Psychological distress and its associated factors among people with specific chronic conditions (diabetes and/or hypertension) in the Sidama region of southern Ethiopia: A cross-sectional study.

BACKGROUND: The majority of people with long-term, non-communicable medical conditions experience significant psychological anguish. Poor mental health or psychological distress influences low lifestyle decisions that result in obesity, inactivity, and cigarette use as well as poor health literacy and limited access to health promotion activities. OBJECTIVES: The study's purpose was to measure the prevalence of psychological distress and it's predictors in patients with chronic non-communicable diseases who were being treated in selected hospitals in the Sidama region of southern Ethiopia in 2022. METHODOLOGY: Institutional based cross-sectional study was carried out using a sample of 844 patients receiving medication for either high blood pressure or diabetes mellitus or both between May1 and August 31, 2022. To gauge psychiatric distress, the Amharic translation and Ethiopian validation of the Kessler 6 scale (K-6) was employed. The analysis was done using binary logistic regression and an odds ratio with the corresponding 95% confidence interval was estimated to measure the strength of the association. P value <0.05 was considered to declare the significance. RESULT: Patients with diabetic mellitus, hypertension or both had a 49.6% prevalence of psychological distress at selected Sidama hospitals. Age, drug side effects, history medical complications following diabetic mellitus/hypertension, and body mass index of the patient were all significantly linked with psychological distress (P<0.05). CONCLUSION: According to the results of this study, psychological distress is far more prevalent than it was in past studies in Ethiopia and other African countries. To lessen the problem, all stakeholders must cooperate, but health agencies, policymakers, and NGOs particularly need to put in extra effort. The study also showed a significant association between body mass index, patient age, drug side effects, and history of medical complications following diabetic mellitus /hypertension.

Insomnia and common mental disorder among patients with pre-existing chronic non-communicable diseases in southern Ethiopia: a survey during COVID-19 pandemic.

Background: COVID-19 has been causing significant mental health problems and other health-related issues. Despite the fact that COVID-19 has a significant impact on chronic disease patients, there is scant research on insomnia, common mental health disorders (CMD), and their associated factors among chronic disease patients. Objective: The purpose of this study was to assess the prevalence of insomnia and common mental disorders (CMD) and their associated factors among patients with pre-existing chronic NCDs in Sidama, southern Ethiopia. Methods: A multicenter cross-sectional study was undertaken between June 1 and September 1, 2021. The study included 633 participants. CMD and insomnia were assessed using a 20-item Self-Reported Questionnaire (SRQ-20) and a 7-item Insomnia Severity Index (ISI) scale, respectively. To describe the various variables, descriptive statistics were used. We performed multivariable logistic regression analysis to identify independent factors associated with CMD and insomnia. A value of p < 0.05 was considered statistically significant at a 95% confidence interval. Results: The prevalence of insomnia and CMD was found to be 39.3% and 46.8%, respectively. Being merchant (AOR = 0.33; 95% CI = 0.13, 0.82), having a diagnosis of diabetes mellitus (AOR = 1.89; 95% CI = 1.04, 3.46), comorbid diagnosis (AOR = 3.96; 95% CI = 2.27, 6.89), low social support (poor (AOR = 3.37; 95% CI = 1.51, 7.57) and moderate (AOR = 3.13; 95% CI = 1.46, 6.69)), symptoms of insomnia (AOR = 12.08; 95% CI = 7.41, 19.72) and poor quality of life (QOL) (AOR = 1.67; 95% CI = 1.04, 2.72) were independent predictors of CMD. We also found out that, having cardiovascular disorders (CVDs) (AOR = 2.48; 95% CI = 1.18, 5.19), CMD (AOR = 12.09; 95% CI = 7.46, 19.61), and poor QOL (AOR = 2.04; 95% CI = 1.27, 3.26) were significantly associated with insomnia symptoms. Conclusion: Our study suggests that substantially high prevalence of CMD and insomnia. Significant association between CMD and occupation, diagnosis, comorbidity, social support, insomnia, and QOL were found. We also revealed that having CVDs, CMD, and poor QOL were significantly associated with insomnia symptoms. Therefore, dealing with the mental health problems of patients with chronic NCDs is an essential component of public health intervention during the COVID-19 pandemic.

