Mental health dynamics of adolescents: A one-year longitudinal study in Harari, eastern Ethiopia.

AIMS: This study aims to assess the dynamics of in-school adolescents' mental health problems in Harari regional state, eastern Ethiopia for a year. MATERIALS AND METHODS: Using multistage sampling technique, we conducted a year-long longitudinal study at three public high schools between March 2020 and 2021. Three hundred fifty-eight in-school adolescents were chosen by systematic random sampling for the baseline assessment, and 328 completed the follow-up assessment. We used self-administered, adolescent version of SDQ-25 Questionnaire to collect the data. Wilcoxon matched-pairs signed-rank test and McNemara's Chi-squared tests were used to examine the median difference and distribution of mental health problems between times one and two. Random-effects logistic regressions on panel data was used to identify factors associated with mental health problems. A p-value < 0.05 was considered as statistically significant. RESULTS: The magnitude of overall mental health problems at baseline assessment was 20.11% (95% CI: 16-25), with internalizing problems accounting for 27.14% (95% CI: 23-32) and externalizing problems accounting for 7.01% (95% CI: 4.6-10.3). At the follow-up assessment, these proportions rose to 22.56% (95% CI, 18-27) for overall problems and 10.3% (95% CI, 7.7-14.45) for externalizing problems. On other hand, internalizing problems decreased unexpectedly to 22.86% (95% CI, 18.6-27.7) at follow-up assessment. Internalizing problem scores at time two were significantly lower than baseline among older adolescents, girls and those with average wealth index in our study cohort. CONCLUSIONS: The prevalence of mental health problems were high among the study cohort. The proportion of overall problems and externalizing problems has increased over time, indicating a deterioration in the mental health of the study cohort. However, the decrease in internalizing problems among older adolescents, girls, and those with an average wealth index is a positive sign. The findings highlight that tailored interventions are required to reduce externalizing problems and maintain the decrease in internalizing problems. These interventions should target middle-aged and male adolescents from low-income families.

Prevalence and correlates of internalizing and externalizing mental health problems among in-school adolescents in eastern Ethiopia: a cross-sectional study.

Adolescent's mental health issues are a major social burden and a significant public health issue, but they have not received enough attention in Ethiopia. Therefore, this study aimed to determine the prevalence and correlates of internalizing and externalizing mental health problems among in-school adolescents in the Harari region, eastern Ethiopia. A cross-sectional study was conducted among 3227 in-school adolescents. Multistage sampling was used to select schools and eligible students to participate in the study. A guided, self-administered strength and difficulty questionnaire measured mental health problems. Data were double-entered, validated, and cleaned using EpiData 3.1 and analyzed using STATA version 17. Ordinal logistic regression analysis was performed to estimate the adjusted odds ratio between mental health problems and their correlates. Statistical significance was set at p-value < 0.05. The magnitudes of mental health problems among in-school adolescents by subscale was 24.17% (95% CI 22.72; 25.67) for internalizing and 11.93% (95% CI 10.85; 13.09) for externalizing problems. A high internalizing problem score was associated with females, rural residents, alcohol users, attending public schools, those bullied at school, and those in the lowest wealth index. Likewise, the likelihood of a high externalizing problem score was high among alcohol users, adolescents whose fathers are uneducated, rural, and bullied at school. The study suggests that mental health problems are prevalent among in-school adolescents in Ethiopia, especially internalizing problems. The study also identifies several risk factors associated with internalizing and externalizing problems, such as wealth index, school types, alcohol use, bullying, and rural residence. These factors may indicate the need for more mental health awareness and support programs for adolescents in Ethiopia. This highlights that schools and communities should prioritize mental health awareness and support programs for adolescents. These programs should be tailored to address the specific needs of the population, such as rural residents, those in the lowest wealth index, and those who have experienced bullying.

Depressive disorder, bipolar disorder, and associated factors among adults, in the Eastern part of Ethiopia.

