Skip to main content

Advertisement

SpringerLink
Log in

Psychiatric Morbidity, Phenomenology and Management in Hospitalized Female Foreign Domestic Workers in Lebanon

  • Brief Report
  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

    We’re sorry, something doesn't seem to be working properly.

    Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Abstract

40 million female domestic workers worldwide experience the inhumane conditions associated with this unregulated occupation, a situation that induces psychiatric morbidities in many. The case in Lebanon is not any better where it is estimated that one foreign domestic worker (FDW) commits suicide weekly. 33 female FDW and 14 female Lebanese (control group, CG) were enrolled. Brief Psychotic Rating Scale (BPRS) and Clinical Global Impression (CGI) scales were administered on admission and discharge and socio-demographic, living conditions, mental health care data and phenomenological observations were collected. Sexual, physical, and verbal abuses were detected in FDW (12.5, 37.5, and 50.0 %. respectively). 66.7 % of them were diagnosed with brief psychotic episode. The mean duration of hospital stay (13.1 days) was significantly lower in the FDW group. The mean cumulative antipsychotic dose of the FDW was 337.1 mg of chlorpromazine equivalent and the mean BPRS total pre-score of FDW was 66.4 with a much improved state on the CGI global improvement scale, all of which were nonsignificantly different from the CG. Striking phenomenological findings among FDW were acute anorexia (39.4 %), nudity (30.3 %), catatonic features (21.2 %), and delusion of pregnancy (12.1 %). Inpatient FDW are more diagnosed with psychotic than affective disorders and receive approximately similar treatment as controls in spite of the trend to rapidly discharge and deport the worker to limit the costs. Both groups presented with similar severity, although the FDW had peculiar phenomenological observations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  • Ajami, L. (2007). Foreign domestic workers in Lebanon. American University of Beirut (unpublished Masters thesis).

  • Anbesse, B., Hanlon, C., Alem, A., Packer, S., & Whitley, R. (2009). Migration and mental health: a study of low-income Ethiopian women working in Middle Eastern countries. International Journal of Social Psychiatry, 55(6), 557–568.

    Article  PubMed  Google Scholar 

  • Andre, C. (2006). TF1 interview. Retrieved from: http://lci.tf1.fr/science/2006-04/greve-faim-violence-par-culpabilisation-4894390.html.

  • Ayalon, L. (2012). Suicidal and depressive symptoms in Filipino home care workers in Israel. Journal of Cross Cultural Gerontology, 27, 51–63.

    Article  PubMed  Google Scholar 

  • BBC News. (2003). Maid abuse case shocks Malaysia. Retrieved from: http://www.news.bbc.co.uk/1/hi/world/asia-pacific.

  • Belai, B. (2006). Between a rock and a hard place: Migrant workers caught in Middle East conflict. http://www.ethiopianreporter.com/modules.php?name=News&file=article&sid=7468.

  • Berg, A. O., Melle, I., Rossberg, J. I., Romm, K. I., Larsson, S., Lagerberg, T. V., et al. (2011). Perceived discrimination is associated with severity of positive and depression/anxiety symptoms in immigrants with psychosis: A cross-sectional study. BMC Psychiatry, 11(77). doi:10.1186/1471-244X-11-77.

  • Bhugra, D. (2004). Migration and mental health. Acta Psychiatrica Scandinavica, 109(2), 243–258.

    Article  CAS  PubMed  Google Scholar 

  • Cantor-Graae, E., & Selten, J. P. (2005). Schizophrenia and migration: A meta-analysis and review. American Journal of Psychiatry, 162(1), 12–24.

    Article  PubMed  Google Scholar 

  • Castles, S., & Davidson, A. (2000). Citizenship and migration: Globalization and politics of belonging. London: McMillan.

    Google Scholar 

  • Chammartin, G. (2005). Domestic workers: Little protection for the underpaid. http://www.migrationinformation.org/Feature/display.cfm?id=300.

