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Kassaw C, Alemayehu S. The Trends of Suicidality Over the Past 10 Years (1999-2022) in the Ethiopian General Population and the Way Forward in Tackling It. Psychol Res Behav Manag 2023; 16:3231-3236. [PMID: 37599797 PMCID: PMC10439282 DOI: 10.2147/prbm.s419426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 08/07/2023] [Indexed: 08/22/2023] Open
Abstract
Suicide is defined as a death caused by willful acts of taking one's own life. It might be a way for people to get away from suffering or anguish. Globally, an estimated a million people individuals lose their life due to suicide annually. Before the age of 50 years old more than half (58%) of all suicide deaths occur. This commentary aims to highlight the Ethiopian context, feasible preventive measures, and the way forward in tackling suicidal behavior. Worldwide in adolescent age groups between the ages of 15 and 29, suicide is the fourth leading cause of death. Even though suicide occurs everywhere in the world, according to data in 2019, 77% of all suicides that occurred in the world reside in developing countries. Due to the numerous psychosocial pressures present in Ethiopia, one in four citizens suffers from a mental disorder. According to Ethiopian national data figures, suicide ideation affects 9%, 5-16% of people, whereas suicidal attempt affects 4%, 1-8%. Even though, there is a variation of prevalence over the years based on the variation in design, settings, and sample size. There is an increment in the prevalence's suicidal ideation and attempts in the past 10 years. The country's Ministry of Health needs to act to address and prevent this urgent public health situation. The prevention of suicide should be a top concern, and working with numerous stakeholders is an efficient and practical approach.
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Affiliation(s)
| | - Selamawit Alemayehu
- Departments of Psychiatry, St. Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Wordefo DK, Kassim FM, Birhanu E, Mamo G. Suicidal behaviors and associated factors among patients attending an emergency department: a facility-based cross-sectional study. BMC Psychiatry 2023; 23:462. [PMID: 37357261 DOI: 10.1186/s12888-023-04949-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 06/10/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND Emergency departments (ED) are an important site for screening patients with suicidal behaviors. However, there is insufficient data in low-and middle-income countries regarding the magnitude of suicidal attempts among patients attending EDs. Therefore, the present study aimed to screen suicidal behavior and factors associated with suicide in patients attending an ED of Addis Ababa Burn, Emergency and Trauma Hospital, Ethiopia. METHOD A facility-based quantitative cross-sectional study was conducted between April and June 2018. A total of 398 participants were recruited using a consecutive sampling technique. The collected data collected includes structured questionnaires containing sociodemographic determinants, chronic medical illness conditions, substance use characteristics, social support level, common mental disorders (CMD) screening, suicidal behaviors assessment and suicidal attempts reason and method. RESULTS The prevalence of suicidal behavior and suicidal attempts were 8% and 6.3%, respectively. Suicide was attempted most frequently in the 18-24 age group. There was no overall difference in sex distribution for suicidal attempts. However, there were sex-based differences when the age group was taken into consideration. The commonest underlying reason for the attempt was social reasons (44%), while the most frequently reported attempt method was hanging (36%). No single factor was found to be significantly associated with the suicidal attempt. CONCLUSION Although suicidal behaviors are more common in patients attending the ED than in the general population, these facts have previously got little attention in patient attending EDs in low and middle income countries. The present findings support the need for a more detailed assessment of suicidal behaviours in patients attending ED and in patients with CMD.
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Affiliation(s)
- Dureti Kassim Wordefo
- Department of Psychiatry, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Faiz Mohammed Kassim
- Department of Psychiatry, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
| | - Elizabeth Birhanu
- Department of Psychiatry, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Girma Mamo
- Department of Psychiatry, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Engda AS, Belete H, Wubetu AD, Engidaw NA, Amogne FK, Kitaw TM, Bete T, Kebede WM, Atinafu BT, Demeke SM. Magnitude and determinants of suicide among overweight reproductive-age women, Chacha and Debre Berhan Town, Ethiopia: community based cross-sectional study. Int J Ment Health Syst 2022; 16:41. [PMID: 35974397 PMCID: PMC9382839 DOI: 10.1186/s13033-022-00551-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 07/29/2022] [Indexed: 11/10/2022] Open
Abstract
Background The magnitude and impact of women's suicidal behaviors, like suicidal ideation and suicidal attempts, are an important public health problem in low and middle-income countries, including Ethiopia. Suicidal behavior and being overweight are typical complications of reproductive age with many undesired consequences. Despite both having a serious impact on women of reproductive age, they are neglected in Ethiopia. Accordingly, this study aimed to examine the magnitude and determinants of suicide among overweight reproductive-age women in Chacha and Debre Berhan towns, Ethiopia. Methods A community-based cross-sectional study design was once employed from April 1, 2020 to June 1, 2020. The Composite International Diagnostic Interview was used to measure suicidal attempts and ideation, and the data was collected by direct interview. All collected data were entered into Epi Data version 4.6 and analyzed with SPSS version 25. Bivariate and multivariable regression models were used to determine the factors associated with a suicidal attempt and ideation. A p-value of less than 0.05 was considered statistically significant. Result Of the total participants, 523 were included, with a response rate of 93.7%. The prevalence of suicidal ideation was 13.0% (95% CI 10.1–15.9), whereas suicidal attempt was 2.3% (95% CI 1.1–3.6). Based on multivariable regression analysis, the odds of suicidal ideation have been higher among overweight women with stressful life events, depression, and younger age groups. Conclusion Suicidal ideation was frequent in overweight reproductive-age women. Preventing, treating, and using coping mechanisms regarding identified factors is a good way to minimize the burden of suicide.
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Affiliation(s)
- Abayneh Shewangzaw Engda
- Department of Psychiatry, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia.
| | - Habte Belete
- Department of Psychiatry, College of Health Sciences and Medicine, Bahir Dar University, Bahir Dar, Ethiopia
| | - Abate Dargie Wubetu
- Department of Psychiatry, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Nigus Alemnew Engidaw
- Department of Psychiatry, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Fetene Kasahun Amogne
- Department of Midwifery, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Tebabere Moltot Kitaw
- Department of Midwifery, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Tilahun Bete
- Department of Psychiatry, College of Health Sciences and Medicine, Haramaya University, Harar, Ethiopia
| | - Worku Misganaw Kebede
- Department of Nursing, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Bantalem Tilaye Atinafu
- Department of Nursing, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Solomon Moges Demeke
- Department of Psychiatry, College of Health Science Woldia University, Woldia, Ethiopia
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Gesese AA, Ochan OO. Suicidal behavior, suicidal ideation and patterns among youths in Anywaa zone, Gambella, Southwest Ethiopia: a mixed-methods study. BMC Psychiatry 2022; 22:389. [PMID: 35681194 PMCID: PMC9185871 DOI: 10.1186/s12888-022-03971-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 04/27/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Suicide is a major public health problem and for decades, it has remained one of the leading causes of injury and death worldwide. The objectives of this study were to investigate the prevalence of suicidal behavior, suicidal ideation, and patterns among youth in the Anywaa zone of the Gambella regional state, Southwest Ethiopia. METHODS AND MATERIALS A mixed-method study design was used in which a quantitative survey was conducted along with qualitative interviews and FGDs in the Anywaa zone. A total of 136 respondents were included in the survey study from the two woredas. The survey was conducted to assess the prevalence of suicidal behavior and ideations in a sample of preparatory school youth students. A pre-tested and structured questionnaire was used for the descriptive analysis. Qualitative information was also obtained through interviews and focus group discussions to identify the patterns of suicide and to gain more nuanced participants/ survivors' experiences. Data were analyzed using SPSS version 20, for which descriptive statistics were used. Qualitative data were analyzed using thematic analysis. RESULTS Suicidal behaviors and ideation were high among youths in the study area. In this study 62.3% of respondents reported they had heard others talk about their wish to die by suicide, 68 (64.2%) of youth said they had heard many youths claim that "I feel like there is no way out", 48 (43.3%) reported having seen someone with the signs of planning a suicide such as obtaining a weapon or writing a suicide note. About 68 (64.2%) of participants said, "My family would be better off without me." The majority of respondents were in the age groups ranging from 26 to 30 years. The results on the patterns of suicide attempts showed that hanging and drug overdose or poisoning were the most common patterns used by both men and women. CONCLUSION The findings indicate that the prevalence of suicide-related behaviors and ideations was high among youths in the Anywaa zone. The results on the patterns of suicide attempts showed that hanging and drug overdose or poisoning were the most common patterns used by both men and women. As a result, we would like to recommend that Government, Non-Governmental Organizations NGOs, and Faith-Based Organizations (FBOs), along with health care providers and counselors should work together by creating awareness, and by establishing Programs that target youths. Meanwhile, early identification and management of suicide risk in youth should be strengthened.
