Quality of life among caregivers of patients with severe mental illness in northwest Ethiopia, 2022: an institutional-based cross-sectional study.

Background: Severe mental illness has negative consequences not only for the person suffering from it but also for their caregiver's quality of life and the community in which they reside. These impacts could be particularly visible in low- and middle-income countries, where the treatment gap for mental illnesses is particularly high. There is a dearth of evidence in Ethiopia. Objective: This study aims to assess the quality of life and its associated factors among caregivers of patients with severe mental illness at Felege Hiwot and Tibebe Ghion Compressive Specialized Hospital, Bahir Dar, Northwest Ethiopia, in 2022. Methods: An institution-based cross-sectional study design was conducted at Felege Hiwot and Tibebe Ghion Compressive Specialized Hospitals from 13 June to 13 July 2022. A systematic random sample technique was utilized to select 469 study participants. The World Health Organization quality of life-BREF questionnaire was utilized to assess quality of life, and perceived stigma was measured through a family interview schedule questionnaire. The data were gathered using the epicollect5 software with a face-to-face interview method and then exported to SPSS-25. Simple and multiple linear regression analyses were conducted to identify associated factors of quality of life for variables that are statistically significant (p-value< 0.05) with B-coefficients and a 95% CI. Descriptive statistics were used to describe the outcome and predictor variables. Results: A total of 456 respondents participated, with a response rate of 97.2%. The result showed that the mean quality-of-life score of caregivers of patients with severe mental illness for each domain (mean ± standard deviations) was between 46.5 ± 18.7 and 51.2 ± 19.9, with the worst score of zero in the environmental domain and 94 in the social domain. In multiple regression, living in a rural area (B = -5.2; 95% CI, -8.9, -1.8), being illiterate (B = -7.2; 95% CI, -10.6, -3.7), having chronic medical illness (B = -5.2; 95% CI, -8.6, -1.7), having probable cases of anxiety (B = -6.9, 95% CI, -10.5, -13.3), having probable cases of depression (B = -4.9; 95% CI, -8.2, -1.7), and the presence of perceived stigma (B = -7.9; 95% CI, -11.2, -4.77) were significantly associated with the overall quality of life. This analysis suggests that the identified factors can predict over 40% of the variability in overall quality of life scores for caregivers. Conclusion: The quality of life of caregivers of patients with severe mental illness was found to be low. Living in a rural area, being illiterate, having chronic medical illnesses, having probable cases of anxiety and depression, and being stigmatized were negatively associated with the overall quality of life. The findings indicate the necessity for health professionals, the government, and other concerned bodies to pay more attention to caregivers' quality of life.

Perceived stress and its psychosocial and clinical correlates among patients with pulmonary tuberculosis: A cross-sectional study.

Background: Although various psychosocial consequences of pulmonary tuberculosis (PTB) have been thoroughly evaluated, perceived stress has not been well studied. Aim: This study assessed perceived stress and its psychosocial and clinical correlates. Methods: An institution-based cross-sectional study was conducted among 410 PTB patients. Data were analyzed by Statistical Package for the Social Sciences (SPSS) v23. Independent sample t-test and Pearson correlation were used to test the association between perceived stress and other variables. Assumptions of linear regression were checked. Multiple regression analysis was done to identify statistically significant association at P < 0.05. Results: Anxiety, perceived social support, and stigma were found to have significant association with perceived stress in multiple regression analysis. Perceived social support and duration of treatment were negatively significantly associated with perceived stress. Patients with PTB had high perceived stress, and moderate to strong significant correlation was observed among variables. Conclusion: Interventions tailored at addressing various psychosocial aspects of tuberculosis (TB) are needed.

Suicidal ideation and associated factors among pregnant women attending antenatal care in Jimma medical center, Ethiopia.

