Chronic mass psychogenic illness among women in Derashe Woreda, Segen Area People Zone, southern Ethiopia: a community based cross-sectional study.

BACKGROUND: Outbreaks of mass psychogenic illness (MPI), which are a constellation of physical signs and symptoms suggestive of organic illness with no identifiable causes. MPI has been documented in numerous cultural, ethnic, and religious groups throughout the world. The aims of this study were to document the nature and impacts of the illness, to assess interventions, and to come up with recommendations and management formulations for dealing with such kinds of outbreaks in the future. METHODS: Community based cross-sectional study was conducted in June, 2015 in Derashe Woreda, Segen Area People Zone of the Southern Nations Nationalities and People's Region. Women with complaints of breast cancer but with no objective findings were the subjects of the study. Ninety-seven women were investigated using a semi-structured questionnaire for quantitative study. Two focus group discussions with seven affected and seven non-affected women and four key informant interviews were conducted using guiding questionnaires. Quantitative data was analyzed using SPSS version 20 software packages while qualitative data was analyzed manually going through thematic areas. RESULT: The ages of the ninety-seven study participants ranged from 17 to 56 years, with a mean (SD) of 32.8 (8.7) years. Onset of illness was dated back to the year 2012 following the death of a 43 year old socially active woman with complications of breast cancer. Following her death many women started to report multiple vague physical complaints similar to those of the deceased woman. Even though the responses from the study participants did not specifically point to a single possible cause and means of transmission, high numbers of women believed the source of their illness could be punishment from God while some said that the cause of their suffering could be environmental pollution. Since the illness was taken to be contagious, affected women faced stigma and discrimination. Moreover, school activities and social gatherings were limited significantly. CONCLUSION: Unrealistic and exaggerated rumors and inadequate explanations about the nature and spread of the illness were the main contributing factors for the spread and prolongation of the outbreak. An organized intervention, clear and adequate explanations about the nature and transmission of the illness can contain MPI within a short period of time.

Socio-demographic characteristics, clinical profile and prevalence of existing mental illness among suicide attempters attending emergency services at two hospitals in Hawassa city, South Ethiopia: a cross-sectional study.

BACKGROUND: Suicide is a major public health problem worldwide. It contributes for more than one million deaths each year. Since previous suicidal attempt was considered as the best predictor of future suicide, identifying factors behind suicidal attempt are helpful to design suicide prevention strategies. The aim of this study was to assess socio-demographic characteristics, clinical profile and prevalence of existing mental illness among patients presenting with suicidal attempt to emergency services of general hospitals in South Ethiopia. METHODS: We conducted a cross-sectional study on patients presenting with complications of suicidal attempt to emergency departments of two general hospitals in Hawassa city from November, 2014 to August, 2015. Data was collected using semi-structured questionnaire which contained socio-demographic and clinical variables. The Mini International Neuropsychiatric Interview version 5 (MINI PLUs) was used to assess the prevalence of existing mental illness among study participants. Data was entered and analyzed using IBM SPSS statistics 21 software package. RESULTS: A total of 96 individuals were assessed, of whom 56 (58.3%) were females. The mean age of study participants was 21.5 (8.0) years. The majority, 75 (78.1%), of the study participants were aged below 25 years. Ingesting pesticide poisons and corrosive agent were used by the majority to attempt suicide. Mental illness was found in only three (3.1%) of the study participants. Impulsivity (the time between decision to attempt suicide and the actual attempt of less than 5 min) was reported by 30 (31.2%) of the study participants, of whom 18 (60%) were males. Males were found three times more likely to attempt suicide impulsively than women (COR = 3.0, 95% CI 1.2-7.3). Quarreling with family members, facing financial crisis, and having unplanned and unwanted pregnancy were reported by the majority of study participants as immediate reasons to attempt suicide. CONCLUSIONS: The presence of stressful life events and impulsivity behind suicidal behavior of the younger generation implies that designing suicide prevention strategies for this group is crucial. Moreover, further research is needed to systematically examine the relationship between the presence of mental illness and suicidal attempt with a larger sample size and more robust methodology.