  • Chen, S. X., Benet-Martinez, V., & Bond, M. H. (2008). Bicultural identity, bilingualism, and psychological adjustment in multicultural societies: Immigration-based and globalization-based acculturation. Journal of Personality, 76, 803–838.

    Article  PubMed  Google Scholar 

  • Chen, E. Y. H., Harrison, G., & Standen, P. J. (1991). Management of first episode psychotic illness in Afro-Caribbean patients. British Journal of Psychiatry, 158, 517–522.

    Article  CAS  PubMed  Google Scholar 

  • Chung, H., Mahler, J. C., & Kakuma, T. (1995). Racial differences in treatment of psychiatric inpatients. Psychiatric Services, 46, 586–591.

    CAS  PubMed  Google Scholar 

  • Cochrane, R., & Bal, S. (1987). Migration and schizophrenia: An examination of five hypotheses. Social Psychiatry, 22, 181–191.

    Article  CAS  PubMed  Google Scholar 

  • DeCoux, H. (2007). The role of treatment setting and high acuity in the overdiagnosis of schizophrenia in African Americans. Archives of Psychiatric Nursing, 21(6), 327–335.

    Article  Google Scholar 

  • DeSouza, E., & Cerqueira, E. (2009). From the kitchen to the bedroom: Frequency rates and consequences of sexual harassment among female domestic workers in Brazil. Journal of Interpersonal Violence, 24, 1264–1284.

    Article  PubMed  Google Scholar 

  • Dutta, S., & Vankar, G. K. (1996). Delusions of pregnancy: A report of four cases. Indian Journal of Psychiatry, 38, 254–256.

    CAS  PubMed Central  PubMed  Google Scholar 

  • El Solh, C. (2007). Assessment of the labour migration situation in Lebanon: Case of women migrant domestic workers. Beirut: IOM, ILO.

    Google Scholar 

  • El-Hilu, S., Mousa, R., Abdulmalek, H., Kamel, N., Zohdi, M., & Al-Aamriti, M. (1990). Psychiatric morbidity among foreign housemaids in Kuwait. International Journal of Social Psychiatry, 36, 291–299.

    Article  CAS  PubMed  Google Scholar 

  • Esim, S., & Smith, M. (Eds.). (2004). Gender and Migration in Arab States. The case of domestic workers. Beirut: ILO.

    Google Scholar 

  • Goodwin, F. K., & Jamison, K. R. (2007). Manic-depressive illness: Bipolar disorders and recurrent depression (2nd ed.). Oxford: Oxford University Press.

    Google Scholar 

  • Hardwick, P. J., & Fitzpatrick, C. (1981). Fear, folie, and phantom pregnancy: Pseudocyesis in a fifteen-year old girl. British Journal of Psychiatry, 139, 558–560.

    Article  CAS  PubMed  Google Scholar 

  • Huda, S. (2005). Report of the special rapporteur on the human rights aspects of the victims of trafficking in persons, especially women and children, sigma huda, on her mission to Lebanon. United Nations Economic and Social Counsel.

  • Hutchinson, G., & Haasen, C. (2004). Migration and schizophrenia. The challenges for European psychiatry and implications for the future. Social Psychiatry and Psychiatric Epidemiology, 39, 350–357.

    Article  PubMed  Google Scholar 

  • International Labour Migration. (2010). Global and regional estimates on domestic workers.

  • Irrinnews. (2006). Lebanon: Female migrant workers face uncertain futures. http://www.peacewomen.org/news/Lebanon/May06/migrants_uncertain_future.html.

  • Jackson, A. (2006). The use of psychiatric medications to treat depressive disorders in African American women. Journal of Clinical Psychology, 62(7), 793–800.

    Article  PubMed  Google Scholar 

  • Jenkins, S. B., Revita, D. M., & Tousignant, A. (1962). Delusions of childbirth and labour in a bachelor. American Journal of Psychiatry, 118, 1048–1050.

