Depression and anxiety prevalence and correlations among cancer patients at Tikur Anbesa Hospital in Addis Ababa, Ethiopia, 2018: Cross-sectional study.

Background: People with cancer, as well as their family members and loved ones, frequently experience distress. Distress can sometimes escalate from a normal level to one that interferes with therapy, makes it difficult for you to function or cope, and has an impact on many aspects life. About 1 in 4 people with cancer experience major or clinical depression, and anxiety is also a common problem for cancer patients. Anxiety and depression are the most familiar mental illnesses among cancer patients. Objectives: The objectives of this study was to assess the prevalence and correlates of depression and anxiety among cancer patients attending treatment at Tikur Anbessa specialized hospital. Methods: Hospital based cross-sectional study was conducted from 15 April to 15 May 2018. This study was conducted at Tikur Anbessa Specialized Hospital is in Addis Ababa, capital city of Ethiopia. A pretested interviewer administered questionnaire was used to collect data by trained psychiatry nurses. The Hospital Anxiety and Depression Scale was used to collect an outcome variable (the presence of anxiety and depression). Result: According to the study, anxiety and depression were present in 54.6 percent and 40.4 percent of the Tikur Anbessa Specialized Hospital's cancer patients, respectively. Factors that were strongly associated with depression were being a woman, having less education, bleeding right now, being younger (30 to 39 years old), and suffering discomfort. With AOR of 2.18 (1.38-3.44), 1.73 (1.10-2.85), 2.57 (1.61-4.11), 2.28 (1.12-4.63), 1.64 (1.00-2.69), respectively with 95% CI. On the other hand factors significantly associated with anxiety among cancer patients attending treatment at Tikur Anbessa specialized hospital were marital status with AOR 2.10 (1.01-4.02), feeling discomfort 2.06 (1.00-3.03), and bleeding 3.52 (2.31-5.64. Conclusion: Guidelines for screening and treating depression and anxiety in cancer patients should be developed by psychiatry departments in collaboration with oncology department. Oncology and psychiatry department better work and capacitate link to help for good of patients. To enhance and widen the current findings, additional research on depression and anxiety risk factors should be done.

Prevalence and Predictors of Depression Among Eritrean Refugees in Ethiopia: A Cross-Sectional Survey.

BACKGROUND: Depressive disorders place an enormous burden on society and ranked fourth in the global disease burden accounting for 4.4% of the total disability-adjusted life years and 11.9% of total years lived with disability. Depression is associated with high level of morbidity and it is the most common contributor to suicide. Refugees have higher rates of mental disorders, in particular depression than those usually found in the non-war affected general population. There is a dearth of evidence in Ethiopia regarding the mental health of refugees. OBJECTIVE: This study aimed to assess the prevalence of depression and associated factors among Eritrean refugees in Tigray North Ethiopia. METHODS: A cross-sectional study was conducted at Maiayni refugee camp. A total of 800 participants were interviewed using systematic random sampling method. Pretested, structured and interviewer administered questionnaire that included socio demographic, clinical, behavioral, Harvard trauma questionnaire, and the patient health questionnaire (PHQ-9) was used. Descriptive statistics and binary logistic regression analyses were carried out. RESULTS: With 786 (98.3%) of response rate, the prevalence of depression was found to be 37.8%, 95% confidence interval (34.2, 41.2). The odds of depression was higher in females [(AOR=8.92 95% CI (5.21, 15.25)], older age [(AOR=2.72 95% CI (1.03-7.16)], those who never attended school [(AOR=3.09 95% CI (1.16-8.24)], among the unemployed [(AOR=2.36 95% CI (1.16-4.83)], those with poor social support [(AOR=8.67 95% CI (4.24-17.77)], past psychiatric history [(AOR=4.76 95% CI (1.94-11.67)], family history of a psychiatric disorder [(AOR=3.96 95% CI (1.93-8.13)], those who were using substances [(AOR=4.08 95% CI (2.51-6.65)], and among those who stayed for longer than a year at the camp [(AOR=4.18 95% CI (2.47-7.08))]. CONCLUSION: The study revealed that depression is a major mental health and public health problem among Eritrean refugees in Ethiopia. Several socio-demographic, psychosocial, behavioral and clinical factors were significant predictors of depression among the study participants. Mental health service provision for the refugees needs to be part of the support.

