Psychiatry Journal

Background. Tramadol has gained popularity among the drugs of the most active population especially the respondents in Ghana abuse especially farmers who nicknamed as “farm and buy cow.” It has recently become a public health concern, and stakeholders are worried about tramadol abuse and its implications on health in the Upper West Region. The study sought to measure the prevalence of tramadol/related substance abuse and the associated factors. Methods. A community-based analytic cross-sectional study involving 420 respondents was conducted. The participants were selected using a multistage sampling technique. Semistructured questionnaire was used to generate the data. Results. About 77.6% of the respondents abuse tramadol while 83.9% of the participants take at least one other related substance or drug. Participants with history of any substance abuse were 5 times more likely to abuse tramadol [; 95% CI (1.501-17.656); ], compared to respondents with no history of any substance abuse. Respondents who take tramadol to enhance sex were 4 times more likely to abuse tramadol [; 95% CI (1.352-10.545); ]. Formal sector employment was protective against tramadol abuse [; 95% CI (0.017-0.595); ] compared to self-employment and the unemployed. In addition, use of nonopioid prescription drugs for posttraumatic/pain management reduced the risk of tramadol abuse [; 95% CI (0088-0.640); ] compared to the posttraumatic/pain management dependence on prescription of only opioid like tramadol. Conclusion. An infantile municipality like Jirapa is challenged with high level of tramadol and related substance which has serious repercussion on the health system in the Jirapa district. It is important that measures are taken by the stakeholders to stop tramadol and related substance and mitigate the impact of drug abuse in the district.

Background. The present study is aimed at investigating the relationship between changes in symptoms and changes in social functioning during cognitive behavioral therapy (CBT) for social anxiety disorder (SAD). Methods. Ninety-six patients with SAD were treated with manualized group CBT. Measures of social anxiety symptoms, depression symptoms, cognition, and social functioning were administered at baseline and endpoint. Using multiple regression analysis, we examined the associations between the changes in four aspects (work, home management, social leisure activities, and private leisure activities) of social functioning as dependent variables and the changes in four factors (social interaction, public speaking, observation by others, and eating and drinking in public) in social anxiety symptoms, depression symptoms, and cognition as independent variables. Results. The changes in work functioning were predicted by the changes in the public speaking factor in social anxiety symptoms. The changes in depression symptoms predicted the changes in home management. The significant predictors of changes in social leisure activities were the changes in the social interaction factor and depression symptoms. The changes in private leisure activities were predicted by the changes in the observation by others factor. The changes in cognition predicted nothing. Conclusion. The present study suggested that the changes in social anxiety or depression symptoms may predict several aspects of social functioning changes in patients with SAD over the course of CBT. In order to improve social functioning, our results may be useful for selecting the fear or feared situation in CBT for SAD. Trial Registration. The clinical study registration number in the Japanese trials registry is UMIN CTR 000031147.

Background. Bipolar disorder is a severe mental illness and has huge morbidity and mortality. Relapse is a challenging treatment failure in patients with mental illness, especially in patients with bipolar which causes high economic and social burdens. In the mental health delivery system, relapse is common and can be defined as becoming ill again after apparent recovery and a worsening condition of psychiatric patients. Due to psychiatric patients that may stop medication on their own in contrary to the advice of mental health professionals, relapse of mood episodes, delayed remission, and residual symptoms usually leads to hospitalization, increased suicide risk, and/or impede psychosocial recover. Therefore, understanding the nature of relapse in patients in low-income countries helps to prevent recurrence and related health care expenses. Objective. The objective of this study was to assess the prevalence and factors associated with relapse among patients with bipolar disorders in central Ethiopia. Method. Facility-based cross-sectional study was conducted from May to June 2015 at Amanuel Mental Specialized Hospital. Relapse was calculated among 400 samples of people with bipolar disorder, and systematic random sampling was used to select the study participants. Oslo’s social support scale and ASSIST were used to identify factors with relapse, and a binary and multivariable logistic regression analysis model was performed to control the confounding factors. Odds ratios (OR) with the corresponding 95% confidence interval (95% CI) were determined to evaluate the strength of association. Results. The prevalence of relapse was 71% among patients with bipolar disorder. The longer morbidity (longer than 5 years) had a higher risk of relapse [, 95% confidence interval (CI): 2.44 to 6.27], while good medication adherence found to be a protective factor for relapse [, 95% CI: 0.22 to 0.72]. Conclusion. The prevalence of relapse was found pretty high among patients with bipolar disorders (71%). Working on treatment adherence and controlling the psychopathology is important to prevent relapse among bipolar patients.