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Affiliation(s)
- Abreha Addis Gesese
- Gambella Teachers' Education and Health Science College, Department of Clinical Nursing, Gambella, South-West, Ethiopia.
| | - Okani Ojulu Ochan
- grid.7123.70000 0001 1250 5688Addis Ababa University, College of Education and Behavioral Studies, School of Psychology, Addis Ababa, Ethiopia
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Motsa MPS, Chiou HY, Chen YH. Association of chronic diseases and lifestyle factors with suicidal ideation among adults aged 18-69 years in Eswatini: evidence from a population-based survey. BMC Public Health 2021; 21:2245. [PMID: 34893094 PMCID: PMC8665558 DOI: 10.1186/s12889-021-12302-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 11/11/2021] [Indexed: 12/26/2022] Open
Abstract
Background How chronic diseases and lifestyle affect suicidal ideation in the sub-Saharan region remains unclear. We investigated the association of chronic diseases and lifestyle with suicidal ideation in the past year and the potential modifying role of sociodemographic status on this association. The findings can guide suicide prevention interventions. Methods We analyzed 3026 respondents from the World Health Organization STEPwise approach to noncommunicable disease risk factor surveillance conducted in Eswatini in 2014. The outcome was past-year suicidal ideation, and the main predictors were chronic diseases and lifestyle. Multiple logistic regression was used to estimate predictors, and subgroup analysis was performed to assess effect modification. Results The prevalence of past-year suicidal ideation was 9.9%. After adjustment for covariates, including sex, marital status, employment status, and education level, individuals aged 18–30 years (adjusted odds ratio [aOR]: 2.27, 95% confidence interval [CI]: 1.22–4.22) were more likely to have had past-year suicidal ideation than those aged 45–69 years. After adjustment for covariates among employed individuals, having high blood pressure (aOR: 3.38, 95% CI: 1.54–7.40), not exercising (aOR: 2.65, 95% CI: 1.09–6.39), drinking alcohol (aOR: 2.40, 95% CI: 1.14–5.05), being aged 18–30 years (aOR: 3.50, 95% CI: 1.01–12.1), and being exposed to threats (aOR: 2.37, 95% CI: 1.01–5.53) were significantly associated with past-year suicidal ideation. Conclusions Among currently employed individuals, having high blood pressure, not exercising, and drinking alcohol were associated with past-year suicidal ideation. The findings highlight the importance of developing and strengthening systems for early identification of suicidal ideation risk.
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Affiliation(s)
- Mfundi President Sebenele Motsa
- PhD Program in Global Health and Health Security, College of Public Health, Taipei Medical University, 250 Wuxing St., Taipei City, 110, Taiwan
| | - Hung-Yi Chiou
- School of Public Health, College of Public Health, Taipei Medical University, 250 Wuxing St., Taipei City, 110, Taiwan.,Institute of Population Health Sciences, National Health Research Institutes, Zhunan Town, Miaoli County, 35053, Taiwan
| | - Yi-Hua Chen
- School of Public Health, College of Public Health, Taipei Medical University, 250 Wuxing St., Taipei City, 110, Taiwan.
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Cruzeiro Szortyka ALS, Faria NMX, Carvalho MP, Feijó FR, Meucci RD, Flesch BD, Fiori NS, Fassa AG. Suicidality among South Brazilian tobacco growers. Neurotoxicology 2021; 86:52-58. [PMID: 34214458 DOI: 10.1016/j.neuro.2021.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 05/04/2021] [Accepted: 06/25/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To assess prevalence of suicidal ideation and suicide attempt among South Brazilian tobacco growers and to analyze the associated factors related to the suicidal ideation. METHODS A cross-sectional study was conducted in 2011 with a random sample of 2469 tobacco growers in São Lourenço do Sul/RS. Suicidal ideation was characterized by the question "Has the thought of ending your life been on your mind?". Suicide attempt was assessed by the question "Have you ever tried to kill yourself?". Investigation of factors associated with suicidal ideation was done by means of Poisson regression. RESULTS Prevalence of suicidal ideation and suicide attempt was 2.5 % and 1.2 % respectively. In the adjusted analysis, suicidal ideation was associated with being female, older age, moderate participation in religious activities and difficulty in paying debts. Those who worked in activities that required inadequate postures (hunched over or other forced positions), as well as farmers who performed 6-9 pesticide-related tasks demonstrated greater risk of suicidal ideation. Regarding health conditions, medical diagnosis of asthma, chronic low back pain, number of lifetime green tobacco sickness episodes and lifetime pesticide poisoning were positively associated with suicidal ideation. CONCLUSION Suicidal thoughts and attempts are relevant mental health problems among tobacco growers. Reducing pesticide use, as well as exposure to nicotine and improving socio-economic conditions, can reduce suicidal ideation and improve the mental health of exposed workers.
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Affiliation(s)
- Ana Laura Sica Cruzeiro Szortyka
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, Brazil; Psychology Course, Federal University of Pelotas, Pelotas, Brazil.
| | - Neice Muller Xavier Faria
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, Brazil
| | - Maitê Peres Carvalho
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, Brazil
| | - Fernando Ribas Feijó
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, Brazil; Postgraduate Program in Health, Environment and Work, Federal University of Bahia, Brazil
| | - Rodrigo Dalke Meucci
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, Brazil; Postgraduate Program in Public Health, Foundation Federal University of Rio Grande, Rio Grande, Brazil
| | - Betina Daniele Flesch
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, Brazil
| | - Nadia Spada Fiori
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, Brazil
| | - Anaclaudia Gastal Fassa
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, Brazil
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Bifftu BB, Tiruneh BT, Dachew BA, Guracho YD. Prevalence of suicidal ideation and attempted suicide in the general population of Ethiopia: a systematic review and meta-analysis. Int J Ment Health Syst 2021; 15:27. [PMID: 33761982 PMCID: PMC7992356 DOI: 10.1186/s13033-021-00449-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 03/06/2021] [Indexed: 02/08/2023] Open
Abstract
Background In Ethiopia, in spite of the high burden of suicide related-adverse effect, substantial variability in the reported prevalence of individual studies about suicidal ideation and attempted suicide; there is no national level epidemiological evidence. Thus, the present study aimed to determine the pooled prevalence of suicide ideation and suicidal attempt in the general population. Methods We followed the PRISMA Guidelines to report the results of the finding. Databases including: PubMed/Medline, SCOPUS, CINAHL (EBSCOhost), African Journal Online (AJOL) and African Indexed Medicus (AIM) were searched. Heterogeneity was assessed by Cochrane chi-square (χ2) and quantified by I2 statistics test. Sensitivity test and subgroup analysis performed. Publication bias was tested by funnel plots and Egger’s test. Effect size was calculated by random effects model. Results A total of 12 studies for suicidal ideation and 10 studies for attempted suicide were included in the study. The prevalence of suicidal ideation and attempted suicide were ranged from 1 to 55% and 0.6% to 14% respectively. The 12-month pooled prevalence of suicidal ideation and suicidal attempt were 9% (5–16%), I2 = 99.64%, p < 0.001 and 4% (1–8%), I2 = 98.11%, p < 0.001] respectively. The lifetime pooled prevalence of attempted suicide was found to be 4% (3–6%). We found evidence of significant heterogeneity for suicidal ideation [I2 = 99.64%, p < 0.001] and attempted suicide [I2 = 98.11%, p < 0.001]. The subgroup analysis could not identified source of heterogeneity. The sensitivity analysis showed that none of the point estimates was outside of the overall 95%CI for suicidal ideation and attempted suicide. No evidence of publication bias from the visual inspection of the funnel plot for suicidal ideation and [Egger’s test (P = 0.174)] and attempted suicide [Egger’s test (P = 0.318)]. Conclusion High prevalence of suicidal ideation and attempted suicide were observed in the general population of Ethiopia. These suggest the need of strengthening the awareness of suicidal behaviours and evaluate the effectiveness of the national health strategy in addressing the issues of suicidal behaviours.