    CAS  PubMed  Google Scholar 

  • Jones, B., & Gray, B. (1986). Problems in diagnosing schizophrenia and affective disorders among blacks. Hospital Community Psychiatry, 37(1), 61–65.

    CAS  PubMed  Google Scholar 

  • Jureidini, R. (2002). Women migrant domestic workers in Lebanon. International Migration Papers no. 48. Geneva: ILO.

  • Jureidini, R. (2009). In the shadows of family life: Towards a history of domestic service in Lebanon. Journal of Middle East Women’s Studies, 5(3), 74–101.

    Article  Google Scholar 

  • Kerbage, H., El-Chammay, R., & Richa, S. (2013). Mental health legislation in Lebanon: Nonconformity to international standards and clinical dilemmas in psychiatric practice (submitted).

  • Khan, N. Z., & Lynch, M. A. (1997). Recognizing child maltreatment in Bangladesh. Child Abuse and Neglect, 21(8), 815–818.

    Article  CAS  PubMed  Google Scholar 

  • Leucht, S., et al. (2012). Equipercentile linking of the Brief Psychiatric Rating Scale and the Clinical Global Impression Scale in a catchment area. European Neuropsychopharmacology, 22(7), 501–505.

    Article  CAS  PubMed  Google Scholar 

  • Messias, D. (2001). Transnational perspectives on women’ s domestic work: Experiences of Brazilian immigrants in the United States. Women and Health, 33, 1–20.

    Article  CAS  PubMed  Google Scholar 

  • Mkandawire-Valhmu, L. (2010). “Suffering in thought”: An analysis of the mental health needs of female domestic workers living with violence in Malawi. Issues in Mental Health Nursing, 31(2), 112–118.

    Article  PubMed  Google Scholar 

  • Morlan, K. K., & Tan, S. (1998). Comparison of the Brief Psychiatric Rating Scale and the Brief Symptom Report. Journal of Clinical Psychology, 54(7), 885–894.

    Article  CAS  PubMed  Google Scholar 

  • Ödegaard, Ö. (1932). Emigration and insanity. Acta Psychiatrica et Neurologica Scandinavica Supplementum, 4, 1–206.

    Google Scholar 

  • Pande, A. (2012). From ‘‘balcony talk’’ and ‘‘practical prayers’’ to illegal collectives: Migrant domestic workers and meso-level resistances in Lebanon. Gender & Society, 26, 382–405.

    Article  Google Scholar 

  • Parrenas, R. S. (2001). Transgressing the nation-state: The partial citizenship and “imagined (global) community” of migrant Filipina domestic workers. Signs, 26(4), 1129–1154.

    Article  CAS  PubMed  Google Scholar 

  • Phyllis, L., Cheng, J., Chow, D., Ungvari, G., & Leung, C. (2009). Acute psychiatric disorders in foreign domestic workers in Hong Kong: A pilot study. International Journal of Social Psychiatry, 55(6), 569–576.

    Article  Google Scholar 

  • Ryan, A. M., Gee, G. C., & Laflamme, D. F. (2006). The association between self-reported discrimination, physical health and blood pressure: Findings from African Americans, Black immigrants, and Latino immigrants in New Hampshire. Journal of Health Care for the Poor and Underserved, 17, 116–132.

    Article  PubMed  Google Scholar 

  • Sales, E. C., & Santana, V. S. (2003). Depressive and anxiety symptoms among housemaids. American Journal of Industrial Medicine, 44(6), 685–691.

    Article  PubMed  Google Scholar 

  • Sayres, N. (2003). An analysis of the situation of Filipino domestic workers. Geneva: International Labour Organization.

    Google Scholar 

  • Selten, J. P., & Cantor-Graae, E. (2005). Social defeat: Risk factor for schizophrenia? British Journal of Psychiatry, 187, 101–102.

