Mental Health of Disabled Palestinian Adults in the Gaza Strip

Abstract

Aim: The aim of the study was to investigate the prevalence of mental health problems among disabled people, and Psychological problems in association with other sociodemographic factors. Methods: Subjects: The sample responded to the interview were 416 participants with response rate of 100%, it consisted of 263 males (63.21%) and 153 females (36.79%). The age ranged from 19-70 years with mean age was 33.56 years. The results showed that 222 of participants had physical disability (53.4%), and 194 had other disability (vision, multiple, mental, hearing, and speech disability) (46.6%).  Measures: The participants were interviewed with self-reported questionnaire: including sociodemographic scale, Beck Depression Inventory, General Health Questionnaire, and Brief Symptom Inventory. Results: The results showed that the mean psychological symptoms was 81.19, somatization mean = 11.05, obsessive compulsive symptoms mean was 10.84, interpersonal sensitivity mean = 6.56, depression mean was 9.59, anxiety mean was 10.50, hostility mean was 7.63, phobic anxiety mean was 7.9, paranoid mean was 7.26, and psychosis mean was 6.86.   For differences between the two groups, participants with other disability showed statistically significant paranoia symptoms than those with physical disability. The results showed that there were no statistically significant differences in psychological symptoms in both physical and other disability according to sex. However, for general sample, disabled females reported more anxiety than males. According to GHQ-28, 54% of the sample (316) said that their feelings about general health were worse to very worse. Also, 89.1% said that they found themselves wishing they were dead and away from it all and 74.2% found at times they couldn't do anything because their nerves were too bad more than usual. The study showed than mean GHQ-28 was 12.12, somatization mean was 3.21, anxiety mean was 3.31, social dysfunction mean was 3.34, and depression mean was 2.27. The result showed that 42.6% of the physically disabled adults were rated as psychiatric morbidity cases according to GHQ-28 scale compared to 37.3% of other disability.  Also, there were no significant differences in mental health according to GHQ scale and subscales (somatization, anxiety, depression, and social function) and participants with physical or other disability. The most common depressive symptoms were: self-criticism (28.2%) and irritability (24.2%). Our results showed that 10.1% of participants with physical disability had moderate to severe depression compared to 6.6% with other disability. There were no statistically significant differences between the two groups in prevalence of depression. Conclusion and Clinical Implications: This is the first study of disabled people in the Gaza Strip which showed that 42.6% of the physically disabled adults were rated as psychiatric morbidity cases compared to 37.3% of participants with other disability that 10.1% of participants with physical disability had moderate to severe depression compared to 6.6% with other disability. These findings highlight the need for training of the staff working in such target group to enable them of early detection of those with mental health problems and being able to deliver community mental health interventions such as counseling and support therapy for them and their families. Also, more supervision from the specialized organizations working in the field of mental health to support the staff working in different organizations working with such group to increase the level of networking and referral system for cases need more psychological intervention.