Population level mental distress in rural Ethiopia.

Journal: BMC psychiatry

Volume: 14

Issue: 

Year of Publication: 2015

Affiliated Institutions:  Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, PO Box , Addis Ababa, Ethiopia. abe.wassie@kcl.ac.uk.

Abstract summary 

As part of a situational analysis for a research programme on the integration of mental health care into primary care (Programme for Improving Mental Health Care-PRIME), we conducted a baseline study aimed at determining the broad indicators of the population level of psychosocial distress in a predominantly rural community in Ethiopia.The study was a population-based cross-sectional survey of 1497 adults selected through a multi-stage random sampling process. Population level psychosocial distress was evaluated by estimating the magnitude of common mental disorder symptoms (CMD; depressive, anxiety and somatic symptoms reaching the level of probable clinical significance), harmful use of alcohol, suicidality and psychosocial stressors experienced by the population.The one-month prevalence of CMD at the mild, moderate and severe threshold levels was 13.8%, 9.0% and 5.1% respectively. The respective one-month prevalence of any suicidal ideation, persistent suicidal ideation and suicide attempt was 13.5%, 3.8% and 1.8%. Hazardous use of alcohol was identified in 22.4%, significantly higher among men (33.4%) compared to women (11.3%). Stressful life events were widespread, with 41.4% reporting at least one threatening life event in the preceding six months. A similar proportion reported poor social support (40.8%). Stressful life events, increasing age, marital loss and hazardous use of alcohol were associated with CMD while stressful life events, marital loss and lower educational status, and CMD were associated with suicidality. CMD was the strongest factor associated with suicidality [e.g., OR (95% CI) for severe CMD = 60.91 (28.01, 132.48)] and the strength of association increased with increase in the severity of the CMD.Indicators of psychosocial distress are prevalent in this rural community. Contrary to former assumptions in the literature, social support systems seem relatively weak and stressful life events common. Interventions geared towards modifying general risk factors and broader strategies to promote mental wellbeing are required.

Authors & Co-authors:  Fekadu Abebaw A Medhin Girmay G Selamu Medhin M Hailemariam Maji M Alem Atalay A Giorgis Tedla W TW Breuer Erica E Lund Crick C Prince Martin M Hanlon Charlotte C

Study Outcome 

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Statistics
Citations :  Hanlon C, Medhin G, Alem A, Araya M, Abdulahi A, Tomlinson M, Hughes M, Patel V, Dewey M, Prince M. Sociocultural practices in Ethiopia: association with onset and persistence of postnatal common mental disorders. Br J Psychiatry. 2010;197(6):468–475.
Authors :  10
Identifiers
Doi : 10.1186/1471-244X-14-194
SSN : 1471-244X
Study Population
Men,Women
Mesh Terms
Adolescent
Other Terms
Study Design
Cross Sectional Study
Study Approach
Country of Study
Ethiopia
Publication Country
England