الفهرس 
Introduction and aim of the Present studyOnly 14 pages are availabe for public view
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Abstract
Ac1cording to the American Psychiatric Association (APA), mental illnesses ,are associated with distress an1d/or problems functioning in social], ·work or family .a1ctivities which may lead to some consequ1ences such as low life satisfaction levels, 1depression, post traumatic stress disorder (PTSD) and other psycho1]logical problems.Refugees are always c.onsid1ered among the weakest and more vulnerable groups in any setting. Th1ey need h1ealth care attention in their hosting country esp1e1cially mental h1ealth care because they suffer1ed in their home country, during the escaping journey and in the ho1sting country as a new 1environment as well.
The aim of the study was to assess the psychological pro1b1lems among Syrian refugees in Alexandria with the fo1llowing specific objectives:1.To estimate the prevalence 01f 1depr1essi1on and post-traumatic stress symptoms ,among Syrian refugees in Alexandria.2.To id1entify· po1ssible determinants of dep1ression and post-traumatic stress symp1t1oms amo1ng Syrian refugees.3.To assess the satisfaction with life 1of Syrian refugees. A cross sectional study was condu1cted among 420 ,a1dult Syrian refugees aged 18 years an1d above, staying in Alexandria, coming from Syria since at least 3 months, able to read an1d write, and attending Soriano 1Connnunity Center in Alexandria. A predesigned stru1ctured self-administered questionnaire was used to collect perso1nal data such as age, :level of educatio1n, marital status, income, numb1er of family members, health insurance status, smoking status,, habits and medi1callihistory.
Psy1chologilcal testing was p1erformed using the Arabic version of the PTSD Checklist, civilian v1ersio1n ’’PCL-C’’’ PTSD, th1e Arab1ic v1er1sion 01f Beck Depr1ession In·vento1ry se1cond edition (BDI-II), and The Arabic version of Satisfaction with Life Scale ’’SWLS’’’. The co1llect1e1d data was revised for accuracy and completeness. Data entry and analysis were 1done using Statistica] Pa1ckage for the Social Sciences (SPSS) version 24 statistical software.
The study revealed the following main results:
Personal characteristics of studied Syrian refugees. •l• The age of the studied Syrian refugees ranged between 18 and 80 y1ears old with a mean age of 31.9 + lQ,.4 years.•:• More than three quarters (78..6%) of participants were females and 21.4% ·were males. Most of them were married (60·.7%) while 21.91% wer1e singl1e., 6.9% were widowed, 6.0% were divorced and 4.5% ·were engage1d.•:• The maj1ority of Syrian refugees (81.7%) were living in urban ar1eas while 11.9% were living in slums and 6.4% wer1e living in rur.al .areas •:• About quarters (72.91%) of Syrian refuge1es were not working.•:• Income was not enough for 74..8% of the studied refugees while 25.2% mentioned that they ha1d en1ough income..•:• The majority _of Syrian refugees (93.8%) had no health insurance •:• More than three quarters of participants (77.’9%) were no1n-smokers while 17.4% of them were current smokers and 4.7% w·1ere 1ex-smokers. Nearly one thir1d (33.8%) 1of them
pra1cticed sports while mo1re than two thirds (6:8.1%) had :hobbies.•:• More th.an on1e thir1d of participants (39.8%) ha1d hist1ory of at 1e.ast one chronic disease such as sinusitis., hyp1ertension, thyroi1d diseases and diabetes.•!• More than on1e third (38.l %) 1of parti1cip.ants reported having 01ne or mor1e psychological problem mo1stly depression, sleeping disorders an1d anxiety,.•:• More th.an on1e quarter (26.9%) 01f participants had family history of psychological problems.•:• Half of participants mentioned that their parents had a g1ood relationship with each other, 36.9% mentioned they had a very ,goo1d relationship while 1only 13.1% menti1oned they ha1d a bad relationship.•:• The reillati1onship between participants and their fathers ·was very good in 3’9.1%, good in 51.4% and bad in 9..5%. The r1elationship between them and their mothers was very go1od in 52.1% of them, good in 43.6% .and bad in 4.3%.Prevalence and determinants of depression among studied Syrian refugees. The p1rev.alence of depressi1on .among studied Syrian refugees w.as 46%. The pr1evalen1ce of moderate to sever1e depressio1n was higher among females (50·.3%), divorced participants (76%), slum residents (.58%), those who1 reported not having 1enough income (4’9.7%) and those without health insurance 1cover.age (48% ). Also, the prevalence was higher among participants havin,g a :history of chronic diseases (63.5%), those having a history of psychological problems (73.1%) and those having a family history of p1sy·chologi1cal pr1oblems (.5’9.3%).