    Article  PubMed  Google Scholar 

  • Selten, J. P., Cantor-Graae, E., & Kahn, R. S. (2007). Migration and mental health. Current Opinions in Psychiatry, 20(2), 111–115.

    Article  Google Scholar 

  • Shorter, E. (2006). Hysteria and catatonia as motor disorders in historical context. History of Psychiatry, 17, 461–468.

    Article  PubMed Central  PubMed  Google Scholar 

  • Sohler, et al. (2004). Are there racial differences in the way patients with psychotic disorders are treated at their first hospitalization? Psychological Medicine, 34, 705–718.

    Article  PubMed  Google Scholar 

  • Stober, G. (2001). Genetic predisposition and environmental causes in periodic and systematic catatonia. European Archives of Psychiatry and Clinical Neuroscience, 251(Suppl 1), 21–24.

    Article  Google Scholar 

  • Tidey, J. W., & Miczek, K. A. (2001). Social defeat stress selectively alters mesocorticolimbic dopamine release: An in vivo microdialysis study. Brain Research, 721, 140–149.

    Article  Google Scholar 

  • United Nations, Department of Economic and Social Affairs, Population Division. (2013). World population prospects: The 2012 revision, highlights and advance tables. Working paper no. ESA/P/WP.228.

  • Walkup, J., McAlpine, D. D., Olfson, M., Labay, L. E., Boyer, C., & Hansell, S. (2000). Patients with schizophrenia at risk for excessive antipsychotic dosing. Journal of Clinical Psychiatry, 61, 344–348.

    Article  CAS  PubMed  Google Scholar 

  • WHO. (1973). Report of the international study of schizophrenia. Geneva: World Health Organization.

    Google Scholar 

  • WHO Expert Consultation. (2004). Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet, 363(9403), 157–163.

    Article  Google Scholar 

  • Williams, C. L., & Berry, J. W. (1991). Primary prevention of acculturative stress among refugees: Application of psychological theory and practice. American Psychologist, 46, 632–641.

    Article  CAS  PubMed  Google Scholar 

  • Woods, S. W. (2003). Chlorpromazine equivalent doses for the newer atypical antipsychotics. Journal of Clinical Psychiatry, 64(6), 663–667.

    Article  CAS  PubMed  Google Scholar 

  • Zahid, M. A., Fido, A. A., Alowaish, R., Razik, M. A., & Johsen, M. A. (2003). Psychiatric morbidity among housemaids in Kuwait: The vulnerability factors. International Journal of Social Psychiatry, 49, 87–96.

    Article  PubMed  Google Scholar 

  • Zahid, M. A., Fido, A. A., Razik, M. A., Mohsen, M. A. M., & El-Sayed, A. A. (2004). Psychiatric morbidity among housemaids in Kuwait. Medical Principles and Practice, 13, 249–254.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

Psychiatric Hospital of the Cross and the following doctors: Charles Baddoura, Alain Mehana, Jocelyne Azar, Fouad Tahan, Oussama Dahdouh.

Author information

Authors and Affiliations

  1. Department of Psychiatry, Saint-Joseph University, Beirut, Lebanon

    Nada Zahreddine, Rabih Chammai, François Kazour & Sami Richa

  2. Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon

    Rima Talaat Hady

  3. Hospital of The Cross, Beirut, Lebanon

    Dory Hachem

Authors
  1. Nada Zahreddine
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rima Talaat Hady
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rabih Chammai
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. François Kazour
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Dory Hachem
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sami Richa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sami Richa.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zahreddine, N., Hady, R.T., Chammai, R. et al. Psychiatric Morbidity, Phenomenology and Management in Hospitalized Female Foreign Domestic Workers in Lebanon. Community Ment Health J 50, 619–628 (2014). https://doi.org/10.1007/s10597-013-9682-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-013-9682-7

Keywords

Search

Navigation