Health related quality of life among people with mental illness: The role of socio-clinical characteristics and level of functional disability.

Background: People with mental illness (PWMI) have declining health related quality of life (HRQoL), which is frequently equivalent to or greater than that of medical disorders. Although, HRQoL is rapidly being recognized as an essential treatment outcome indicator in modern psychiatry, research on the identification and significance of factors impacting QoL in PWMI is still in its early stages. Objective: The aim of this study was to identify predictors of HRQoL among people with mental illness who underwent outpatient follow-up in Sidama region, southern Ethiopia. Methods: We conducted a multicenter, cross-sectional study from April-1, to May-30, 2022. A total of 412 participants took part in the study, using an interviewer-administered structured questionnaire. The HRQoL was measured using the 12-item Short-Form Health Survey-Version 2 (SF-12v2) scale. To describe different variables, descriptive statistics were employed. To find independent HRQoL predictors, we used multivariable linear regression analysis. P-value of <0.05 were declared statistically significant at 95% confidence interval (CI). Result: Out of 412 participants, nearly two-third 261 (63.3%) were male and nearly half 203 (49.3%) were diagnosed as schizophrenia. HRQoL was positively associated with social support (ß = 0.321) and being single (ß = 2.680). Conversely, functional disability (ß = -0.545), being a student (ß = -4.645) and jobless (ß = -3.279) by occupation, and being diagnosed with depression (ß = -2.839) were negatively impacted HRQoL among PWMI. Conclusion: HRQoL of people with mental disorders in this study was significantly associated to social support, marital status, occupation, diagnosis and level of functional disability. Therefore, the mental health care system should develop HRQoL promoting measures that enhance PWMI functioning, social support and employment.

Quality of life among patients with chronic non-communicable diseases during COVID-19 pandemic in Southern Ethiopia: A cross-sectional analytical study.

Background: The COVID-19 outbreak became a continuing global health agenda. It has a significant impact on individuals' quality of life (QOL). Patients with preexisting medical conditions may have severely reduced QOL. The aim of this study was to assess QOL and its associated factors among patients with chronic non-communicable diseases (NCDs) during COVID-19 pandemic at Sidama Regional State, southern Ethiopia. Methods: We conducted a multicenter, cross-sectional study from 1 June to 1 September 2021. A total of 633 participants took part in the study, using an interviewer-administered structured questionnaire. The QOL was measured using the World Health Organization Quality of Life (WHOQOL-BREF) Scale, which has 12 items. To describe different variables, descriptive statistics were employed. To find independent factors associated with QOL, we used multivariable linear regression analysis. P-value of < 0.05 was declared statistically significant at 95% confidence interval (CI). Results: The majority (56.4%) of participants were male and about half (53.1%) had a diagnosis of diabetes mellitus. The multivariable linear regression model showed statistically significant negative association between different independent variables such as age (ß = -0.188, 95% CI = -0.238 to -0.139), being female (ß = -1.942, 95% CI = -3.237 to -0.647), duration of illness ≤ 5 years (ß = -4.222, 95% CI = -6.358 to -2.087), alcohol use in the past 3 months (ß = -4.574, 95% CI = -6.905 to -2.243), common mental disorder (CMD) (ß = -1.512, 95% CI = -2.924 to -0.100), insomnia (ß = -0.274, 95% CI = -0.380 to -0.168), and QOL. Also, there is a statistically significant positive association between QOL and being illiterate (ß = 3.919, 95% CI = 1.998-5.841) and living in the rural area (ß = 2.616, 95% CI = 1.242-3.990). Conclusion: In general, the findings confirmed that the COVID-19 pandemic had a negative impact on patients with chronic NCDs QOL. The QOL was significantly influenced by age, gender, educational status, residence area, duration of illness, alcohol use, CMD, and insomnia during COVID-19 pandemic. Thus, this study suggests that addressing insomnia, co-morbidities of mental disorders, and alcohol use has the potential effect to improve the QOL of patients with chronic medical illnesses.

