Anxiety and associated factors among prisoners in North West of Amhara Regional State, Ethiopia.

BACKGROUND: Mental illnesses are more common among the prison population than the general public. However, little attention is given to mental health service in low and middle income countries in general. The problem is more so for prisoners where the overall health care is poor. Therefore, the aim of this study was to assess the prevalence of anxiety and the associated factors among prisoners of North West Amhara, Ethiopia. METHODS: Institutional based cross-sectional study was employed from February to March 2015 by taking a sample of 700 prisoners. Simple random sampling method was employed to select three prisons out of 10 prisons found in the North West Amhara region. Generalized Anxiety Disorder 7-item (GAD-7) scale was used to assess prisoners' anxiety status. The receiver- operator characteristic (ROC) curve was used to determine the cutoff point with high sensitivity and specificity. Structured and pretested interviewer administered questionnaire was used for data collection. Data were checked, coded and entered into Epi Info version 7 and analyzed using R version 3.2.0. Bivariable and multivariable logistic regression analyses were carried out to identify factors associated with anxiety. Odds ratio with its 95 % confidence interval was used as a measure of association. Akaike's Information's Criterion (AIC) was used to check model fitness. RESULTS: A total of 649 prisoners were included in the analysis making the response rate 92.5 %. The prevalence of Anxiety was found to be 36.1 % (95 % CI: 32.7, 39.9). The odds of Anxiety was 2.49(95 % CI: 1.38, 4.55) times higher among prisoners who used to be unhappy in their life before imprisonment. Moreover, smokers were 2.6 (AOR = 2.6, 95 % CI: 1.08, 6.6) times more likely to have anxiety compared with non smokers. However, the odds of the odds of anxiety was 89% lower among Debre-Tabor prisoners (AOR = 0.11, 95 % CI: 0.06, 0.20) and 57 % lower among Gondar prisoners (AOR = 0.43, 95 % CI: 0.28, 0.67). CONCLUSION: The prevalence of anxiety is found to be very high among prisoners in North West Ethiopia. Anxiety was associated with current smoking and having had a dissatisfying life. Screening prisoners for common mental disorders and integrated health care is necessary.

Psychological distress and associated factors among prisoners in North West Ethiopia: cross-sectional study.

BACKGROUND: Currently, mental health is an important public health problem and the leading cause of disability worldwide. Studies have shown that, mental illnesses are more common among the prison population than the general population. However, still there is no accurate count of persons with mental disorder who are incarcerated in Ethiopia and information about prisoners' health conditions is scarce. The purpose of this study was to assess the prevalence and associated factors of psychological distress among prisoner inmates found in prisons of Northwest, Ethiopia. METHODS: Institution based cross sectional study was conducted among 649 prisoners from January to February 2015. Multistage sampling technique was used to select the study participants. Data were collected by using a structured interviewer administered questionnaire. Psychological distress was measured using the Kessler Psychological Distress Scale (K10). Receiver Operating Characteristic curve (ROC curve) analysis was done by STATA version 12 software in order to determine a cutoff point with high sensitivity and specificity. Bivariate and multivariable logistic regression models were fitted to identify associated factors. Adjusted odds ratio with its 95 % Confidence interval was used to declare the statistical significance between psychological distress and associated factors. RESULTS: Prevalence of psychological distress among prisoners was found to be 83.4 % (95 % CI 80.6, 86.0 %). Long duration of stay in the prison (AOR = 0.95; 95 % CI 0.89-0.97), low to no satisfaction with prison services (AOR = 3.01; 95 % CI 1.38-6.51), and place of prison were factors significantly associated with psychological distress among prisoners. CONCLUSION: The prevalence of psychological distress among prisoners was found to be very high. Due attention needs to be given in addressing the mental health needs of the prisoners.