Quality of Life and Associated Factors Among Patients with Epilepsy Attending Outpatient Department of Saint Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, 2019.

BACKGROUND: Epilepsy is strongly associated with an impaired quality of life. Patients suffering from epilepsy have a poorer quality of life than both the general population and many other chronic disease sufferers. However, attention is not given on the quality of life of people with epilepsy other than focusing on symptom reduction. This increases the frequency of seizures, impacts on the ability to perform and increases health-related costs. The aim of this study was to assess quality of life and associated factors among patients with epilepsy attending the outpatient department of Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. METHODS: An institution-based cross-sectional study design was conducted between May and June 2019 at Amanuel Mental Specialized Hospital. A systematic random sampling technique was used to get a total number of 447 samples. Data on quality of life was assessed through interviews using the World Health Organization Quality of Life-Brief (WHOQOL-BREF) Version. The collected data were coded, entered into EpiData 3.1, and analyzed by using SPSS version 20. Simple and multiple linear regression analysis models were fitted and the unstandardized ß coefficient at 95% confidence interval was employed. The statistical significance was accepted at p-value <0.05. RESULTS: The mean score of quality of life was 61.1±11.6 (95%CI: 59.05, 61.23). Perceived stigma (ß=-2.13, 95%CI:-2.96, -1.30), frequent seizure (ß=-3.16, 95%CI: -4.27, -2.04), AED adherence (ß=1.24, 95%CI: 1.10, 1.30), antiepileptic drug side effect (ß=-0.32, 95%CI: -0.38, -0.26), anxiety (ß-1.91, 95%CI: -2.95, -0.86), depression (ß=-3.59, 95%CI: -4.67, -2.52), poor social support (ß=-2.51, 95%CI: -3.62, -1.40) and moderate social support (ß=-1.60, 95%CI: -2.58, -0.62) were significantly associated factors with quality of life. CONCLUSION: The finding from this study indicated that quality of life of patients with epilepsy were moderate. Perceived stigma, frequent seizure, comorbid depression and anxiety, antiepileptic drug nonadherence, antiepileptic drug side effect and poor social support were the predictors of quality of life.

Pathways through homelessness among women in Addis Ababa, Ethiopia: A qualitative study.

BACKGROUND: There has been a paradigm shift in understanding homelessness. The shift is from the belief that homelessness results from lack of secure housing towards the view which explains homelessness in terms of the complex interactions of factors which determine the pathways into and out of homelessness. The evidence base for women's homelessness is less robust than men's homelessness. The effect of gender and its relationship with homelessness has been neglected. Addis Ababa, the capital city of Ethiopia, is estimated to be home for around 50,000 homeless people. This study aims to explore pathways through homelessness in women who were sheltered in a facility for the homeless in Addis Ababa. METHODS: In-depth interviews were conducted in 2019 with 14 women who were 'roofless', and were gathered for support in a temporary shelter in Addis Ababa, Ethiopia. The shelter was one of the eight such facilities established in Addis Ababa few months earlier than the study. For data analysis the QDA Miner 5.0.30 software was used and data was analyzed using thematic analysis approach. RESULTS: The analysis revealed that determinant factors for pathways into homelessness among women occurred on the background of predisposing factors, such as poverty, being raised by caregivers other than biological parents, child marriage, unstable employment history. On top of the predisposing factors listed above the occurrence of precipitating factors such as problems with marriage, migration, death of parents, deception, became the immediate cause of homelessness. Despite mentions of positive experiences of homelessness such as mutual support and good social life within network of homeless people, the net effect of the interaction between negative and positive experiences of the homeless life, together with the effectiveness of coping strategies by the participants resulted in the participants' decision of whether homelessness is tolerable. Finally, the presence of perpetuating factors such as lack of affordable house, feeling of shame to go back home, and unfavorable situation at home discouraged participants from exiting the homeless situation. CONCLUSION: From the findings of the study we conclude that the predisposing factors and the precipitating factors resulted in the occurrence of onset of homelessness among the participants. Once homeless, the experiences of life as homeless, and the availability of the means to exit from it determined whether the participants would stay homeless or exit from it.

