Psychiatry Journal最新文献

Background: Stigma resistance is described as the capacity to counteract or remain unaffected by the stigma of mental illness. Patients who have high stigma resistance have shown good treatment outcome, so working on this issue is crucial since little is known about the stigma resistance level among patients with mood disorders.

Objectives: To determine the magnitude and determinant factors of stigma resistance among patients with mood disorder attending at St. Paul's Hospital.

Methods: A cross-sectional study design was conducted on 238 study samples, and systematic random sampling was used to get the study participants. Internalized Stigma of Mental Illness Scale was used to measure stigma resistance. Data was entered using EpiData 3.1 and exported to the Statistical Package for Social Science 22.0 for analysis. Linear regression analysis (P < 0.05) was used to identify a significant association between the outcome and predictor variable.

Results: Out of 238 study samples, 235 patients took part with a 99% response rate. The overall percentage of stigma resistance was 49.5%. Low educational status (B = -1.465, 95% CI (-2.796, -0.134), P ≤ 0.031), disability (B = -0.064, 95% CI (-0.102, -0.026), P ≤ 0.001), nonadherence due to stigma (B = -1.365, 95% CI (-2.151, -0.580), P ≤ 0.001), duration of treatment (B = 0.091, 95% CI (0.042, 0.141), P ≤ 0.001), internalized stigma (B = -2.948, 95% CI (-3.642, -2.254), P ≤ 0.001), and self-esteem (B = 1.859, 95% CI (0.812, 2.906), P ≤ 0.001) were significantly associated with stigma resistance.

Conclusion: This study found that only half of the patients had stigma resistance. Low educational status, high self-stigma, low self-esteem, disability, and short duration of treatment were negatively associated with stigma resistance, so working on those modifiable identified factors with focal stakeholders will be crucial to promote the stigma resistance level of patients with mood disorder.

Background: Promoting mental health and care in the community setting leads to the recovery of patients with mental illness. Although recovery in mental health is a complex phenomenon, caregivers and community members have important roles to play in the recovery process for patients with mental illness. Little is documented on how recovery is promoted in the community setting. This study explored the experience of patients, caregivers, and community members on how recovery can be realized in a patient with severe mental illness in Dar es Salaam.

Methods: We conducted four focus group discussions (FGDs): two with caregivers and the other two with community members. Also, six in-depth interviews were held with patients with mental illness. Participants were purposively selected based on the type of information needed. Both FGD and in-depth interviews were digitally recorded and transcribed. Qualitative content analysis was used to analyze data. Findings. Four themes emerged from this study, which include promoting patients' participation in household activities, improving patients' support system, promoting patients' self-care management, and providing safety and protection among patients with mental illness. However, financial, psychological, and establishing care and support centers and professional supports emerged as subthemes from patients' support system.

Conclusion: Caregivers and community members are significant stakeholders for promoting recovery for people with mental illness. The current study reveals that patients' involvement in home activities, promoting self-care management, improving patients' support systems, and providing safety and protection are important factors that promote recovery for people with mental illness. Advocating mental health awareness for caregivers and community members will bridge the gap to enhance the recovery for people with mental illness. Further research is needed in this area to explore the health care providers' perspectives on the recovery process of mental illness in the hospital setting.

Background: A mental health problem is a significant cause of overall disease burden globally. Among this problem, stress and depression are the central problems observed among university students due to the transitional nature. Consequently, the problem has an adverse effect on the wellbeing and academic performance of students.

Objective: To assess perceived stress, depression, and associated factors among undergraduate health science students at Arsi University in 2019 in Oromia, Ethiopia.

Methods: An institutional-based cross-sectional study design on undergraduate health science students was employed for the study from February 25 to April 15, 2019. Data were collected by using a self-administered questionnaire of the perceived stress scale (PSS-14) item and Beck depression inventory 21 items.

Result: All of the study subjects were between ages 18 and 30 with a mean age of 20.9 ± 1.83 standard deviation years. The current prevalence of perceived stress among study subjects was 63.5%. Age category, study year, pressure to maintain a good grade, practical attachment, lack of dormitory safety, and the financial problem were identified as significantly associated factors of perceived stress. In addition to this study, results also revealed that the prevalence of depression among students was 4.4% in which thinking about career future prospects was a significantly associated factor.

Conclusion: Stress was a significant problem among study participants where a small proportion of study subjects presented with depression. Comprehensive counseling and guidance aligned with training on awareness creation were recommended.

Background: Khat chewing has become prevalent in the world due to the improvement of road and air transportation. In Ethiopia, khat chewing is more prevalent and widely practiced by men. Khat has a negative effect on social, economic, and mental health. There is variation in khat cultivation, use, and factors that associated with khat chewing in the Ethiopian regions. Therefore, this study is aimed at showing spatial distribution and factors associated with khat chewing among male adults 15-59 years in Ethiopia.

