RESUMO
BACKGROUND: Expressed emotion (EE) measures the emotion among caregivers of schizophrenic patients and is predictive of symptom levels in a range of medical and psychiatric conditions. It is worth assessing expressed emotion and associated factors among caregivers of patients with schizophrenia in Ethiopia since there is limited data on this issue in this part of the world. OBJECTIVE: To assess the status of expressed emotions and selected patients' clinical factors among caregivers of patients with schizophrenia attending Psychiatry Outpatient Unit of Jimma University Medical Center, Southwest Ethiopia, 2019. METHOD: A cross-sectional study was conducted on 422 caregivers of schizophrenic patients using a consecutive sampling technique. Data were collected using a structured interviewer administrated questionnaires (Family Questionnairre) which assessed the level of expressed emotion. Data were entered into Epidata 4.4 and analyzed by Statistical package for social science (SPSS) version 25. Descriptive statistics was which used to summarize data, bivariate logistic regression was done to identify candidate variables for multivariable logistic regressions and the association between expressed emotion and predictor variables was identified by using multiple logistic regression models. RESULTS: High expressed emotion was observed in 43.6% of respondents while caring for schizophrenic patients for about 6-8 years, having 3-4 episodes of the illness which was significantly associated with high expressed emotion. CONCLUSIONS: This study revealed that there is a high level of expressed emotion among caregivers. It also showed that increment in the episode of the illnesses had a significant association with high caregivers' expressed emotion. Hence, health care systems which provide interventions for patients with schizophrenia need to design proper strategies to address caregivers' needs as well.
RESUMO
Background: People living with HIV/AIDS have a higher rate of depression/depressive symptoms and this highly affects antiretroviral medication adherence. Therefore, much stronger evidence weighing the burden of depressive symptoms/major depression is warranted. Methods: We investigated PubMed, Scopus, Psych-Info, and Embase databases for systematic review studies. A PRISMA flow diagram was used to show the search process. We also used the Assessment of Multiple Systematic Reviews (AMSTAR) checklist scores. A narrative review and statistical pooling were accompanied to compute the pooled effect size of outcome variables. Results: Overall, 8 systematic review studies addressing 265 primary studies, 4 systematic review studies addressing 48 primary studies, and six systematic review studies addressing 442 primary studies were included for depressive symptoms, major depression, and their effect on medication non-adherence, respectively. Globally, the average depressive symptoms prevalence using the random effect model was 34.17% (24.97, 43.37). In addition, the average prevalence of major depressive disorder was obtained to be 13.42% (10.53, 16.31). All of the 6 included systematic review studies reported a negative association between depressive symptoms and antiretroviral medication non-adherence. The pooled odds ratio of antiretroviral medication adherence among patients with depressive symptoms was 0.54 (0.36, 0.72) (I 2 = 0.0%, p = 0.487). Conclusion: Globally, the prevalence of depressive symptoms and major depression is high. There existed a high degree of association between depressive symptoms and antiretroviral medication non-adherence. So, focused intervention modalities should be developed and implemented.