A qualitative exploration of substance misuse among homeless women in Addis Ababa, Ethiopia.

BACKGROUND: Substance use among homeless people is higher compared to the general population. In some studies, reported rates of problematic drug use among the homeless vary, with estimates ranging from 25 to 70%. There is a common perception that substance abuse and homelessness are linked, but there is considerable debate about the direction of the relationship. Despite observations of high levels of substance use among the homeless population in Addis Ababa, there are limited studies to date conducted on the topic. This study aims to explore the factors associated with onset of substance use and its continued use, patterns of substance use and its social and health consequences among female residents of a shelter in Addis Ababa, Ethiopia. METHODS: A qualitative study was conducted in 2019. In-depth interviews were conducted on 14 study participants who were selected purposively. The qualitative data analysis software QDA Miner 5.0.30 was used for data processing and analysis. RESULTS: Four major thematic areas were identified and they comprised the categories under which sub-themes were identified and coded. The major segments or categories included the following: reasons for the onset of substance use after becoming homeless, experiences of substance use and reasons for continued use, the harms which resulted on them from substance use, and the means of obtaining supply of the substances. CONCLUSION: Factors related to life on streets were strong reasons for onset of substance use, as well as for its continued use. Homeless women suffered untimely death, addiction, and ill health from use of substances; however, they gave priority to obtaining substances than any other thing, and used every means to grab a supply of the substances.

The prevalence and associated factors of depression among patients with schizophrenia in Addis Ababa, Ethiopia, cross-sectional study.

BACKGROUND: Depression is common among people with schizophrenia and associated with severe positive and negative symptoms, higher rates of disability, treatment resistance and mortality related to suicide, physical and drug-related causes. However, to our knowledge, no study has been conducted to report the magnitude of depression among people with schizophrenia in Ethiopia. Therefore, this study aimed to determine the prevalence and associated factors of depression among people with schizophrenia. METHOD: A hospital-based cross-sectional study was conducted among 418 patients with schizophrenia selected by systematic sampling technique. Patient Health Questionnaire 9 (PHQ-9) was used to measure depression among the study participants. To identify the potential contributing factors, we performed binary and multivariable logistic regression analysis adjusting the model for the potential confounding factors. Odds ratios (OR) with the corresponding 95% confidence interval (95%CI)) was determined to evaluate the strength of association. RESULT: The prevalence estimate of depression among people with schizophrenia was found to be 18.0% [95% confidence interval: 14.50-22.30]. Our multivariable analysis revealed that current substance use (AOR 2.28, 95%CI (1.27, 4.09), suicide attempt (AOR 5.24, 95%CI (2.56, 10.72), duration of illness between 6 and 10 years (AOR 2.09, 95%CI (1.08, 4.04) and poor quality of life (AOR 3.13, 95%CI (1.79, 5.76) were found to be the factors associated with depression among people with schizophrenia. CONCLUSION: The current study revealed that comorbid depression was high among people with schizophrenia and associated with current substance use, suicide attempt, and long duration of the illness as well as poor quality of life. Attention needs to be given to address comorbid depression among people with schizophrenia.

Insight and Associated Factors among Patients with Schizophrenia in Mental Specialized Hospital, Ethiopia, 2018.