In addition, the prevalence was higher among participants with history of domestic violence (671%)., those who reported using physical punishment of their children (6101%), those having bad p1arents’ relationships (70.9%), those having bad relationships with th1err fathers (7.5%) and those having bad r1elationships with th1eir mothers (.55.6%).
Prevalence ao1d determinants of post-traumatic str1ess disorder” among stnd:i1ed Syria relieves The majority of participants (89.3%) suffered from PTSD. The prevalence of moderate to highly severe PTSD symptoms was ’higher ,among ex-smokers (95%), those having a :history of psychological problems (98.8%) or a family history of psychologically problems (’94.7%) and those having a history of domestic violence (94.3%).Prevalence and determinants of satisfaction with life ,among studied Syrian refugees: Only one third of p1,articipants was satisfied with their lives, more than half (59..3%)were dissatisfied while 7.1% w1ere neutral The prevalence of satisfaction with life was higher among slum residents (42%), those with university and postgraduate levels of edu,cation (43% ), those working as specialists (,61.5%),, those having enough in1come (37.7%), those who had hobbi1es (38.5% ). The prevalence was also higher in those without a history of chronic diseases (37.2%)., those without a :history of psychological] p1roblems (40%), those without a family history of psychological problems (3,6.5%), those :having no history of domestic violence (37.1%), those having good parents’ relations hips (35.3’%) and those having bad relation ships with their fathers (35%).Among the studied samp1le, 31,.9% had depression, PTSD and were dissatisfied with their lives at the time of the study. Logistic regression analysis identified residence, health insurance, chronic diseases and history of psychological problems as predictors tor depression and identified history of psychological problems as a pr1e1dictor for PTSD,. On the other hand, linear regr1ession analysis identified income, hobbies and family history of psychological problems as predictors for satisfaction with life..6.2. Conclusions:Based on the results of this study, the ·following could b1e concluded:•!• Syrian refugees are a vulnerable group and most of them having psychological problems do not go to specialists to get proper diagnosis which sometimes makes their case worse.•:• More than one third ,of Syrian refugees suffered from d1epressi,on, the majority ,of them suffered from P’TSD and more than half of them were dissatisfied with their liv1es•:• Residence, health insurance status, history of chronic diseases ,and history of psychological probl1ems were the most important: determinants of d1epression among Syrian refugees.•!• History, of psychological problems is the most important determinant of PTSD among Syrian refugees!• Income, family history of psycho]logical problems ,and hobbies are associated with satisfaction with life among Syrian refugees.6.3.Recommendations:The following are the main reco1mmendations for this study:1.Recommendations to the hosting country:•!• More attention needs to be giv1en to refugees .as they are a vulnerab1le group that needs attentio1n and effort to be included among genera] population.•!• Proper planning of using refugees as 1extra human resources can lessen the eco1nomic burden and can be used for the best of th1e country.2.Recommendations to the Egyptian Ministry of Health a:nd Population:•!• Proper and affordable access 1of refugees to1 mental :health car1e is .a profound need to face th1eir psychological problems.•!• Incorporation of high-quality :ment.al health services in all :health care cent1ers should ab1e a p1riority to1 the h1ealth care system.•!• Health care workers should be well trained to care for different natio1nalities sp1ecially refugees .as this ne1e1ds a go1od un1derstanding of the sensitivity and difference between Egyptian culture and their home country culture.
•!• Conducting mental health awareness sessions .and campaigns can be of great help1 to refugees aiming for early detection .and prop1er treatment of psychological problems.3.Re·commend.ations to the Syrian refugees:•!• Being 1enga,ged in the community .and having hobbies 1can 1:,iositi.vely affect mental health .and wellbeing and act as a protective fa1ctor against psychological problems.•!• Seeking professional mental health h1elp early can be very useful in controlling and treating any ps·ycholo1gical probl1em compared to delayed diagnosis.