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Affiliation(s)
- Berhanu Boru Bifftu
- School of Nursing, University of Gondar College of Medicine and Health Science, Gondar, Ethiopia.
| | - Bewket Tadesse Tiruneh
- School of Nursing, University of Gondar College of Medicine and Health Science, Gondar, Ethiopia
| | - Berihun Assefa Dachew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.,Institute for Social Science Research, The University of Queensland, Brisbane, QLD. 4068, Australia
| | - Yonas Deressa Guracho
- Department of Psychiatry, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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Shumet S, Azale T, Angaw DA, Tesfaw G, Wondie M, Getinet Alemu W, Amare T, Kassew T, Mesafint G. Help-Seeking Preferences to Informal and Formal Source of Care for Depression: A Community-Based Study in Northwest Ethiopia. Patient Prefer Adherence 2021; 15:1505-1513. [PMID: 34267506 PMCID: PMC8275152 DOI: 10.2147/ppa.s311601] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/11/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Globally, 350 million people are suffering from depression. Many people suffering from depression use different sources of help for their problems. People with different mental health problems seek help from formal and/or informal sources. This gives crucial information on community beliefs and perception regarding their preference for help. This study helps to guide effective planning and provision of mental health services, and health policy of the country to explore the community's preference to different sources of help. OBJECTIVE The aim was to contrast patterns of formal and informal help-seeking preferences for depression among residents of Aykel town, Northwest Ethiopia. METHODS This cross-sectional population-based study included 832 participants. We used a major depressive disorder case vignette and general help-seeking questionnaire (GHSQ) to assess preference to seek help. Study participants were selected by multistage cluster sampling technique. An independent sample t-test and analysis of variance test (ANOVA) was performed. RESULTS A total of 656 subjects (78.8%) showed high propensity to intimate partner, and 655 (78.7%) of the study subjects had high propensity to mental health professional. The mean score of the residents' preference to seek help from informal sources was 3.41±0.60. The mean score of preference to seek help from formal sources was 3.18±0.75. A total of 276 (33.2%) subjects showed high propensity to both informal and formal sources of help. The results also showed there was a mean score difference in preference for informal help between subjects with strong social support and low and moderate social support (P<0.001). CONCLUSION The result suggests that the majority of the residents had a higher preference to seek help from informal sources than formal sources of care. Providing and strengthening both formal and informal sources of help in conjunction are crucial to get a more qualified and effective care for depressed patients.
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Affiliation(s)
- Shegaye Shumet
- Department of Psychiatry, University of Gondar, Gondar, Ethiopia
| | - Telake Azale
- Department of Health Education and Behavioral Science, University of Gondar, Gondar, Ethiopia
| | - Dessie Abebaw Angaw
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | - Getachew Tesfaw
- Department of Psychiatry, University of Gondar, Gondar, Ethiopia
| | - Messele Wondie
- Department of Psychiatry, University of Gondar, Gondar, Ethiopia
| | | | - Tadele Amare
- Department of Psychiatry, University of Gondar, Gondar, Ethiopia
| | - Tilahun Kassew
- Department of Psychiatry, University of Gondar, Gondar, Ethiopia
| | - Gebremeskel Mesafint
- Mizan-Tapi University, College of Health Science, Department of Nursing, Mizan Aman, Ethiopia
- Correspondence: Gebremeskel Mesafint Mizan-Tapi University, College of Health Science, Department of Nursing, Mizan Aman, EthiopiaTel +251918209867 Email
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Belete H, Misgan E, Belete T. Prevalence and Associated Factors of Suicidal Behavior Among Patients and Residents in Northwest Ethiopia. Front Psychiatry 2021; 12:560886. [PMID: 34646166 PMCID: PMC8502868 DOI: 10.3389/fpsyt.2021.560886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 08/18/2021] [Indexed: 11/18/2022] Open
Abstract
There are a million suicide deaths in the world annually, and 75% of these occur in low- and middle-income countries (LMICs). However, there are limited resources to prevent suicidal deaths in those regions. The aim was to assess the prevalence of suicidal behavior and associated factors among patients visiting for medical care at a health center and residents in the community. A comparative study was employed by interviewing 2,625 residents in the community and 1,363 patients at the health center about suicidal behavior in northwest Ethiopia, from March 2017 to February 2018. Logistic analysis was employed with adjusted odds ratios and 95% confidence interval (CI) and with p-value < 0.05. The total prevalence of suicidal behavior (ideation, plan, and attempt) was found to be 5.6% (with 95% CI range 5-6%). It was found to be 4.4% with 95% CI range 4-5% in residents and 7.9% with 95% CI range 6-9% in patients. Female sex, depressive symptoms, physical/verbal abuse, and feeling stigmatized were identified as a risk factors for suicidal behavior, whereas a healthy lifestyle, such as eating regular meals of fruits and vegetables, doing physical exercise regularly, and having public health insurance were identified as protective risk factors for suicidal behavior even after adjusting for being a patient or not. The proportion of suicidal behavior was double in patients compared with residents. Suicidal behavior should be assessed in patients who visit for medical help and integration of mental health service within the primary health care system is recommended, especially in low-income countries.
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Affiliation(s)
- Habte Belete
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Eyaya Misgan
- Department of Gynecology and Obstetrics, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tilahun Belete
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Mekonen T, Getnet A, Belete A, Menberu M, Fekadu W. Suicidal behavior among people with epilepsy in Northwest Ethiopia: A comparative cross-sectional study. Epilepsy Behav 2020; 111:107233. [PMID: 32563892 DOI: 10.1016/j.yebeh.2020.107233] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 05/06/2020] [Accepted: 06/05/2020] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Premature mortality is common in people with epilepsy, but the causes vary where suicide is considered as one of the commonest. OBJECTIVE The objective of this study was to compare suicidal behavior between people with epilepsy and the general population and identify associated factors in Northwest Ethiopia. METHODS We have conducted a comparative cross-sectional study in Northwest Ethiopia. We have selected people with epilepsy from outpatient departments and the comparisons from the general population. Suicidal behavior was assessed by the revised version of Suicidal Behaviors Questionnaire (SBQ-R). Logistic regression was implemented to look for associations between factors and the dependent variable. RESULTS The prevalence of suicidal behavior in people with epilepsy was 18.2%, significantly higher than the community sample, which was 9.8% (p-value = .001). This difference persists in the multivariable logistic regression model by which the odds of suicidal behavior in people with epilepsy was two times more as compared to the community sample. Other variables positively associated with suicidal behavior for the overall sample were depressive symptoms, no formal education, divorced/widowed marital status, and higher perceived criticism. Better social support was protective factor for suicidal behavior. CONCLUSION The proportion of suicidal behavior is twofold higher in people with epilepsy than the general population. Routine screening for suicide risk should be an integral part of epilepsy treatment.