BACKGROUND: Insight is the degree of the patient's awareness and understanding of their attributions, feelings, behavior and disturbing symptoms. Majority of the patients with schizophrenia have poor insight and insight is an important prognostic indicator in schizophrenia to enhance treatment compliances and reducing the risks of clinical deterioration. The main objective of this study was to assess insight and its associated factors among patients with schizophrenia at mental specialized hospital in Ethiopia. METHODS: Institutional based cross-sectional study was conducted from May to June 2018 Mental Specialized Hospital among 455 patients with schizophrenia. Insight was measured by an abridged version of Scale to assess unawareness of mental disorder. Positive and Negative Syndrome Scale, Calgary depressive scale, Oslo social support scale was used to identify factors associated with insight. Simple and multiple linear regression analysis were used to assess associated factors of insight in the participants. RESULTS: The mean score of insight was 13.66 (95% CI 13.27, 14.04). Age at first onset of illness, duration of treatments, depressive symptoms were inversely associated with mean insight score; whereas unemployed, positive and negative syndrome, previous hospitalization, >=2 episodes were positively associated with mean insight score. CONCLUSION: Nearly half of the study participants were scored above the mean insight score so, the clinicians and psychotherapists should have to work together to improve insight among patients with schizophrenia.

Prevalence and associated factors of post-traumatic stress disorder among emergency responders of Addis Ababa Fire and Emergency Control and Prevention Service Authority, Ethiopia: institution-based, cross-sectional study.

OBJECTIVE: To assess the prevalence and associated factors of post-traumatic stress disorder (PTSD) among emergency responders at Addis Ababa Fire and Emergency Control and Prevention Service Authority, Ethiopia. DESIGN: Institution-based, cross-sectional design. SETTING: The study was conducted at the Fire and Emergency Control and Prevention Service Authority, Addis Ababa, Ethiopia. PARTICIPANTS: 603 emergency responders who worked in the Fire and Emergency Control and Prevention Authority during the study period. MEASUREMENT: Data were collected using a self-administered questionnaire: an adaptation of the standardised PTSD Checklist-Civilian Version. The questionnaire was administered to subjects on duty. Social support was measured using the Oslo 3-Item Social Support Scale, while other stressful life events were measured using the List of Threatening Experiences, that is, experiencing one or more stressful life events in the last 6 months. Reliability and construct validity were verified. To be diagnosed with PTSD, a subject must display at least three different types of symptoms at once. Coded variables were entered into Epi Info V.3.5.1 and then exported to SPSS V.20 for analysis. Descriptive and bivariate and multivariate logistic regressions and 95% CI were employed to establish and test statistically significant associations. RESULTS: A total of 603 subjects participated in the study, with 19.9% prevalence rate of PTSD (95% CI 16.9 to 23.1). The study found family history of mental illness (adjusted OR (AOR)=2.82; 95% CI 1.65 to 4.84), longer years of service (AOR=2.67; 95% CI 1.54 to 4.63), as well as prolonged exposure to emergency situations (AOR=0.44; 95% CI 0.24 to 0.84) and road traffic accidents (AOR=2.71; 95% CI 1.67 to 4.42) as significant predictors of PTSD among emergency responders. CONCLUSION: The prevalence of PTSD was high among the study population. Family history of mental illness, length of service, duration of exposure and type of exposure were found to be associated with PTSD. Mental health education and linking emergency responders with available mental health services/facilities should be prioritised to mitigate the problem.

Assessment of sexual dysfunction and associated factors among patients with schizophrenia in Ethiopia, 2017.

BACKGROUND: Sexual dysfunction is remarkably prevalent amongst psychiatric patients than general population. This might be due to either the nature of the illness itself or the unwanted effect of the medication they are taking for the illness which limits the capability of forming interpersonal and sexual relationships. This issue is rarely raised in developing countries, and the aim of this study was to assess magnitude and factors contributing to sexual dysfunction among patients with Schizophrenia. METHOD: Hospital based cross sectional study was conducted at Amanuel Mental Specialized Hospital from January to June 2017. The sample required for this study was determined by using single population proportion formula and the final sample size was 423; and systematic random sampling was used to select participants. We used Change in Sexual Functioning Questionnaire to measure sexual dysfunction. The collected data was cleaned, interred in to Epi data and transferred to SPSS version 20 for farther analysis. The OR with 95% CI was used to measure association and P-value < 0.05 was used as statistically significant. RESULT: A total of 422 patients with Schizophrenia were involved in the study. The prevalence of General Sexual dysfunction was 82.7%; and in male and female patients the prevalence was 84.5 and 78.6% respectively. Marital status (Unmarried, Divorced and widowed, history of relapse and poor quality of life were associated significantly to global sexual dysfunction. CONCLUSION: The magnitude of Sexual dysfunction was found to be high among patients with schizophrenia and it is associated with different factors like unmarried, divorced, widowed, relapse and poor quality of life. Treating physicians should be conscious to sexual dysfunction during evaluation and treatment of patients with Schizophrenia. Special attention should be given to single, divorced, widowed patients and patients with history of relapse to improve quality of life of this patients.

