomic neighborhoods in Sin-El-Fil, Lebanon. Data were collected through a telephone survey between June and October 2022. The outcomes depressive and anxiety symptoms were investigated for Lebanese and Syrian populations. Depressive and anxiety symptoms were defined as having a PHQ-9 and GAD-7 score of 10 or more respectively. Outcomes predictors were identified through LASSO regression, discrimination and model calibrations were assessed using area under curve (AUC) and C-Slope. ResultsOf 2,045 participants, 1,322 were Lebanese, 664 were Syrian, and 59 were from other nationalities. Among Lebanese and Syrian populations, 25.3% and 43.9% had depressive symptoms, respectively. Additional predictors for depressive symptoms were not attending school, not feeling safe at all at home, and not having someone to count on in times of difficulty. Not having legal residency documentation for Syrian adults was a context-specific predictor for depressive symptoms. These predictors were similar to that of anxiety symptoms. Both Lebanese and Syrian models had good discriminations and excellent calibrations. ConclusionThis study highlights the main predictors of poor mental health were financial, health, and social indicators for both Lebanese and Syrian adults during the concurrent crisis in Lebanon. Findings emphasise social protection and financial support are required in populations with low socioeconomic status. Research in contextO_ST_ABSWhat is already known on this topicC_ST_ABSThe prevalence of depression and anxiety has increased globally. Vulnerable populations, such as refugees and populations of low socioeconomic status, are more prone to depression and anxiety. What this study addsThis study included Lebanese and Syrian adults residing in low socioeconomic status areas of Sin-El-Fil, Lebanon. This is a population-based comparison of the predictors to poor mental health in Lebanon between refugees and Lebanese. The study highlights the need to meet financial, physical, and social needs of individuals to address mental health. How this study might affect research, practice, or policyThe findings of this study highlight the need to reduce financial stress, address physical pain and social isolation, and advocate for Syrian residency documentation to reduce the occurrence of anxiety and depressive symptoms in people living in low socioeconomic conditions.