BACKGROUND: Suicidal ideation (SI) among pregnant women is a major public health concern worldwide and is associated with a higher risk of completed suicide. However, there are limited studies that determined the prevalence and the potential determinants of suicidal ideation in Sub-Saharan Africa, including Ethiopia. Therefore, this study aimed to explore the prevalence of suicidal ideation and associated factors among pregnant women attending antenatal care in Jimma, Ethiopia. METHODS: An institutional-based cross-sectional study was conducted among 423 pregnant women attending Jimma medical center in Southwest, Ethiopia. A systematic random sampling technique was used to select the study participants. Suicidal ideation assessed using the Suicidality Module of the World Mental Health survey initiative version of the World Health Organization Composite International Diagnostic Interview (CIDI). Other tools used are EPDS, Abuse Assessment Scale (AAS), DASS -21, PSS, Maternity Social Support Scale (MSSS), and Pittsburgh Sleep Quality Index (PSQI). A multivariable logistic regression analysis was used to explore the potential determinants of suicidal ideation among the participants. RESULT: The prevalence of SI among women who are on antenatal care was found to be 13.3% (95% CI (10.1,16.4). In multivariable analysis, marital status with lack of cohabiting partners (AOR = 2.80,95%CI:1.23,6.37), history of abortion (AOR = 2.45,95% CI:1.03,5.93), having depression (AOR = 4.28,95% CI:1.75,10.44),anxiety(AOR = 2.99,95% CI:1.24,7.20), poor sleep quality (AOR = 2.85,95% CI:1.19,6.79), stress (AOR = 2.50, 95% CI:1.01,5.67), and intimate partner violence (AOR = 2.43, 95% CI:1.07,5.47) were found to be significant predictors of suicidal ideation. CONCLUSION: The prevalence of SI among pregnant women was found to be huge. Lack of cohabiting partners, previous history of abortion, depression, anxiety, intimate partner violence, poor sleep quality, and stress were variables that are independent predictors of suicidal ideation. Screening and interventions of antenatal SI are needed.

Depression and its determinants among adolescents in Jimma town, Southwest Ethiopia.

OBJECTIVES: To determine the prevalence and socio-demographic and parental-related factors of depression among school adolescents in Jimma town, southwest Ethiopia. METHODS: Using a cross-sectional survey, 546 school adolescents were screened for depression using the patient health questionnaire (PHQ-9) from five randomly selected public and private schools. Oslo social support scale, adverse childhood experience tool, and socio-demographic questionnaire were used to gather data on risk factors. Linear regression analysis was used, and unstandardized beta (ß) coefficients with 95% confidence intervals (CI) were reported to declare statistical significance. RESULTS: A total of 546 adolescents participated in the study, with a response rate of 97.3%. The mean (±SD) age of participants was 16.8 ± 1.3 years. The majority (81%) of the adolescents were attending day classes at public schools. The prevalence of depression was found to be 28% using the patient health questionnaire. Based on the PHQ-9 depression severity scale, 18.5% and 8.2% of the adolescent had moderate and moderate to severe depression while 1.3% had severe depression. In the final multivariate linear regression analysis, it was found that sex, rural residence, low social support, being in higher grade level, and adverse childhood experience were found to be independently associated with a higher score of depression. CONCLUSION: One in three adolescents was found to have a depressive syndrome. We recommend schools to integrate school mental health service that contains routine screening and intervention services. Moreover, efforts are needed to sensitize and educate the communities on child protection, social support, and safeguarding to effectively tackle the magnitude of adolescent depression.

Prevalence and Associated Factors of Depression and Anxiety Among Patients with Pulmonary Tuberculosis Attending Treatment at Public Health Facilities in Southwest Ethiopia.