Predictors of unrecognised comorbid depression in patients with schizophrenia at Amanuel mental specialized hospital, Ethiopia: a cross-sectional study.

BACKGROUND: The occurrence of depression in patients with schizophrenia (PWS) increases the risk of relapse, frequency and duration of hospitalisation, and decreases social and occupational functioning. OBJECTIVE: This study aimed to assess prevalence of unrecognised comorbid depression and its determinants in PWS. METHOD: A cross-sectional study was conducted from 1 to 30 March 2019 at Amanuel mental specialized hospital among 300 PWS. The 9-item Calgary Depression Scale for Schizophrenia was used to assess comorbid depression. Logistic regression was used to determine the association between outcome and explanatory variables. Statistical significance was declared at p value <0.05 with 95% CI. RESULTS: The prevalence of unrecognised comorbid depression was found to be 30.3%. Living alone (adjusted OR (AOR)=3.49, 95% CI=0.45 to 8.36), having poor (AOR=4.43, 95% CI=1.45 to 13.58) and moderate (AOR=4.45, 95% CI=1.30 to 15.22) social support, non-adherence to medication (AOR=3.82, 95% CI=1.70 to 8.55), presenting with current negative symptoms such as asocialia (AOR=4.33, 95% CI=1.98 to 9.45) and loss of personal motivation (AOR=3.46, 95% CI=1.53 to 7.84), and having suicidal behaviour (AOR=6.83, 95% CI=3.24 to 14.41) were the significant predictors of comorbid depression in PWS. CONCLUSION: This study revealed considerably a high prevalence of unrecognised comorbid depression among PWS. Therefore, clinicians consider timely screening and treating of comorbid depression in PWS.

Suicide Behavior and Its Predictors in Patients with Schizophrenia in Ethiopia.

BACKGROUND: People with schizophrenia (PWS) are at greater risk of suicide. However, suicide behaviors that occur in PWS are often overlooked, inadequately characterized, and not consistently integrated into treatment. Despite this burden and consequences in Ethiopia, there is a dearth of studies concerning suicide behavior in PWS. Therefore, this study is aimed at assessing the magnitude of suicide behavior and its predictors among PWS in Ethiopia. METHODS: An institution based cross-sectional study was employed. Data were collected using the structured interviewer-administered questionnaire from a sample of 300 PWS at Amanuel Mental Specialized Hospital (AMSH). The revised version of Suicide Behavior Questionnaire (SBQ-R) was used to assess suicide behavior in PWS. The data was collected from March 1 to 30, 2019. Binary logistic regression was performed to identify independent predictors of suicidal behavior at 95% confidence level. Statistical significance was declared at p value <0.05. RESULT: A total of 300 patients with schizophrenia participated in the study. More than two-thirds of 203 (67.7%) of the participants were males, and 116 (38.7%) participants were between the ages of 28 and 37 years. We found that the prevalence of suicide behavior among PWS was 30.3%. Being unemployed (AOR = 3.65, CI = 1.32, 10.05), family history of suicide (AOR = 3.16, CI = 1.38, 7.23), substance use (AOR = 2.51, CI = 1.13, 5.59), current positive psychotic symptoms (hallucination (AOR = 6.39, CI = 2.86, 14.29), and delusion (AOR = 4.15, CI = 1.95, 14.29) and presence of comorbid depression (AOR = 4.81, CI = 1.98, 11.68) were independent significant predictors with suicidal behavior in PWS. CONCLUSION: The prevalence of suicidal behavior among PWS was found to be high. Hence, designing strategies for early screening and intervention is the most critical prevention strategy of suicide in PWS.

Post-traumatic Stress Disorder Symptoms and Its Predictors Among Healthcare Workers Following COVID-19 Pandemic in Southern Ethiopia: A Cross-Sectional Study.