Prevalence of mental distress and associated factors among Hawassa University medical students, Southern Ethiopia: a cross-sectional study.

BACKGROUND: Mental distress is a mental health problem expressed with variable levels of depressive, anxiety, panic or somatic symptoms. Owing to several factors tertiary level students are among the population with higher prevalence of mental distress and an even more higher prevalence has been reported in medical students. The aim of this study was to determine the prevalence of mental distress among medical students, and to evaluate contextually relevant associated factors. METHODS: A cross-sectional study was conducted among medical students attending Hawassa University College of Medicine and Health Sciences in 2013/2014 academic year. Stratified random sampling was implemented with each strata representing the year of study of the students. Data on mental distress was collected using the Self-Reporting Questionnaire-20 (SRQ-20). Data was entered into and analyzed using IBM SPSS statistics 21. A cut-off point of 8 and above was used to classify students as having mental distress. RESULTS: Among 240 students included in the study, 72 (30%) of them were found to have mental distress. There was no significant difference in mental distress between males and females (COR = 1.18, 95% CI = 0.62-2.25). On bivariate analysis, students with age less than or equal to 21 years showed higher odds of having mental distress (COR = 2.3, 95% CI: 1.26-4.22), but because of having high correlation with students' year of study, age was excluded from the multivariate model. In this study being a pre-medicine student (AOR = 3.61, 95% CI: 1.45-8.97), perceiving medical school as very stressful (AOR = 3.89, 95% CI: 1.52-9.94), perceiving living environment as very crowded (AOR = 2.43, 95% CI: 1.24-4.77) and having a feeling of insecurity about one's safety (AOR = 2.93, 95% CI: 1.51-5.68) had statistically significant association with mental distress. CONCLUSIONS: In this study one-third of medical students were found to have mental distress. Designing prevention and treatment programs to address contextually relevant factors is very important.

Movement disorders in neuroleptic-naïve patients with schizophrenia spectrum disorders.

BACKGROUND: Spontaneous Movements Disorders (SMDs) or dyskinetic movements are often seen in patients with schizophrenia and other psychotic disorders, and are widely considered to be adverse consequences of the use of antipsychotic medications. Nevertheless, SMDs are also observed in the pre-neuroleptic ear and among patients who were never exposed to antipsychotic medications. The aim of this study was to determine the extent of SMDs among antipsychotic-naïve patients in a low income setting, and to evaluate contextually relevant risk factors. METHODS: The study was a cross-sectional facility-based survey conducted at a specialist psychiatric hospital in Addis Ababa, Ethiopia. Consecutive consenting treatment-naïve patients with a diagnosis of schizophrenia, schizoaffective disorder and schizophreniform disorder contacting services for the first time were assessed using the Simpson-Angus Rating Scale (SAS) and the Abnormal Involuntary Movement Scale (AIMS) to evaluate the presence of SMDS. Scale for the Assessment of Negative Symptoms (SANS) and Scale for the Assessment of Positive Symptoms (SAPS) were administered to evaluate negative and positive symptom profiles respectively. Body mass index (BMI) was used as a proxy measure for nutritional status. RESULT: Sixty-four patients, 67.2% male (n = 43), with first contact psychosis who met the DSM-IV-TR criteria for schizophrenia (n = 47), schizophreniform disorder (n= 5), and schizoaffective disorder (n = 12) were assessed over a two month study period. Seven patients (10.9%) had SMDs. BMI (OR = 0.6, 95% CI = 0.40, 0.89; p = 0.011) and increasing age (OR = 1.10; 95% CI = 1.02, 1.20; p = 0.017) were associated with SMD. CONCLUSIONS: This finding supports previous suggestions that abnormal involuntary movements in schizophrenia and other psychotic disorders may be related to the pathophysiology of psychotic disorders and therefore cannot be attributed entirely to the adverse effects of neuroleptic medication.