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Affiliation(s)
- Tesfa Mekonen
- Psychiatry Department, College of Medicine and Health Sciences, Bahir Dar University, Ethiopia; School of Psychology, University of Queensland, Australia.
| | - Asmamaw Getnet
- College of Health Sciences, Debre Markos University, Ethiopia
| | - Amsalu Belete
- College of Medicine and Health Sciences, Debre Tabor University, Ethiopia
| | - Melak Menberu
- Psychiatry Department, College of Medicine and Health Sciences, Bahir Dar University, Ethiopia
| | - Wubalem Fekadu
- Psychiatry Department, College of Medicine and Health Sciences, Bahir Dar University, Ethiopia; Department of Psychiatry, College of Health Sciences, Addis Ababa University, Ethiopia
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Prevalence and associated factors of suicidal ideation and attempt among undergraduate medical students of Haramaya University, Ethiopia. A cross sectional study. PLoS One 2020; 15:e0236398. [PMID: 32785295 PMCID: PMC7423400 DOI: 10.1371/journal.pone.0236398] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 07/06/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Suicide is a disastrous act which has a significant effect on the global burden of disease, contributing yearly to 1.4% of the total burden with the foremost role played by a people aged between 15 and 35 years. Medical students are one of the high-risk groups for suicide. This increased risk may begin during medical school and leads to premature death. But, there is a paucity of epidemiologically reliable data on the issue. Therefore, the current study was aimed to assess the prevalence and associated factors of suicidal ideations and attempt among undergraduate medical students of Haramaya University. METHOD An institutional based cross-sectional study was conducted from May 13 to June 12, 2019 at College of Health and Medical Science, Haramaya University. Stratified sampling technique was used and a total of 757 participants were selected by using simple random sampling technique. Data were collected using a self-administered questionnaire. Suicidal ideation and attempt were assessed by using suicidal module of world mental health survey initiative version of the World Health Organization, composite international diagnostic interview. Data were analyzed using Statistical Package for Social Science Version 20. Descriptive results were presented by tables and graphs. Bivariate and multivariate logistic regression analyses were done to identify factors associated with suicidal ideation and attempt. P-values less than 0.05 were considered statistically significant and the strength of association was presented by an adjusted odds ratio with 95% confidence interval. RESULT The study showed that the prevalence of suicidal ideation and attempt were 23.7% (95%CI, 20.5-26.8) and 3.9% (95%CI, 2.6-5.5), respectively. Cumulative grade point average (AOR = 0.30, 95% CI: 0.18-0.49), current alcohol use (AOR = 2.26, 95%CI: 1.45-3.55), depression (AOR = 3.58, 95%CI: 2.23-5.76), anxiety (AOR = 3, 95%CI: 1.88-4.77), and poor social support (AOR = 2.57, 95%CI: 1.41-4.68) were the factors statistically associated with the suicidal ideation. Depression (AOR = 5.4, 95%CI: 1.45-20.14) and anxiety (AOR = 3.19, 95%CI: 1.01-10.18) were associated with the suicidal attempts. CONCLUSION This study showed that the high prevalence of suicidal ideation and attempt as compared to the prevalence of suicidal behavior among other university students who were studying in other fields. Cumulative Grade Point Average, current alcohol use, depression, anxiety and poor social support were the factors statistically associated with the suicidal ideation. Depression and anxiety were the ones associated with the suicidal attempt. Early screening, detection and management of suicidal behavior and associated mental health problems were recommended for undergraduate medical students.
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Necho M, Belete A, Tsehay M, Zenebe Y. A meta-analysis of depressive symptoms among Ethiopian prisoners and a narrative description of its associated factors: a country based systematic review and meta-analysis study. BMC Psychiatry 2020; 20:281. [PMID: 32503475 PMCID: PMC7275530 DOI: 10.1186/s12888-020-02662-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 05/11/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The burden of depression in prisoners is increasing and factors such as co-existence of medical illness, lack of social support and longer duration of sentences are contributing to it. However, no pooled evidence on the magnitude and factors of depression in prisoners existed in Ethiopia. The current meta-analysis was therefore aimed to have aggregate evidence on the magnitude and factors of depression in prisoners of Ethiopia. METHODS A search of databases on PubMed, Scopus, and EMBASE was carried out systematically. Besides, grey literature sources were extensively investigated. Moreover, the reference lists of the articles selected were searched. Random effects and quality-effects models were used to describe the pooled prevalence of depressive symptoms with 95% CI. We also detect heterogeneity between studies using Cochran's Q- statistic and the Higgs I2 test. A sensitivity analysis was also implemented. Publication bias was checked with Egger's test and funnel plots visually. RESULTS Among 232 papers identified through the specified database searches only 17 full-text articles were assessed for eligibility and only nine (9) studies fulfilled the prespecified criteria and incorporated in the final meta-analysis. The pooled prevalence of Depressive symptoms among prisoners was 53.40%(95% CI: 41.33, 65.46). The pooled prevalence of Depressive symptoms in prisoners was 41.9% in Southwest Ethiopia, 44.43% in North West of Ethiopia, 59.05% in Addis Ababa, and 72.7% Southern Ethiopia. Besides, the pooled Depression symptoms prevalence among prisoners was 51.24% as measured with PHQ-9 and 56.15% with BDI-II. Besides, studies that utilized a relatively large sample size (≥350) yields a smaller pooled prevalence of Depression symptoms, 51.93% than those which utilized smaller sample sizes (< 350); 54.13%. CONCLUSION The pooled magnitude of depression in prisoner's population is very high, 53.40%. This pooled effect size for the Depression symptoms was significantly higher in the southern region of the country than in the southwest region. Besides, the pooled prevalence was significantly higher as measured by the BDI-II tool than by PHQ-9. Also, studies that utilized a larger sample size provided a significantly lower pooled magnitude of symptoms of depression than studies that utilized a smaller sample size.
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Affiliation(s)
- Mogesie Necho
- Department of Psychiatry, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia.
| | - Asmare Belete
- grid.467130.70000 0004 0515 5212Department of Psychiatry, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia
| | - Mekonnen Tsehay
- grid.467130.70000 0004 0515 5212Department of Psychiatry, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia
| | - Yosef Zenebe
- grid.467130.70000 0004 0515 5212Department of Psychiatry, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia
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Pieterse D, Hoare J, Louw KA, Breet E, Henry M, Lewis I, Bantjes J. Methods of deliberate self-harm in a tertiary hospital in South Africa. S Afr J Psychiatr 2020; 26:1399. [PMID: 32391183 PMCID: PMC7203532 DOI: 10.4102/sajpsychiatry.v26i0.1399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 01/20/2020] [Indexed: 01/19/2023] Open
Abstract
Background Little is known about the methods of deliberate self-harm (DSH) in South Africa (SA), despite the importance of means restriction as a public health strategy to reduce the morbidity and mortality associated with self-harm. Aim The aim of this study was to investigate the range of methods used in DSH and identify the socio-demographic and clinical factors associated with violent and non-violent methods of DSH among patients treated at a tertiary hospital in SA. Setting The study was conducted at an urban, tertiary level emergency department at Groote Schuur hospital in Cape Town, South Africa. Method Data were collected from 238 consecutive DSH patients who presented for emergency department treatment at the hospital. Logistic regression models were used to explore the factors associated with violent and non-violent methods of DSH. Results Self-poisoning was the most common method of self-harm (80.3%). Prescription medication was the most common form of self-poison (57.6%), while a large number of patients used non-prescription paracetamol (40.9%). In the regression analysis, male gender, stating that the reason for DSH was to escape a situation and history of substance use were associated with violent method of DSH. Conclusion Improved monitoring of prescription medications commonly used in DSH is integral to public health suicide prevention strategies in SA. This study underscores the need for substance use interventions in the healthcare setting.