Background: COVID-19 causes immense psychological pressure on communities in addition to physical misery. There is currently a scarcity of data on the psychological impact of the COVID-19 epidemic on Ethiopian healthcare workers (HCWs). Therefore, this study was aimed to assess the post-traumatic stress disorder (PTSD) symptoms and its predictors following COVID-19 pandemic among healthcare workers (HCWs) in southern Ethiopia. Methods: A hospital based cross-sectional study design was used among 387 randomly selected HCWs between September 25 and October 25, 2020 at four selected public hospitals in Sidama National Regional State, southern Ethiopia. Impact of Event Scale-Revised (IES-R) was used to collect data post-traumatic stress disorder (PTSD) symptoms. Logistic regression analyses with 95% CI were used to examine the relationship between independent and outcome variables. Result: The prevalence of PTSD symptoms was found in 56.8% of participants. Significant factors that increase risk of PTSD symptoms were being female (AOR = 1.91, 95% CI = 1.19, 3.05), married (AOR = 1.87, 95% CI = 1.12, 3.14) and nurses (AOR = 3.31, 95% CI = 1.66, 6.63). On the other hand, HCWs working other than emergency unit such as inpatients/wards (AOR = 0.43, 95% CI = 0.24, 0.75), OPD (AOR = 0.48, 95% CI = 0.24, 0.97) and other units (AOR = 0.49, 95% CI = 0.25, 0.96) less likely to be affected by PTSD symptoms. Conclusion: The current study showed high levels of PTSD symptoms as psychological challenges for HCWs. Sex, age, marital status, type of profession and working environment were significant factors for PTSD symptoms in HCWs during the pandemic. HCWs require mental health support during and after the pandemic.

Prevalence and determinant factors of mental health problems among healthcare professionals during COVID-19 pandemic in southern Ethiopia: multicentre cross-sectional study.

OBJECTIVE: To assess the prevalence of depression, anxiety and stress and its determinant factors during COVID-19 pandemic among healthcare professionals in southern Ethiopia. DESIGN: Multi-centre cross-sectional study. SETTING AND STUDY PERIOD: Randomly selected public hospitals in Sidama, southern Ethiopia between 25 September 2020 and 25 October 2020. PARTICIPANTS: 387 healthcare professionals were randomly selected. OUTCOME MEASURES: Prevalence and determinant factors of depression, anxiety and stress was assessed. RESULT: Depression, anxiety and stress prevalence were shown to be 50.1% (95% confidence interval (CI) 45.0% to 55.0%), 55.0% (95% CI 51.1% to 59.9%) and 38.5% (95% CI 33.6% to 43.2%), respectively. Being female (adjusted odd ratio (AOR) 3.71, 95% CI 2.31 to 5.97), married (AOR 2.28, 95% CI 1.34 to 3.86), living alone (AOR 1.87, 95% CI 1.09 to 3.20), nurses (AOR 2.94, 95% CI 1.44 to 5.99) and working in inpatients (AOR 0.53, 95% CI 0.29 to 0.93) were significantly associated with depressive symptoms. Moreover, older age groups (AOR 3.15, 95% CI 1.04 to 6.56), females (AOR 3.25, 95% CI 2.01 to 5.25), married (AOR 1.69, 95% CI 1.01 to 2.87) and nurses (AOR 3.32, 95% CI 1.63 to 6.78) were significantly associated with symptoms of anxiety. Stress symptoms were significantly high among females (AOR 2.47, 95% CI 1.53 to 3.97), married (AOR 2.77, 95% CI 1.60 to 4.78), living alone (AOR 2.01, 95% CI 1.15 to 3.52), nurses (AOR 2.34, 95% CI 1.11 to 4.92) and working in units other than emergency (inpatient (AOR 0.32, 95% CI 0.18 to 0.57) and other units (AOR 0.48, 95% CI 0.25 to 0.95)). CONCLUSION: The current study found that healthcare professionals have high levels of depression, anxiety and stress symptoms. Sex, age, marital status, type of profession, living status and working environment were significant factors for mental health problems in healthcare professionals during the pandemic. Healthcare professionals require mental health support at which monitoring and control can be performed during and after the pandemic.