BACKGROUND: Depression and anxiety are the most commonly occurring psychiatric comorbidities among patients with pulmonary tuberculosis (PTB). Co-occurring anxiety and depression in PTB patients result in poor adherence to anti-tuberculosis medication. This in turn results in lower success rate of treatment and an upsurge in morbidity and mortality. Despite this problem existing globally, little has been explored in southwest Ethiopia. OBJECTIVE: The aim of this study was to assess the prevalence and associated factors of depression and anxiety among patients with pulmonary tuberculosis receiving treatment at public health facilities in southwest Ethiopia. MATERIALS AND METHODS: A facility-based cross-sectional study was conducted from April to May 2019. Data were collected from 410 PTB patients using hospital anxiety and depression scale (HADS). Epi data version 3.1 and SPSS version 23 were used to enter and analyze data respectively. Multiple logistic regressions were fitted to identify the strength of association between outcome and explanatory variables. P <0.05 was considered statistically significant. RESULTS: Prevalence of depression and anxiety among PTB patients were 229 (55.9 %) and 224 (54.6%), respectively. High perceived stress [AOR=3.61 (1.99, 6.53)], perceived stigma [AOR=10.13 (5.52, 18.63)], being in an intensive phase of treatment [AOR= 3.33 (1.83, 6.07)], and low body mass index [AOR=2.07 (1.13, 3.80)] were significantly associated with depression. Being female [AOR=2.42 (1.39, 4.22)], perceived stigma [AOR=3.58 (1.99, 6.42)], high perceived stress [AOR=4.40 (2.52, 7.69)], and family history of mental illness [AOR=2.66 (1.19, 5.94)] had significant association with anxiety. CONCLUSION: More than half of the study participants were found to have probable depression and anxiety. This indicates the need to pay attention to the mental health condition of patients with PTB, particularly to those with identified risk factors.

A cross-sectional study of psychopathy and khat abuse among prisoners in the correctional institution in Jimma, Ethiopia.

BACKGROUND: Khat abuse and psychopathy are both strongly related to criminal activity. Higher rates of substance use in people with psychopathy are hypothesized to be related to psychopathic personality traits, which include high sensation seeking, low conscientiousness and neuroticism, impulsivity, and irresponsibility. Little is known, however, about the association between psychopathy and khat abuse among prisoners in Ethiopia. Therefore, we evaluated the presence of these two factors in prisoners in the correctional institution in Jimma, Southwest Ethiopia. MATERIALS AND METHODS: We used a cross-sectional study design to collect data from 336 prisoners from June 5 to July 5, 2017. Study participants were selected by a systematic random sampling technique. Khat abuse was assessed with the Drug Abuse Screening Tool and psychopathy with the Psychopathy Checklist: Screening Version. We also assessed nicotine dependence with the Fagerstrom Test for Nicotine Dependence; alcohol use disorder, with the alcohol use disorder identification test; adverse traumatic life events, with the Life Events Checklist; and social support, with the Oslo 3-Item Social Support Scale. Data were entered into EpiData version 3.1 and analyzed in bivariate and multivariable logistic regression models. Variables with a P value < 0.05 in the final fitted model were declared to be significantly associated with the outcome variable. RESULTS: The overall prevalence of lifetime khat use was 59.9%, and the prevalence of khat abuse in prisoners with psychopathy was 78.0%. Prisoners with psychopathy had a three times higher odds ratio of abusing khat than those without psychopathy (AOR = 3.00 [1.17-7.67]). Among the confounders, a family history of substance use (AOR = 2.50 [1.45-4.31]), poor support (AOR = 2.28 [1.11-4.67]), alcohol use disorder (AOR = 7.78 [4.16-14.53]), and suicidal ideation and suicide attempts (AOR = 2.26 [1.45-4.31]) were also positively associated with khat abuse. CONCLUSIONS: The prevalence of khat abuse was higher in prisoners with possible or probable psychopathy.

Trauma exposure and alcohol use disorder among prisoners in Jimma Zone correctional institution, Southwest Ethiopia: a cross-sectional study.