BACKGROUND: Depressive disorder is one of the severe and common mental illnesses in the general population. Bipolar disorder is a severe, persistent mental illness associated with significant morbidity and mortality. However, there is a paucity of data on the prevalence of depressive disorder, and bipolar disorder in our study area. OBJECTIVE: This study aimed to assess the prevalence of depressive and bipolar disorders among adults in Kersa, Haramaya, and Harar Health and Demographic Surveillance Sites in Eastern Ethiopia. METHODS: A community-based cross-sectional study was conducted among 1,416 participants. A multi-stage sampling was employed to select the participants. DSM-5 diagnostic criteria was used to assess depressive disorder and bipolar disorder. Data was collected using a standard questionnaire. Data were entered into Epi-Data 3.1 and analyzed using SPSS version 26. Both binary and multivariate logistic regression analyses were done. Those with a p-value < 0.05 in the final model were considered statistically significant. RESULTS: The overall prevalence of depressive and bipolar disorders among our study participants was 6.7% (95% CI: 5.40, 8.20) and 2.1% (95% CI: (1.40, 3.00), respectively. The independent predictors of depressive disorder included a family history of mental illness, chronic medical illnesses, unemployment, low educational status, divorced or widowed, poor social support, and current alcohol use or khat chewing. Single, males, divorced or widowed, and current consumers of alcohol were independent predictors for bipolar disorder. CONCLUSIONS AND RECOMMENDATION: The results of our investigation showed that bipolar illness and depression were significant public health issues. It was shown that although bipolar disorder is highly prevalent in the society, depression is a widespread concern. As a result, it is imperative that the relevant body grow and enhance the provision of mental health services. Furthermore, research on the effects and burdens of bipolar disorder in the community is required.

Internalizing and externalizing mental health problems affect in-school adolescent's health-related quality of life in eastern Ethiopia: A cross-sectional study.

AIMS: This study aimed to examine the association between mental health problems and health-related quality of life (HrQoL) among in-school adolescents 13-19 years in the Harari region, eastern Ethiopia. MATERIALS AND METHODS: A cross-sectional study was conducted on 3227 in-school adolescents aged 13 to 19 using multistage sampling. The KIDSCREEN-10 questionnaire assessed health-related quality of life (HrQoL), while a self-administered version of the strength and difficulty questionnaire (SDQ) examined mental health issues. Data were double entered, validated, and cleaned using EpiData version 3.1 and analyzed using STATA 14.1. An ordinal logistic regression model investigated the link between the outcome variable and the predictors. The results were reported using an odds ratio with a 95% confidence interval (CI), and a p-value of less than 0.05 was considered statistically significant. RESULTS: A quarter of the adolescents (23%) reported poor health-related quality of life; adolescents with internalizing and externalizing mental health problems had the lowest health-related quality of life. After controlling for potential confounders, adolescents with abnormal (AOR = 0.48, 95% CI: 0.39, 0.59) and borderline (AOR = 0.59, 95% CI: 0.45, 0.78) levels of internalizing problems had a 52% and 41% lower probability of having high HrQoL than those with normal levels. Furthermore, individuals with abnormal (AOR = 0.59, 95% CI: 0.45, 0.77) and borderline (AOR = 0.64, 95% CI: 0.45, 0.92) levels of externalizing difficulties had a 41% and 36% lower chance of having a high health-related quality of life. CONCLUSIONS: Nearly a quarter of in-school adolescents had poor health-related quality of life. High scores for internalizing and externalizing mental health problems significantly impacted the adolescents' health-related quality of life. This emphasizes the need to address mental health issues in the school setting to improve adolescents' overall quality of life.

High Social Capital is Associated with Decreased Mental Health Problem Among In-School Adolescents in Eastern Ethiopia: A Cross-Sectional Study.

Purpose: The importance of social capital for adolescent mental health has not been explored in low resource settings like Ethiopia. In this study, we examined the association between social capital and mental health problems among in-school adolescents in Harari Regional State, eastern Ethiopia. Methods: A cross-sectional study was conducted among 3227 in-school adolescents of 13-19 years. A multistage sampling was used to select participants. Guided self-administered questionnaire was used to collect data. Mental health problem was measured using a self-administered version of the strength and difficulty questionnaire (SDQ), while social capital questionnaire for adolescent students (SCQ-AS) was used to collect data about the condition of social capital. The data were double entered, validated, and cleaned using EpiData 3.1 and analyzed using STATA 14.1. The association between the outcome variable and predictors was analyzed using an ordinal logistic regression model. The result was reported using an odds ratio along with 95% confidence interval (CI) and a p-value <0.05 was considered statistically significant association. Results: A total of 740 (22.93%) students had mental health problem, of which 9.7% (95% CI, 8.7-10.8) and 13.20% (95% CI, 12-14) were classified as "abnormal" and "borderline", respectively. Factors associated with decreased mental health problem were increased network of friends at school (AOR = 0.75, 95% CI: 0.58-0.99), increased trust in school or neighborhood (AOR = 0.52, 95% CI: 0.44-0.63), and high social cohesion in the community (AOR = 0.75, 95% CI: 0.62-0.89). Conclusion: Higher social capital is associated with a decreased mental health problem among in-school adolescents. Prevention and treatment of mental health problems require strengthening social capital at school, household, and in the neighborhood.