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Affiliation(s)
- Deirdre Pieterse
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Jacqueline Hoare
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Kerry-Ann Louw
- Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Elsie Breet
- Department of Psychology, Stellenbosch University, Cape Town, South Africa
| | - Michelle Henry
- Centre for Higher Education Development, University of Cape Town, Cape Town, South Africa
| | - Ian Lewis
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Jason Bantjes
- Department of Psychology, Stellenbosch University, Cape Town, South Africa
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Abstract
AIM To assess the prevalence and associated factors of suicidal behaviour (suicidal ideation, plan or suicide attempt) in postpartum mothers. METHOD An institutional cross-sectional study was employed from March to April 2017. SETTING Two primary health centres and one referral hospital in northwestern Ethiopia. PARTICIPANTS A total of 1065 mothers aged ≥18 years during routine postnatal care were included and 988 of them completed the study. Those who were unable to communicate due to illness were not included. OUTCOME MEASURE Mothers who visit for routine postnatal care were assessed for suicidal behaviour using a suicidal screening tool. Logistic analysis was employed with adjusted OR (AOR) and 95% CI, and with p value less than 0.05 as the level of significance. RESULTS The prevalence of suicidal behaviour (suicidal ideation, plan or suicide attempt) was found at 14.0% (138/988) (95% CI 12.00 to 16.00) in postpartum mothers. Poor wealth of the mother (AOR=2.80, 95% CI 1.18 to 6.84), unplanned pregnancy of the current child (AOR=2.28, 95% CI 1.48 to 3.54), history of rape (AOR=2.26, 95% CI 1.42 to 3.61) and sickness of the new child (AOR=1.68, 95% CI 1.12 to 2.52) were significantly associated with suicidal behaviours. CONCLUSION Suicidal behaviour was found pretty high among postpartum mothers and was associated with poor wealth, unplanned pregnancy, history of rape and sickness of the new infant. It is recommended to screen mothers for possible suicidal behaviour during routine postnatal care.
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Affiliation(s)
- Habte Belete
- Psychiatry, College of Medical and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Eyaya Misgan
- Gynecology and Obstetrics, College of Medical and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Necho M, Mekonnen S, Haile K, Birkie M, Belete A. Suicidal plan, attempt, and associated factors among patients with diabetes in Felegehiwot referral hospital, Bahirdar, Ethiopia: cross-sectional study. BMC Psychiatry 2019; 19:258. [PMID: 31455263 PMCID: PMC6712698 DOI: 10.1186/s12888-019-2253-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 08/22/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Diabetes is a highly prevalent non-communicable disease which is prone to more psychiatric complications like suicide; however, research into this area is limited. Assessing suicidal plan and attempt as well as its determinants are therefore important. METHOD Institution based cross-sectional study was conducted from May 21 to June 21 at the diabetic outpatient clinic by recruiting 421 participants using systematic sampling. Suicide manual of the composite international diagnostic interview (CIDI) was used to assess suicidal plan and attempt. Chart review was used to obtain data regarding the co-morbidity of medical illness and complications of diabetes mellitus. Binary logistic regression was used to identify factors associated with suicidal attempt. Odds ratio with 95% CI was employed and variables with a p-value of< 0.05 in multivariable logistic regression were declared significant. RESULTS From 423 participants 421 participated in the study with 99.5% response rate. The mean age (±SD) of the respondents was 38.0((±13.9) years. The lifetime prevalence of Suicidal plan; an attempt was found to be 10.7 and 7.6% respectively. Being female (AOR = 2.14, 95%CI:1.10,5.65), poor social support (AOR = 3.21,95%CI:1.26,8.98), comorbid depression (AOR = 6.40,95%CI:2.56,15.46) and poor glycemic control (AOR = 4.38,95%CI:1.66,9.59) were factors associated with lifetime suicidal attempt. CONCLUSION The prevalence of suicidal attempt among Diabetes patients is high (7.6%). The suicidal attempt had a statistically significant association with female gender, comorbidity with depression, poor social support and poor glycemic control. Therefore the result of this study helps to do early screening, treatment, and referral of patients with suicidal attempt.
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Affiliation(s)
- Mogesie Necho
- Department of Psychiatry, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia.
| | - Solomon Mekonnen
- 0000 0000 8539 4635grid.59547.3aDepartment of Public Health, University of Gondar, College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Kelemua Haile
- AmanuelMentalSpecialized Hospital, Addis Ababa, Ethiopia
| | - Mengesha Birkie
- 0000 0004 0515 5212grid.467130.7Department of Psychiatry, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia
| | - Asmare Belete
- 0000 0004 0515 5212grid.467130.7Department of Psychiatry, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia
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Habtamu K, Medhin G, Selamu M, Tirfessa K, Hanlon C, Fekadu A. Functional impairment among people diagnosed with depression in primary healthcare in rural Ethiopia: a comparative cross-sectional study. Int J Ment Health Syst 2019; 13:50. [PMID: 31346349 PMCID: PMC6635998 DOI: 10.1186/s13033-019-0305-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 07/10/2019] [Indexed: 12/24/2022] Open
Abstract
Background There have been few studies examining the functioning of clinically-diagnosed people with depression in primary healthcare (PHC) in low- and middle-income countries (LMICs). The aim of this study was to identify factors associated with functional impairment among people diagnosed with depression in PHC in Ethiopia as part of implementation of a task-shared model of mental healthcare. Methods A comparative cross-sectional study was conducted. As part of the Programme for Improving Mental health carE (PRIME), PHC clinicians were trained to diagnose depression using an adapted version of the World Health Organization (WHO) mental health Gap Action Programme (mhGAP). A total of 2038 adult consecutive PHC attendees were screened for depressive symptoms using the 9-item Patient Health Questionnaire (PHQ-9). Those who scored five or above on the PHQ-9 (n = 131) were assessed by PHC workers. Of these, 92 were diagnosed to have depression (“PHC diagnosed cases”) and the remaining 39 people were PHQ positive but considered not to have depression (“non-diagnosed controls”). PHC diagnosed cases were also compared to a community representative sample of adult healthy controls (n = 197; “community controls”). The 12-item version of the WHO Disability Assessment Schedule (WHODAS-2.0) was used to assess functional impairment. Multivariable negative binomial regression models were fitted to examine the association of demographic, social, economic and clinical characteristics with functional impairment. Results No significant difference in functional impairment was found between diagnosed cases and non-diagnosed controls. PHC diagnosed cases were found to have higher depressive symptom severity and suicidality, but lower social support compared to non-diagnosed controls (P < 0.05). In the multivariable model, greater functional impairment was associated with higher depressive symptoms (RR = 1.04; 95% CI 1.02, 1.05) and lower social support (RR = 0.96; 95% CI 0.95, 0.98). Diagnosed cases were found to have higher functional impairment compared to community controls (RR = 1.91; 95% CI 1.74, 2.09). Conclusion In this study, PHC clinicians identified cases of depression with high symptom burden, suicidality and functional impairment. These findings support current initiatives to scale-up mental health services at the PHC level; and indicate that social support is an important target for intervention.