Magnitude and associated factors of aggressive behaviour among patients with bipolar disorder at Amanual Mental Specialized Hospital, outpatient department, Addis Ababa, Ethiopia: cross-sectional study.

BACKGROUND: Aggressive behavior is a challenging behavior among bipolar patients that causes poor social interaction and hospitalization. But, there is no information regards of the magnitude and contributing factors for aggressive behaviour among bipolar patients in Ethiopia. Therefore, this study was designed to assess the prevalence and associated factors of aggressive behaviour among patients with bipolar disorder. METHOD: An institutional based cross sectional study was conducted at Amanual Mental Specialized Hospital from May 1 to June 1, 2015 among 411 participants who were selected by systematic random sampling technique. Data was collected by interview technique by using Modified Overt Aggression Scale, entered and analyzed by using Epi Data 3.1 and Statistical Package for Social Science version 20, respectively. Adjusted Odd Ratio (AOR) with 95% Confidence Interval (CI) were used to show the odd and P-value <0.05 was considered as statistically significant. RESULTS: A total of 411 bipolar patients were included in the study and the prevalence of aggressive behaviour was 29.4%. Significant associated factors for aggression were, having two or more episode [AOR = 2.35 95% CI (1.18, 4.69)], previous history of aggression, [AOR = 3.72, 95% CI (1.54, 8.98)], depressive symptoms [AOR = 3.63, 95% CI (1.89, 6.96)], psychotic symptoms [AOR = 5.41,95% CI (2.88, 10.1)], manic symptoms [AOR = 3.85,95% CI (2.06, 7.19)], poor medication adherence [AOR = 3.73 95% CI (1.71, 8.13)], poor social support [AOR = 2.99 95% CI (1.30, 6.91)] and current use of substance[AOR = 2.17 95% CI (1.16, 4.06)]. CONCLUSION: Prevalence of aggression is high among bipolar patients and associated with many factors. So it needs public health attention to decrease aggression among bipolar patients.

Prevalence and Factors Associated with Perceived Stigma among Patients with Epilepsy in Ethiopia.

Background. Epilepsy stigma is considered to be one of the most important factors that have a negative influence on people with epilepsy. Among all types of stigma perceived stigma further exerts stress and restricts normal participation in society. Methods. Hospital based cross-sectional study was conducted from May 1, 2013, to May 30, 2013. All patients with epilepsy in Ethiopia were source population. The sample size was determined using single population proportion formula and 347 subjects were selected by using systematic random sampling method. Data was analyzed by using SPSS version 20. Results. A total of 346 participants with mean age of 29.3 ± 8.5 SD participated with a response rate of 99.7%. The prevalence of perceived stigma was 31.2%. Age range between 18 and 24 [AOR = 2.84, 95%CI: 1.02, 7.92], difficulty to attend follow-up because of stigma [AOR = 3.15, 95%CI: 1.19, 8.34], seizure related injury [AOR = 1.88, 95%CI: 1.12, 3.15], and contagion belief [AOR = 1.88, 95%CI: 1.10, 5.08] were significantly associated with perceived stigma. Conclusions. Perceived stigma was found to be a common problem among patients suffering from epilepsy. The results reinforce the need for creating awareness among patients with epilepsy and addressing misconceptions attached to epilepsy.