OBJECTIVE: Trauma exposure and alcohol use are closely related, and large proportion of trauma-exposed individuals use alcohol. The data presented in this paper were obtained as part of a study on substance use disorder and associated factors among prisoners in the correctional institution in Jimma, Southwest Ethiopia. Therefore, in this study we examined comorbidity of traumatic life experiences and alcohol use disorder in inmates of correctional institution in Jimma, Southwest Ethiopia. RESULTS: The overall prevalence of lifetime alcohol use disorder was 40.1%, and the prevalence of alcohol use disorder among prisoners with lifetime trauma exposure was 44.0%. Participants with multiple trauma exposures had 2.5-fold higher odds of association for alcohol use disorder than their counterparts (AOR = 2.47 [1.23-4.94]). Living in urban areas (AOR = 4.86 [2.38-9.94]), presence of psychopathy (AOR = 3.33 [1.25-8.86]), khat abuse (AOR = 7.39 [3.99-13.68]), and nicotine dependence (AOR = 2.49 [1.16-5.34]) were also positively associated with alcohol use disorder. The prevalence of alcohol use disorder was higher among prisoners with lifetime trauma exposure. Also, this study indicates that prisoners with multiple trauma exposures had higher odds of association for alcohol use disorder than those with no trauma exposure. A public health intervention targeting survivors of traumatic experiences needs to be designed and implemented.

Substance use disorder and associated factors among prisoners in a correctional institution in Jimma, Southwest Ethiopia: a cross-sectional study.

BACKGROUND: Substance use disorder is an important public health problem and one of the major causes of disability worldwide. Substance use and criminal behavior are closely related and there is a significant association between substance misuse and crime, but little is known about substance use disorder among prisoners, in particular in low-income countries. Therefore, we investigated substance use disorder and associated factors in inmates of a correctional institution in Jimma, Southwest Ethiopia. METHODS: We used a cross-sectional study design to collect data from 336 prisoners from June 5 to July 5, 2017. Study participants were selected from the total of 1460 prisoners eligible for the study by a systematic random sampling technique, i.e., one participant was randomly selected from every four consecutive admissions in the registration book. Alcohol use disorder, nicotine dependence, khat abuse, cannabis use disorder, psychopathy, adverse traumatic life events, and social support were assessed. Data were entered into EpiData version 3.1 and analyzed in bivariate and multivariable logistic regression models with the Statistical Package for Social Science version 21. Variables with a P value < 0.05 in the final fitting model were declared to be associated with the outcome variable. RESULTS: The overall prevalence of substance use disorder was 55.9%. The prevalence of khat abuse was 41.9%; alcohol use disorder, 36.2%; nicotine dependence, 19.8%; and cannabis use disorder, 3.6%. Poor social support, living in urban areas, psychopathy, and a family history of substance use were positively associated with substance use disorder. CONCLUSIONS: Substance use disorder is prevalent among prisoners. The increased morbidity and unpleasant psychosocial consequences associated with substance use disorder, together with our finding that 66.3% of prisoners with substance use disorder were interested in obtaining treatment, suggest a need to establish prison-based treatment in this correctional institution in Jimma.

Prevalence of physical, verbal and nonverbal sexual harassments and their association with psychological distress among Jimma University female students: a cross-sectional study.

BACKGROUND: A number of studies conducted on sexual harassment focused on general magnitude rather than specific details of the various forms of sexual harassment and their effect on psychological health. Thus, the objective of this study was to assess the prevalence rates of the various forms of sexual harassments and their associations with psychological distress among Jimma University female students. METHODS: Three hundred and eighty five (385) female participants were selected from all colleges using stratified and systematic sampling techniques. A structured questionnaire consisting of items on the various forms of sexual harassment and psychological distress was administered. RESULT: The prevalence rates of physical, verbal and nonverbal sexual harassments were 78.2%, 90.4% and 80.0%, respectively, while the prevalence rate of psychological distress among students who had experienced sexual harassment was 63.0%. The multivariable logistic regression analyses indicated that students who were physically [adjusted OR = 3.950, 95% CI = (1.979, 7.884)] and nonverbally [(adjusted OR = 12.099, 95% CI= (5.190, 28.205] harassed were 4 and 12 times more likely to experience psychological distress, respectively, adjusted for all other variables. CONCLUSION: The prevalence of various forms of sexual harassment were higher and strongly associated with psychological distress. Important implications for University officials and policy makers including creating harassment free University have been drawn. Otherwise, female students tend to dropout and their academic achievements suffer a lot as a result of psychological distress; and the government's effort for realizing the gender parity in education would be compromised.