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Relapse and Clinical Characteristics of Patients with Bipolar Disorders in Central Ethiopia: A Cross-Sectional Study
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.
Assessment of Real-Life Outcomes in Schizophrenia Patients according to Compliance
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.
Quality of Life and Associated Factors among Patients with Schizophrenia Attending Follow-Up Treatment at Jimma Medical Center, Southwest Ethiopia: A Cross-Sectional Study
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.
Internalized Stigma and Associated Factors among Patients with Major Depressive Disorder at the Outpatient Department of Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, 2019: A Cross-Sectional Study
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.
Prevalence and Factors Associated with Depression among HIV/AIDS-Infected Patients Attending ART Clinic at Jimma University Medical Center, Jimma, Southwest Ethiopia
Background. HIV is a chronic life-threatening illness and, like other similar chronic and stigmatizing illnesses, can be stressful to manage. Depression is a common mental health problem that deteriorates the quality of life of people with HIV/AIDS and found to be a strong predictor for noncompliance to antiretroviral therapy treatment. Therefore, epidemiological evidence on the factors associated with depression among patients with HIV/AIDS can contribute towards effective and efficient preventive health care strategies for this population. Objectives. To assess the prevalence and factors associated with depression among HIV/AIDS-infected patients attending ART clinic at Jimma University Medical Center, Jimma, Southwest Ethiopia, in 2018. Methods. This study followed an institution-based cross-sectional quantitative study design. A simple random sampling method yielded 303 participants who were interviewed from April to May 2018, using a pretested questionnaire, followed by their card review. The SPSS version 23 was used for bivariate analysis which was used to find out the significance of association. Variables that showed association in bivariate analysis at value < 0.25 were entered to multivariable logistic regressions to control for confounders, and the significance of association was determined by 95% confidence interval and value < 0.05. Results. The point prevalence of depression was 94 (31%). Variables like sex ( ()), marital status ( ()), opportunistic infection ( ()), and medication adherence ( ()) were significantly associated with depression. Conclusion and Recommendation. From the findings of this study, it is possible to conclude that depression was highly prevalent among people living with HIV/ADS. Sex, marital status, opportunistic infection, and medication adherence were found to be associated with depression and need attention from the health professional working in the ART clinic.
Sleep Quality and Associated Factors among Peoples with Epilepsy Who Have a Follow-Up at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, 2019: An Institutional Based Cross-Sectional Study
Background. Sleep is an active cyclic biological phenomenon and necessary for survival. Individuals who suffer from sleep disturbance are less productive, decreased performance, and negative effects on mental health. Despite there are different studies on sleep quality in Ethiopia, no studies have been conducted on magnitude and predictors of sleep quality among people with epilepsy in the study setting. Objective. To assess sleep quality and associated factors among people with epilepsy who have a follow-up at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, 2019. Method. An institution-based cross-sectional study was employed from May-June 2019. Systematic random sampling following face to face interview technique was employed. Epi-data version 3.1 and SPSS version 25 statistical packages were used for data entry and analysis, respectively. Frequencies, proportions, means, SDs, and cross-tabulations were used to summarize descriptive statistics of the data and tables, texts, and graphs were used for data presentation. To identify association and significant predictor with the outcome variable, binary logistic regression was fitted. The variable which has statistical significance was identified on the basis of values ≤ 0.05 and AOR with 95% confident intervals. Results. A total of 423 participants have been enrolled to the study with a response rate of 98.1%. The prevalence of poor sleep quality among peoples live with epilepsy was found 65.4% (95% CI: 61.0, 69.9). Being female (; (95% CI; 1.79, 4.85)), having stress full life events (; (95% CI; 1.43, 3.97)), nonadherent to AED medication (; (95% CI; 1.05, 2.78), poly-therapy treatment (; (95% CI; 1.05, 2.78)), poor seizer control (; (95% CI; 2.21, 12.46)), comorbid medical illness (; (95% CI; 1.18, 5.61)), and anxiety (; (95% CI; 1.52,4.24)) were factors significantly associated with poor sleep quality. Conclusion. This study revealed that more than half of the study participants were found to have poor sleep quality. So, considering the regular assessment of sleep quality and factors associated followed with appropriate intervention is recommended among peoples living with epilepsy.