Tobacco Use Among Reproductive Age Women in Ethiopia: Evidence from the National Health Survey.

PURPOSE: To assess the prevalence and determinants of current tobacco use among reproductive-age women in Ethiopia. METHODS: A cross-sectional study was conducted by utilizing secondary data taken from the Ethiopian Demographic Health Survey of 2016. Descriptive statistics and logistic regressions were used to analyze the data. The odds ratio with a 95% confidence interval was considered to interpret associations and a significant association was stated at a p-value < 0.05. RESULTS: The overall magnitude of current tobacco use was 1.4% (n= 217). Majority of them 59.91% (n= 130) smoke cigarettes and followed by smoking gaya 43.32% (n= 94). Higher prevalence was found among participants from Gambella 44.24% (n= 96), Benishangul.59% (n= 36) and afar regions 13.36% (n= 29). Age group of 25-34 years [AOR = 2.78; 95% CI: 1.69, 4.57)], age group of ≥ 35 years [AOR = 4.24; 95% CI: 2.54, 7.07)], followers of protestant religion [AOR = 2.36; 95% CI: 4.17, 9.42], Islamic religion [AOR = 3.92; 95% CI: 2.16, 7.11], and traditional religion [AOR = 16.23; 95% CI: 8.33, 31.61], being in poorest wealth index [AOR = 15.78; 95% CI: 7.38, 33.70], poorer wealth index [AOR = 5.85; 95% CI: 2.64, 12.97], middle wealth index [AOR = 3.61; 95% CI: 1.57, 8.29], and richer wealth index [AOR = 2.48; 95% CI: 1.10, 5.85], who were never in union [AOR = 0.31; 95% CI: 0.14, 0.67], ever drinking alcohol [AOR = 5.44; 95% CI: 3.71, 7.95] and ever chewing khat [AOR = 7.59; 95% CI: 4.99, 11.55] were factors associated with current tobacco use. CONCLUSION: Women used tobacco in different forms, and its distribution varies across Ethiopian regional states. The concerned body needs to give attention to the identified associated factors and regions with higher tobacco use.

Common mental health problems among adolescents in sub-Saharan Africa: A systematic review and meta-analysis.

Background and aim: This review examined the prevalence of mental health problems among adolescents in sub-Saharan Africa.Methods: The review included studies indexed in the MEDLINE, EMBASE, and PsycINFO databases, supplemented by a search on Google Scholar and tracking of references from articles identified. A total of 725 articles were found, of which 28 met the inclusion criteria. Finally, 22 eligible studies were reviewed.Findings: The pooled current prevalence of mental health problems was 23% (95% CI: 18; 28, I2 = 99.41%). Any depression, 19% (95% CI: 9; 30, I2 = 99.64%), and anxiety, 20% (95% CI: 01; 31, I2 = 99.64%), were the most common mental health problems reported. Attention deficit hyperactivity disorder, 5% (95% CI: 3; 7, I2 = 97.60%), and conduct disorders, 15% (95% CI: 8; 22, I2 = 99.58%), were also significant mental health problems among adolescents in the region.Conclusion: About one in five adolescents in sub-Saharan Africa suffer from one or more mental health problems. The findings have important implications for policy and practice as they indicate that mental health problems are a major public health issue among adolescents in sub-Saharan Africa and that there is a need for effective and context-specific interventions that address mental health.

Prevalence and associated factors of common mental disorders among adult patients attending HIV follow up service in Harar town, Eastern Ethiopia: a cross-sectional study.