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Affiliation(s)
- Kassahun Habtamu
- 1School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, P.O.BOX: 1176, Addis Ababa, Ethiopia
| | - Girmay Medhin
- 2Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Medhin Selamu
- 3Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Kebede Tirfessa
- 3Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Charlotte Hanlon
- 3Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,4Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Centre for Global Mental Health, Kings College London, London, UK
| | - Abebaw Fekadu
- 3Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,5Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Centre for Affective Disorders, King's College London, London, UK.,6Global health & Infection, Brighton and Sussex Medical School, Brighton, UK
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Factors associated with help-seeking behavior among medically serious attempters aged 15-54 years in rural China. Psychiatry Res 2019; 274:36-41. [PMID: 30780060 DOI: 10.1016/j.psychres.2019.02.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 01/01/2019] [Accepted: 02/10/2019] [Indexed: 12/11/2022]
Abstract
Increasing help-seeking behavior was one of the effective methods for suicide prevention. However, help-seeking behavior was less explored in rural China. In this study, we aimed to analyze the factors which were associated with help-seeking behavior among medically serious suicide attempters in rural China. Subjects were 791 medically serious suicide attempters aged 15-54 years in rural China. A face-to-face interview was conducted to evaluate the age, gender, education years, marital status, occupation, religious belief, living alone, physical disease, pesticide at home, family suicide history, negative life events, social support, impulsivity, mental disorder, prior suicide act, suicide intent and suicide method for the attempters. The results supported that there were 29.2% of attempters seek help before suicide behavior, and factors that male (OR = 1.45), experiencing negative life events (OR = 1.12), impulsivity (OR = 1.05), suicide intent (OR = 0.92) and suicide by pesticide (OR = 0.68) were associated with increased help-seeking behavior. It is helpful for us to understanding the features of suicide attempters who do not seek help before suicide behavior, and we also should pay more attention on people with these factors in Chinese suicide prevention.
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Bifftu BB, Dachew BA, Tiruneh BT, Guracho YD. Prevalence of suicidal ideation, suicidal attempt and completed suicide in Ethiopia: a systematic review and meta-analysis protocol. Syst Rev 2019; 8:72. [PMID: 30902112 PMCID: PMC6429799 DOI: 10.1186/s13643-019-0986-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 03/12/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Suicide is an emergency psychiatric problem that needs an urgent intervention. Ethiopia, as a nation, has been experiencing high burden of suicide. Cultural taboo, stigma, and criticism associated with suicidal behaviors affect the communities' attitude and practice toward suicide and its help-seeking behaviors. Thus, this systematic review and meta-analysis will provide the pooled prevalence of suicidal ideation, suicidal attempt, and completed suicide in Ethiopia. METHODS This review protocol is designed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P 2015 Guidelines). Studies reporting the prevalence of suicidal ideation, suicidal attempt, and completed suicide will be included from the databases of PubMed/MEDLINE, Cochrane Library, SCOPUS, EMBASE, and Web of Sciences. The reference lists of retrieved articles, Google Scholar, and national health database reporting suicide will be also searched. No time and language restrictions will be imposed on the search strategy. The methodological quality of included studies will be assessed using the Joanna Briggs Institute critical appraisal tool. The heterogeneity between studies will be measured by the index of heterogeneity (I2 statistics) test. Funnel plots and Egger's test will be used to determine publication bias. Moreover, subgroup and sensitivity analyses will be carried out. The pooled prevalence of suicidal ideation, suicidal attempt, and completed suicide will be calculated by metaprop command using random effects model with the Dersimonian and Laird method. DISCUSSION This systematic review and meta-analysis aims to explore the available epidemiological evidences about suicidal ideation, suicidal attempt, and completed suicide. The final results of this review will be submitted for publication in a peer-reviewed journal and presented at conferences. The review of the results will help to raise awareness about the burden of suicidal ideation, suicidal attempt, and completed suicide in Ethiopia. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018112836.
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Affiliation(s)
- Berhanu Boru Bifftu
- University of Gondar College of Medicine and Health Science, School of Nursing, Gondar, Ethiopia
| | - Berihun Assefa Dachew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- The University of Queensland, Institute for Social Science Research, Indooroopilly, QLD 4068 Australia
| | - Bewket Tadesse Tiruneh
- University of Gondar College of Medicine and Health Science, School of Nursing, Gondar, Ethiopia
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Souraya S, Hanlon C, Asher L. Involvement of people with schizophrenia in decision-making in rural Ethiopia: a qualitative study. Global Health 2018; 14:85. [PMID: 30134989 PMCID: PMC6103856 DOI: 10.1186/s12992-018-0403-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 08/01/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The involvement of people with psychosocial disabilities in decision-making is a fundamental component of a person-centred and recovery-oriented model of care, but there has been little investigation of this approach in low- and middle-income countries. The aim of this study was to explore the involvement of people with schizophrenia in decision-making relating to their care in rural Ethiopia. METHODS A qualitative study was conducted in rural Ethiopia as part of the Rehabilitation Intervention for people with Schizophrenia in Ethiopia (RISE) project, involving two focus group discussions (n = 10) with community-based rehabilitation workers, and 18 in-depth interviews with people with schizophrenia, caregivers, health officers, supervisors and a community-based rehabilitation worker. Thematic analysis was used to examine major themes related to involvement in decision-making in this specific setting. RESULTS Involvement of people with schizophrenia in decision-making in this rural Ethiopian setting was limited and coercive practices were evident. People with schizophrenia tended to be consulted about their care only when they were considered clinically 'recovered'. Caregivers typically had a prominent role in decision-making, but they also acquiesced to the views of health care professionals. People with schizophrenia and caregivers were often unable to execute their desired choice due to inaccessible and unaffordable treatment. CONCLUSIONS Community-based rehabilitation, as a model of care, may give opportunities for involvement of people with schizophrenia in decision-making. In order to increase involvement of people with schizophrenia in rural Ethiopia there needs to be greater empowerment of service users, wider availability of treatment choices and a facilitating policy environment. Further studies are needed to explore concepts of person-centred care and recovery across cultural settings.
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Affiliation(s)
- Sally Souraya
- Department of Population Health, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK. .,Health Services and Population Research Department, Centre for Global Mental Health, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
| | - Charlotte Hanlon
- Health Services and Population Research Department, Centre for Global Mental Health, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.,Department of Psychiatry, Addis Ababa University, College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
| | - Laura Asher
- Department of Population Health, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK.,Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
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Vissoci JRN, Hertz J, El-Gabri D, Andrade Do Nascimento JR, Pestillo De Oliveira L, Mmbaga BT, Mvungi M, Staton CA. Cross-Cultural Adaptation and Psychometric Properties of the AUDIT and CAGE Questionnaires in Tanzanian Swahili for a Traumatic Brain Injury Population. Alcohol Alcohol 2018; 53:112-120. [PMID: 29281046 DOI: 10.1093/alcalc/agx058] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 08/05/2017] [Indexed: 01/15/2023] Open
Abstract
Aims To develop Swahili versions of the Alcohol Use Disorders Identification Test (AUDIT) and CAGE questionnaires and evaluate their psychometric properties in a traumatic brain injury (TBI) population in Tanzania. Methods Swahili versions of the AUDIT and CAGE were developed through translation and back-translation by a panel of native speakers of both English and Swahili. The translated instruments were administered to a sample of Tanzanian adults from a TBI registry. The validity and reliability were analyzed using standard statistical methods. Results The translated versions of both the AUDIT and CAGE questionnaires were found to have excellent language clarity and domain coherence. Reliability was acceptable (>0.85) for all tested versions. Confirmatory factor analysis of one, two and three factor solution for the AUDIT and one factor solution for the CAGE showed adequate results. AUDIT and CAGE scores were strongly correlated to each other (R > 0.80), and AUDIT scores were significantly lower in non-drinkers compared to drinkers. Conclusions This article presents the first Swahili and Tanzanian adaptations of the AUDIT and CAGE instruments as well as the first validation of these questionnaires with TBI patients. Both instruments were found to have acceptable psychometric properties, resulting in two new useful tools for medical and social research in this setting.
