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In Lebanon, no estimate for autism prevalence exists. This cross-sectional study examines the prevalence of Autism spectrum disorder (ASD) in toddlers in nurseries in Beirut and Mount-Lebanon. The final sample included 998 toddlers (16-48 months) from 177 nurseries. We sent parents the Modified Checklist for Autism in Toddlers (M-CHAT) for screening, and a self-administered questionnaire (associated factors). We imputed missing M-CHAT data with successful answers. Since there were no follow-up interviews for the M-CHAT, we used the positive predictive value (0.058) from a large study for prevalence estimates. ASD prevalence was 1 in 66 children (comparable to US). Ratios were: male/female: 1.05; Beirut/Mount-Lebanon: 1.2. Using a more representative sample and ascertaining results are needed for better prevalence estimates in Lebanon.

OBJECTIVE: To assess the completeness of data on death certificates over the past 25 years in Beirut, Lebanon, and to examine factors associated with the absence of certifiers' signatures and the non-reporting of the underlying cause of death. METHODS: A systematic 20% sample comprising 2607 death certificates covering the 1974, 1984, 1994, 1997 and 1998 registration periods was retrospectively reviewed for certification practices and missing data. FINDINGS: The information on the death certificates was almost complete in respect of all demographic characteristics of the deceased persons except for occupation and month of birth. Data relating to these variables were missing on approximately 95% and 78% of the certificates, respectively. Around half of the certificates did not carry a certifier's signature. Of those bearing such a signature, 21.6% lacked documentation of the underlying cause of death. The certifier's signature was more likely to be absent on: certificates corresponding to the younger and older age groups than on those of persons aged 15-44 years; those of females than on those of males; those of persons who had been living remotely from the registration governorate than on those of other deceased persons; and those for which there had been delays in registration exceeding six months than on certificates for which registration had been quicker. For certificates that carried the certifier's signature there was no evidence that any of the demographic characteristics of the deceased person was associated with decreased likelihood of reporting an underlying cause of death. CONCLUSION: The responsibility for failure to report causes of death in Beirut lies with families who lack an incentive to call for a physician and with certifying physicians who do not carry out this duty. The deficiencies in death certification are rectifiable. However, any changes should be sensitive to the constraints of the organizational and legal infrastructure governing death registration practices and the medical educational systems in the country.

This paper examines the association between being in paid work and depression among older adults in three poor urban communities in Beirut, Lebanon. In view of the rapid ageing of Lebanon's population and the growing number of older persons, the deteriorating economic conditions and the lack of pension systems, paid work is an important source of income for older people and deserves special attention. The sample was 328 men aged 65 or more years. Depression was assessed using the 15-item Geriatric Depression Scale. The exposure variable was working for pay at the time of the survey, and the covariates included sociodemographic measures, health characteristics, financial resources and social capital. Around one-third of the men were working, and approximately the same fraction were depressed. Adjusted data showed a protective effect of work on depression (odds ratio 0.50, 95 per cent confidence interval 0.25-0.96). This study is an eye opener on the circumstances of disadvantaged older people in a relatively low-income Eastern Mediterranean Region country, a topic rarely addressed in this area of the world. Old age is viewed as a decline in abilities while in reality many older adults are still able and ready to work. Social policies for older people should promote opportunities to work, not only pension schemes. KEY WORDS--work, labour-force participation, depression, Eastern Mediterranean Region. doi: 10.1017/S0144686X09990171

A cross-sectional study addressed the experience of Lebanese hostages of war in Lebanon. It specifically assessed the prevalence of general distress and its relationship to captivity-related factors and selected psychosocial variables. Trained field researchers using standard measurements interviewed 118 Lebanese hostages released from Khiam prison, an Israeli detention center in Lebanon. Questionnaires administered included the GHQ-12 and the Harvard Trauma Questionnaire. Individuals were detained for 3.4 years on average, and 86% were tortured. Psychological distress was present in 42.1% of the sample compared to 27.8% among the control group. In the multivariate analysis, the significant predictors for distress were: years of education and increase in religiosity after release. In conclusion, even after 2 years of release, more than one-third of the Lebanese hostages released from Khiam prison were found to have psychological distress. Caregivers need to pay special attention to the mental health of hostages of war. The paper discusses the meaning and implications of the factors predicting resilience and vulnerability in this particular population. Keywords: POW; Torture; Psychiatric distress; Hostage; Trauma; Lebanon