BACKGROUND: In developed countries, there are well documented mental health impacts of HIV/AIDS and patients' quality of life. Acquiring HIV/AIDS can be a serious psychological trauma and can predispose a person to different mental disorders. Co-occurring mental illness complicates diagnosis, help-seeking, quality of care provided, treatment outcomes and adherence. However, in Ethiopia, studies about mental health problems in HIV/AIDS treatment settings are limited. The purpose of the current study is to determine the prevalence and associated factors of common mental disorders among adult HIV/AIDS patients undergoing HIV service in Harar town, eastern Ethiopia. Conducting this study is important as baseline information for the concerned stakeholders including health professionals and policymakers and in general to improve the quality of care for HIV/AID patients. METHODS: Institution based cross-sectional study was conducted. We collected data from 420 adult patients through a face to face interviewing technique using a standardized questionnaire and review of medical records. Bivariable and multivariable (binary logistic regression) analyses were used to check the association between common mental disorders (CMDs) and independent variables. Variables which have a p-value < 0.05 during bivariable regression were entered into multivariable (binary logistic regression) and finally which have a p-value of < 0.05 under multivariable (binary logistic regression) were identified as statistically significant association at 95% of confidence interval. RESULTS: All 420 patients were interviewed providing response rate 100%. The result revealed that (28.1%; 95% CI; 26.14, 30.06) of HIV/AIDS patients had CMD. In the final model, stage 4 HIV/AIDS (Adjusted Odds Ratio 3.37, 95% CI: 1.45, 7.83), family history of mental illness (AOR 2.65, 95% CI: 1.26, 5.54) and current drinking alcohol (AOR 5.1, 95% CI: 2.04, 12.79) were found having statistically significant association with CMD. CONCLUSIONS: This study investigated the prevalence and associated factors of CMD among adults living with HIV/AIDS. HIV/AIDS stage, having family history of mental illness and current drinking alcohol were the main identified associated factors of CMD. These factors are important for the hospitals and other concerned bodies for providing prevention and appropriate intervention of common mental disorders among HIV/AIDS patients.

Prevalence and determinants of common mental illness among adult residents of Harari Regional State, Eastern Ethiopia.

INTRODUCTION: Common mental disorders include depression, anxiety and somatoform disorders are a public health problem in developed as well as developing countries. It represents a psychiatric morbidity with significant prevalence, affecting all stages of life and cause suffering to the individuals, their family and communities. Despite this fact, little information about the prevalence of common mental illness is available from low and middle-income countries including Ethiopia. The aim of this study was to determine the magnitude of common mental disorders and its associated factors among adult residents of Harari Region. METHODS: Comparative cross-sectional, quantitative community-based survey was conducted From February 1, 2016 to March 30, 2016 in Harari Regional State using multi-stage sampling technique. A total of 968 residents was selected using two stage sampling technique. Of this 901 were participated in the study. Validated and Pretested Self reported questionnaire (SQR_20) was used to determine the maginitude of common mental disorders. Data was entered and analyzed using Epi-info version 3.5.1 and SPSS-17 for windows statistical packages. Univirate, Bi-variate and multivariate logistic regression analysis with 95% CI was employed in order to infer associations. RESULTS: The prevalence of common mental illnesses among adults in our study area was 14.9%. The most common neurotic symptoms in this study were often head ache (23.2%), sleep badly (16%) and poor appetite (13.8%). Substance use like Khat chewing (48.2%), tobacco use (38.2%) and alcohol use (10.5%) was highly prevalent health problem among study participant. In multivariate logistic regression analysis, respondents age between 25-34 years, 35-44 years, 45-54 years and above 55years were 6.4 times (AOR 6.377; 95% CI: 2.280-17.835), 5.9 times (AOR 5.900; 95% CI: 2.243-14.859), 5.6 times (AOR 5.648; 95% CI: 2.200-14.50) and 4.1 times (AOR 4.110; 95% CI: 1.363-12.393) more likely having common mental illnesses than those age between 15-24 years, respectively. The occurrence of common mental illness was twice (AOR: 2.162; 95% CI 1.254-3.728) higher among respondents earn less than the average monthly income than those earn more than average monthly income. The odds of developing common mental illnesses were 6.6 times (AOR 6.653; 95% CI: 1.640-6.992) higher among adults with medically confirmed physical disability than those without physical disability. Similarly, adults who chewed Khat were 2.3 times (AOR 2.305; 95% CI: 1.484-3.579) more likely having common mental illnesses than those who did not chew Khat. Adults with emotional stress were twice (AOR 2.063; 95% CI: 1.176-3.619) higher chance to have common mental illnesses than adults without emotional stress. CONCLUSION: This study had reveals that common mental disorders are major public health problems. Advancing age, low average family monthly income, Khat chewing and emotional stress were independent predictors of common mental illnesses. Whereas sex, place of residence, educational status, marital status, occupation, family size, financial stress, taking alcohol, tobacco use and family history of mental illnesses were not statistically associated with common mental illnesses.