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Affiliation(s)
- Joao Ricardo Nickenig Vissoci
- Duke Division of Emergency Medicine, Department of Surgery, Duke University Medical Center, 2301 Erwin Road, Durham, North Carolina, 27710, USA.,Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, North Carolina, 27710, USA
| | - Julian Hertz
- Duke Division of Emergency Medicine, Department of Surgery, Duke University Medical Center, 2301 Erwin Road, Durham, North Carolina, 27710, USA
| | - Deena El-Gabri
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, North Carolina, 27710, USA
| | - José Roberto Andrade Do Nascimento
- Graduate Program in Physical Education, Department of Physical Education, Federal University of Vale do São Francisco, Av. José de Sá Maniçoba, Petrolina/PE, 56304-917, Brazil
| | - Leonardo Pestillo De Oliveira
- Graduate Program in Health Promotion, Department of Health and Biological Sciences, UNICESUMAR, Av. Guedner 1610, Maringá/PR, 87050-900, Brazil
| | - Blandina Theophil Mmbaga
- Department of Pediatrics, Kilimanjaro Christian Medical Center, Sokoini Road, Moshi, Tanzania.,Kilimanjaro Clinical Research Institute, Sokoini Road, Moshi, Tanzania
| | - Mark Mvungi
- Department of Pediatrics, Kilimanjaro Christian Medical Center, Sokoini Road, Moshi, Tanzania
| | - Catherine A Staton
- Duke Division of Emergency Medicine, Department of Surgery, Duke University Medical Center, 2301 Erwin Road, Durham, North Carolina, 27710, USA.,Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, North Carolina, 27710, USA
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Tang J, Li G, Chen B, Huang Z, Zhang Y, Chang H, Wu C, Ma X, Wang J, Yu Y. Prevalence of and risk factors for non-suicidal self-injury in rural China: Results from a nationwide survey in China. J Affect Disord 2018; 226:188-195. [PMID: 28988001 DOI: 10.1016/j.jad.2017.09.051] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 09/07/2017] [Accepted: 09/22/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is a highly prevalent and serious public health problem among adolescents worldwide. However, to date there were no studies assessing the prevalence of NSSI defined by suggested DSM-5 criteria among Chinese adolescents. We aimed to conduct a nationwide survey to explore the prevalence of and risk factors for NSSI among school-based adolescents in rural China. METHODS A total sample of 15,623 adolescents in rural China were enrolled by using a multistage sampling method. Data was collected by self-report questionnaires including demographic characteristics, neglect, maltreatment, loneliness, resilience, social support and emotional management ability. NSSI was defined by suggested DSM-5 criteria, according to which the engagement in self-injury took place more than 5 times a year. Multinomial logistic regression models were used to estimate the association between risk factors and NSSI. RESULTS There were 12.2% of adolescents (n = 1908) met the suggested DSM-5 criteria. Approximately 29% reported a history of NSSI at least once during the last year. Significant differences were found in several demographic factors including gender, ethnicity, grade, and family structure between adolescents with and without experiencing NSSI. The top three NSSI behaviors among adolescents with NSSI experience were hitting self, pinching, and pulling hair, with a prevalence rate of 16.7%, 14.1% and 11.2%, respectively. Female, Han ethnicity, fathers' education level, neglect, maltreatment, loneliness, social support, suicidal behaviors and emotional management ability were significantly associated with NSSI by multivariate analysis. No significant relationship was found between resilience and risk of NSSI. LIMITATION The DSM-5 has proposed 6 groups of criteria for NSSI, we only used criteria on frequency given its more accepted feasibility and pragmatic application. Consequently, it may different from other prevalence that estimated by other criteria. CONCLUSION To the best of our knowledge, this is the first study reporting prevalence of NSSI defined by suggested DSM-5 criteria among adolescent in rural China. In comparison to finding from the similar samples of adolescents, Chinese rural adolescents seem to have a relative higher prevalence. The potential risk factors for NSSI include female, father's education, Han ethnicity, psychosocial factors and suicide behaviors. More evidence for further understanding of context of the occurrence, improving access to health care utilization, and identifying the role of psychosocial factors and family relationship, is needed for the prevention and management of NSSI.
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Affiliation(s)
- Jie Tang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China; The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
| | - Guowei Li
- Department of Clinical Epidemiology & Biostatistics, St Joseph's Healthcare Hamilton, McMaster University, Hamilton, ON L8S 4L8, United States.
| | - Baoxin Chen
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China.
| | - Zhijie Huang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China.
| | - Yanmei Zhang
- Department of Child & Women Health Care, School of Public Health, Tongji Medical University, Huazhong University of Science &Technology, Wuhan, China.
| | - Hongjuan Chang
- Department of Child & Women Health Care, School of Public Health, Tongji Medical University, Huazhong University of Science &Technology, Wuhan, China.
| | - Chunxia Wu
- Department of Child & Women Health Care, School of Public Health, Tongji Medical University, Huazhong University of Science &Technology, Wuhan, China.
| | - Xiaoguang Ma
- Department of Nutrition and Food Hygiene, Chronic Disease Research Institute, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China.
| | - Jiaji Wang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China.
| | - Yizhen Yu
- Department of Child & Women Health Care, School of Public Health, Tongji Medical University, Huazhong University of Science &Technology, Wuhan, China.
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Ongeri L, McCulloch C, Neylan T, Bukusi E, Macfarlane S, Othieno C, Ngugi A, Meffert S. Suicidality and associated risk factors in outpatients attending a general medical facility in rural Kenya. J Affect Disord 2018; 225:413-421. [PMID: 28850856 PMCID: PMC5663198 DOI: 10.1016/j.jad.2017.08.059] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 08/10/2017] [Accepted: 08/20/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND Low-and-Middle-Income-Countries (LMICs) account for 75% of global suicides. While primary care populations in high-income countries (HIC) typically have higher prevalence of suicidal behavior relative to general populations, few studies have explored suicidal behavior among general medical outpatients in LMICs. This study addresses the research gap by characterizing potential risk factors for suicidal ideation in a large general medical outpatient setting in rural Kenya. METHODS A cross-sectional study of adult general medical outpatients attending a rural sub-county hospital in Kaloleni, Kenya. Primary outcomes included major depressive disorder (MDD), posttraumatic stress disorder (PTSD) and suicidal behavior measured by the Mini International Neuropsychiatric Interview (MINI 5.0). We use binary logistic regression to model suicidality, mental disorders, intimate partner violence, and lifetime abuse. RESULTS 394 outpatients completed the assessment. The prevalence of SI over the past month was 20%. 18% of those with suicidal ideation over the past month also attempted suicide in the past month. Participants who met criteria for MDD (suicidality item removed) were 19 times [CI: 4.56, 79.05] more likely to report suicidal ideation compared to those without MDD (adjusted odds ratio 12.15 [CI: 2.66, 55.49]). LIMITATIONS This was a cross sectional study design with convenience sampling and hence vulnerable to selection and recall bias. CONCLUSION The prevalence of SI and its strong association with actual suicide attempt in this population, make an urgent public health case for intervention. These data identify MDD as a highly significant correlate of SI.