Objective. To describe and compare demographics, outcomes and comorbidities in schizophrenia patients by treatment compliance. Methods. This was a cross-sectional survey of hospital- or office-based psychiatrists who saw ≥6 schizophrenia patients per week and were responsible for treatment decisions. Recruited physicians completed a patient record form (PRF) for their first 10 consulted schizophrenia patients aged ≥18. These patients voluntarily completed a patient self-completion form (PSC). Compliance was measured by subjective physician assessment. Drivers of and outcomes associated with compliance were identified by regression analyses. Results. A total of 150 physicians completed PRFs for 1489 patients (706 sometimes compliant (SC), 636 always compliant (AC)). A total of 680 patients completed a PSC (327 SC, 295 AC). AC patients were less likely to be male (52.2% vs. 58.6%; ) and unemployed (odds ratio (OR) 0.91, 95% confidence interval (CI) 0.82–1.00; ) or to have had a treatment regimen change (OR 0.56, 95% CI 0.40–0.80; ) than SC patients. AC patients were less likely to have had more comorbidities (OR 0.91, 95% CI 0.82–1.00; ) and hospitalizations in the past 12 months (OR 0.59, 95% CI 0.43–0.80; ) than SC patients. Overall, AC patients had better clinical and humanistic outcomes. Weight gain was a common side effect for all patients; SC patients with weight gain had poorer outcomes than those without weight gain. Conclusion. Schizophrenia patients that were SC experienced poorer clinical outcomes and quality of life. Weight gain may exacerbate these poorer outcomes.

Background. Schizophrenia is one of the most severe, chronic, and disabling mental disorders found globally. The chronic nature of the illness significantly interferes with functioning and results in a poor quality of life, but little is known about the quality of life among schizophrenia patients, in particular in low-income countries. Therefore, we assessed the quality of life and associated factors among patients with schizophrenia attending Jimma University Medical Center, Southwest Ethiopia. Methods. The hospital-based cross-sectional study design was employed to collect data from 352 study participants using a systematic random sampling technique from June to July 2018. Patients’ sociodemographic characteristic, quality of life, psychopathology, medication adherence, comorbid physical illness, and substance use disorder were assessed. Data entry and analysis were done using EpiData version 3.1 and Statistical Package for the Social Sciences (SPSS) version 21.0, respectively. Variables with a value < 0.05 in the final multiple regression models were declared to be associated with the outcome variable. The Results. The response rate of the study was 99.7%. The mean (±standard deviation) score of the World Health Organization Quality of Life Assessment Short Version Scale was . Positive symptoms, negative symptoms, general psychopathologies, comorbid physical illness, khat use disorder, tobacco use disorder, and medication nonadherence were negatively associated with patient quality of life. However, monthly income was found to be positively associated with quality of life. Conclusion and Recommendation. The mean and standard deviation of the quality of life of people with schizophrenia is found to be in this study. The social relationship domain was found with the lowest mean score. Therefore, priority interventions need to be implemented to improve the social deficits.

Background. Internalized stigma has been found to be widespread among patients with major depressive disorder. When internalized stigma exists in patients with depression at a high level, it worsens the treatment outcome and quality of life. So the aim of the study is to assess the magnitude of internalized stigma and associated factors among outpatients with major depressive disorder at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. Methods and Materials. An institutional-based cross-sectional study was conducted among 415 respondents from May 6 to June 13, 2019. Internalized stigma was assessed by using the internalized stigma of mental illness scale. Data was entered to Epi-data version 3.1 and analyzed using SPSS version 20. Bivariable and multivariable binary logistic analysis was done, and values less than 0.05 were considered statistically significant with 95% CI. Results. The prevalence of high internalized stigma among patients with major depressive disorder was 33.5% (95% CI: 29.2, 38.3). Being single (, 95% CI: 1.30, 4.95), having an illness greater than or equal to 2 years of duration (, 95% CI: 1.66, 6.19), history of suicidal attempt (, 95% CI: 1.35, 3.99), nonadherence to treatment (, 95% CI: 1.62, 5.29), poor social support (, 95% CI: 2.09, 10.64), and poor quality of life (, 95% CI: 1.82, 5.49) were significantly associated with high internalized stigma at value < 0.05. Conclusion. The magnitude of internalized stigma was high among patients with major depressive disorder. Reduction of internalized stigma through antistigma campaigns and supports given to patients at the earliest possible time is important to improve treatment outcome and quality of life and minimize suicidal behavior in patients with major depressive disorder.