Despite all the internal and external criticisms of mental health services in Libya, they remain underdeveloped across the country. The World Health Organization has made efforts to improve the country's mental health services; however, until a stable government is formed, patients with mental illness will continue to be deprived of their basic needs.

AimThere is evidence that childhood trauma is a risk factor for the development of psychosis and it is recommended that childhood trauma is inquired about in all patients presenting with psychosis. This study aimed to determine the prevalence of childhood trauma in patients in the UK Early Intervention Service based on a case note review.MethodsThis is a retrospective case note study of 296 patients in an UK Early Intervention Service. Trauma history obtained on service entry was reviewed and trauma experienced categorized. Results were analyzed using crosstab and frequency analysis.ResultsThe mean age of the sample was 24 years, 70% were male, 66% were White, and 23% Asian (ethnicity not documented in 11% of the sample). Approximately 60% of patients reported childhood trauma, 21% reported no childhood trauma, and data were not recorded for the remaining 19%. Among those reporting trauma, the prevalence of most frequently reported traumas were: severe or repeated disruption (21%), parental mental illness (19%), bullying (18%), absence of a parent (13%), and ‘other’ trauma (24%) – the majority of which were victimization events. Sixty-six percent of those reporting trauma had experienced multiple forms of trauma.ConclusionA high prevalence of childhood trauma (particularly trauma related to the home environment or family unit) was reported. This is consistent with other studies reporting on trauma and psychosis. The main weakness of the study is a lack of a control group reporting experience of childhood trauma in those without psychosis. Guidelines recommend that all patients with psychosis are asked about childhood trauma; but in 19% of our sample there was no documentation that this had been done indicating the need for improvement in assessment.

Introduction There has been a global increase in the prevalence of common mental disorders (CMD), particularly in conflict hotspots. The limited amount of resources is one of the key barriers to effective treatment within Low- and Middle-income countries (LAMICs). The lack of service provision for mental health disorders in LAMICs has resulted in limited opportunities to conduct mental health research. Libya is a North African country that has suffered from ongoing conflict with the current political unrest in Libya further impacting the mental health of the population. Main text The aim of this review is to conduct a synthesis of evidence regarding the estimated prevalence and associated risk factors of CMD in Libya. A search was completed in the academic databases; PubMed, Medline, EMBASE, PsychINFO, CINHAL, and the Institute for Development, Research, Advocacy and Applied Care (IDRAAC) from inception to March 2020. Only studies that investigated prevalence and associated risk factors of CMD in Libya were included. A total of 219 studies were identified of which 15 met the inclusion criteria for the review. There were (n = 3) papers investigated the prevalence of depression, (n = 4) studies were focused on stress-related disorders and the remaining papers looked at both anxiety and depression. Statistically, sample sizes of the included studies ranged from (n = 41–13,031) for the prevalence studies (mean = 1188.6, median = 233). Conclusion The status of Libya as a conflict hotspot has led to a reduced level of epidemiological data on mental health, with a vital need to conduct research in CMD. Libya requires better clinical governance which can allow for more scientific research into CMD and enabling the Libyan government to develop evidence-based policy initiatives for CMD.

IntroductionThere is paucity of researches addressing the relationship between individuals struggling to identify, express and communicate their emotions and problematic internet use, especially among medical students.ObjectivesTo assess problematic internet use in Tunisian medical students and to address its relationship with emotion regulation skills.MethodsFirst to fifth-year undergraduate medical students registered in the medical school of Sousse, Tunisia, were offered to answer an online questionnaire survey, involving sociodemographic and clinical data, Internet Addiction Test (IAT) and Difficulties in Emotion Regulation Scale (DERS).ResultsA total of 175 medical students participated in the study with a median age of 22 (20-23) years and a gender ratio of 0.3. Median score of IAT was 40 (30-48). Twenty-four percent of medical students (n=42) reported problematic Internet use. Higher scores of IAT were significantly associated with the perception of an unsatisfactory relationship with parents, not having a leisure activity, family history of psychiatric disorders, personal health conditions and regular alcohol consumption. Scores of IAT were strongly and positively correlated with the following DERS subscores: Non acceptance of emotional responses (r=0.328**), Difficulties engaging in goal directed behaviors (r=0.366**), Impulse control difficulties (r=0.238**), Limited access to emotional regulation strategies (r=0.311**), and Lack of emotional clarity (r=0.311**).ConclusionsProblematic internet use seems to emerge as part of a cluster of symptoms related to ineffective emotion regulation skills. Hence, training for affective regulation abilities appears strategically useful in the control of Internet use.