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Affiliation(s)
- L. Ongeri
- Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya,Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya,Corresponding author at: Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya. (L. Ongeri)
| | - C.E. McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA,Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - T.C. Neylan
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya,Department of Psychiatry, University of California San Francisco (UCSF), San Francisco, USA
| | - E. Bukusi
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya,Global Health Sciences, University of California San Francisco, California, USA
| | - S.B. Macfarlane
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya,Department of Psychiatry, University of Nairobi, Kenya
| | - C. Othieno
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya,Centre for Population Health Sciences, Faculty of Health Sciences-East Africa, Aga Khan University, Nairobi, Kenya
| | - A.K. Ngugi
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya,Department of Psychiatry, University of California San Francisco (UCSF), San Francisco, USA
| | - S.M. Meffert
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya,Department of Psychiatry, University of California San Francisco (UCSF), San Francisco, USA
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Depression and Its Help Seeking Behaviors: A Systematic Review and Meta-Analysis of Community Survey in Ethiopia. DEPRESSION RESEARCH AND TREATMENT 2018; 2018:1592596. [PMID: 30662771 PMCID: PMC6312598 DOI: 10.1155/2018/1592596] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Accepted: 12/05/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Depression is one of the most common mental illnesses affecting around 322 million individual in the world. Although the prevalence of depression is high and its treatment is effective, little is known about its pooled prevalence and help seeking behaviors in the community settings of Ethiopia. Thus, this study aimed to determine the pooled prevalence of depression and its help seeking behaviors in Ethiopia. METHODS A systematic literature search in the databases of Pub-Med, Cochrane, and Google Scholar was performed. The quality of studies was assessed using the Newcastle-Ottawa quality assessment tool adapted for cross-sectional studies. Heterogeneity test and evidence of publication bias were assessed. Moreover, sensitivity test was also performed. Pooled prevalence of depression and its help seeking behavior were calculated using random effects model. RESULTS A total 13 studies for depression, 4 studies for help seeking intention, and 5 studies for help seeking behaviour were included in this review. The pooled prevalence of depression and help seeking intention and behaviour was found to be 20.5% (95% CI; 16.5% -24.4%), 42% (95% CI; 23%-60%), and 38% (95% CI; 23%-52%), respectively. There is no significant heterogeneity for depression (I2 = 0%, p =0.620), help seeking intention (I2 = 0%, p =0.996), and behaviour (I2 = 0%, p =0.896). There is no publication bias for depression egger's test (p =0.689). CONCLUSION More than one in every five individuals were experiencing depression. Less than one-third of individuals with depression seek help from modern treatment. Authors suggest community based mental health screening and treatment.
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Asher L, Fekadu A, Teferra S, De Silva M, Pathare S, Hanlon C. "I cry every day and night, I have my son tied in chains": physical restraint of people with schizophrenia in community settings in Ethiopia. Global Health 2017; 13:47. [PMID: 28693614 PMCID: PMC5504711 DOI: 10.1186/s12992-017-0273-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 06/28/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND A primary rationale for scaling up mental health services in low and middle-income countries is to address human rights violations, including physical restraint in community settings. The voices of those with intimate experiences of restraint, in particular people with mental illness and their families, are rarely heard. The aim of this study was to understand the experiences of, and reasons for, restraint of people with schizophrenia in community settings in rural Ethiopia in order to develop constructive and scalable interventions. METHODS A qualitative study was conducted, involving 15 in-depth interviews and 5 focus group discussions (n = 35) with a purposive sample of people with schizophrenia, their caregivers, community leaders and primary and community health workers in rural Ethiopia. Thematic analysis was used. RESULTS Most of the participants with schizophrenia and their caregivers had personal experience of the practice of restraint. The main explanations given for restraint were to protect the individual or the community, and to facilitate transportation to health facilities. These reasons were underpinned by a lack of care options, and the consequent heavy family burden and a sense of powerlessness amongst caregivers. Whilst there was pervasive stigma towards people with schizophrenia, lack of awareness about mental illness was not a primary reason for restraint. All types of participants cited increasing access to treatment as the most effective way to reduce the incidence of restraint. CONCLUSION Restraint in community settings in rural Ethiopia entails the violation of various human rights, but the underlying human rights issue is one of lack of access to treatment. The scale up of accessible and affordable mental health care may go some way to address the issue of restraint. TRIAL REGISTRATION Clinicaltrials.gov NCT02160249 Registered 3rd June 2014.
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Affiliation(s)
- Laura Asher
- Centre for Global Mental Health, Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abebaw Fekadu
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Solomon Teferra
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Harvard University, Boston, USA
| | - Mary De Silva
- Centre for Global Mental Health, Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Soumitra Pathare
- Centre for Mental Health Law and Policy, Indian Law Society, Pune, India
| | - Charlotte Hanlon
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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25
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Habtamu K, Minaye A, Zeleke WA. Prevalence and associated factors of common mental disorders among Ethiopian migrant returnees from the Middle East and South Africa. BMC Psychiatry 2017; 17:144. [PMID: 28420374 PMCID: PMC5395750 DOI: 10.1186/s12888-017-1310-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 04/12/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ethiopian migrants to the Middle East and South Africa experience a range of problems at various stages of their migration including overwork, sleep deprivation, denial of food, emotional abuse, difficulty adapting to the host culture, salary denial, sexual abuse, labor exploitation, confiscation of their travel documents, confinement, denial of medication, lack of access to legal service and degrading attitude by employers, traffickers and smugglers. These experiences can be associated with different types of mental disorders. This study sought to determine the prevalence of common mental disorders (CMD) and socio-demographic and other migration related associated factors among Ethiopian migrant returnees from the Middle East and South Africa. METHOD A cross-sectional study was conducted using non-probability (i.e. purposive, availability and snowball) sampling techniques. Migrant returnees (n = 1036) were contacted individually at their homes in eight high prevalent immigrant returnee locations in Ethiopia. Common mental disorders were assessed using the self-reporting questionnaire (SRQ-20) and a structured questionnaire was employed to collect data on socio-demographic and migration related characteristics. Data were analyzed using descriptive statistics, univariate logistic regression, and multivariable logistic regression. RESULTS The prevalence of CMD among migrant returnees was found to be 27.6%. Highly prevalent specific CMD symptoms included headaches, poor appetite, being tired, sleeping problems, and feeling unhappy or nervous. Being originally from Amhara and Oromia regions, being Christian, being divorced, not receiving salary on time, not being able to contact family, unable to prepare for domestic labor abroad, lack of cross- cultural awareness, and lack of knowledge and skills for work were all important risk factors for CMD. Migrants experienced adversities at different stages of their migration which are associated with psychological distress and even to long term mental illnesses. CONCLUSIONS CMD symptoms were found to be prevalent among Ethiopian migrant returnees. As pre-migration factors are associated with CMD symptoms, pre-departure training could be useful to mitigate the risk factors. Creating and routinely arranging mental health interventions and rehabilitation services are advisable for returnees who are screened for, or diagnosed with, mental health problems.
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Affiliation(s)
- Kassahun Habtamu
- School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, P.O. BOX: 150588, Addis Ababa, Ethiopia.
| | - Abebaw Minaye
- 0000 0001 1250 5688grid.7123.7School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, P.O. BOX: 150588, Addis Ababa, Ethiopia
| | - Waganesh A. Zeleke
- 0000 0001 2364 3111grid.255272.5Department of Counseling, Psychology and Special Education, Duquesne University, 209-C Canevin Hall, 600, Forbes Avenue, Pittsburgh, PA 15282 USA
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