Methods: A total of 12,594 men were included in this study. ArcGIS version 10.7 software was used to show the spatial distribution of chewing khat among adult men in Ethiopia. The Bernoulli model was applied using Kilduff SaTScan version 9.6 software to identify significant purely spatial clusters for chewing khat in Ethiopia. A multilevel logistic regression model was fitted to identify factors associated with khat chewing. A P value < 0.05 was taken to declare statistically significant predictors.

Results: The EDHS 2016 survey showed that the high proportion of chewing khat was found in Dire Dawa, Harari, Southern Oromia, Somali, and Benishangul Gumuz regions. In spatial scan statistics analysis, a total of 126 clusters (LLR = 946.60, P value < 0.001) were identified. Age group 30-44 years old (AOR = 1.60, 95% CI: 1.37, 1.86) and 45-59 years old (AOR = 1.33, 95% CI: 1.09, 1.61), being single (AOR = 1.86, 95% CI: 1.64, 2.12), Muslim religion followers (AOR = 15.03, 95% CI: 11.90, 18.90), media exposed (AOR = 0.77, 95% CI: 0.68, 0.86), had work (AOR = 2.48, 95% CI: 2.08, 2.95), alcohol drinker (AOR = 3.75, 95% CI: 3.10, 4.53), and region (Afar, Amhara, Benishangul Gumuz, Gambela, Harari, Oromia, Somali, Southern Nations, Nationalities, and People's Region (SNNPR), and Tigray) and two cities (Addis Ababa and Dire Dawa) were statistically significant factors affecting chewing khat in Ethiopia.

Conclusions: In Ethiopia, the spatial distribution of khat chewing among adult men was nonrandom. A high proportion of khat chewing was observed in Dire Dawa, Harari, Southern Oromia, Somali, and Benishangul Gumuz regions. Older age group, being single marital status, alcohol drinker, media unexposed, had no work, and Muslim religion follower were factors affecting khat chewing. Policymakers should be given spatial attention in reducing the prevalence of chewing khat by teaching the health impact of khat chewing through media in the identified regions.

Background: Diabetes mellitus and depression are very common diseases worldwide, and the prevalence rates of both conditions are increasing rapidly. Depression among patients with diabetes mellitus results in poor glycemic control through different mechanisms. Besides, the coexistence of a chronic medical illness with depression reduces the probability of recognizing and treating depression. The study is aimed at assessing the prevalence and factors associated with depression among adults with diabetes mellitus.

Methods: A hospital-based cross-sectional study was conducted among adult diabetes mellitus patients on follow-up in Mizan-Tepi University Teaching Hospital and Tepi General Hospital. A consecutive sampling technique was employed to recruit the study participants, and data were collected through face-to-face interview and medical chart review. Depression was measured using Patient Health Questionnaire-nine (PHQ-9). Binary logistic regression analysis was done and a p value of less than 0.05 was used as a level of significance.

Results: The prevalence of depression among study participants was 37.0% (95% CI 32.0%-42.0%). The majority (44.7%) of the patients had mild depression, while only 2% had severe depression. Being male (AOR = 1.92, 95% CI: 1.15-3.22), urban residence (AOR = 3.02, 95% CI: 1.57-5.78), single marital status (AOR = 7.72, 95% CI: 3.6-16.53), duration of diabetes mellitus 5 years and more (AOR = 2.00, 95% CI: 1.21-3.5), and having sexual dysfunction (AOR = 3.55, 95% CI: 2.13-5.91) were associated with increased odds of depression among diabetes mellitus patients.

Conclusions: The prevalence of depression among diabetes mellitus was high. Therefore, the patients should be thoroughly screened for this comorbid condition, and the significant factors should be addressed during routine follow-up.

Background: Pregnancy and postpartum are considered as high risk periods for the emergence of psychiatric disorder. Although postpartum depressive symptoms have been associated with tragic outcome, such as maternal suicide and infanticide, it is a neglected area of mental health care in developing countries. This study was conducted to find the prevalence and factors associated with postpartum depressive symptoms.

Method: A community-based cross-sectional research design was carried out after selecting the three wards of Bharatpur submetropolitan by nonprobability purposive sampling method. A total of 160 mothers in their 1 month to 12 months of postpartum period were interviewed through semistructured interview schedule and Edinburgh Postnatal Depression Scale (EPDS). Collected data were entered in Epi, data 3.1, and was exported into IBM SPSS 20 version.

Results: The prevalence of depressive symptoms among postpartum mothers was 27.5%. The multivariate analysis identified two factors significantly associated with postpartum depression including respondents who had education level of ≤10 class (odds ratio [AOR] = 3.25, P = 0.03, confidence interval [CI] = 1.10 - 9.58), chronic disease in their family (odds ratio [AOR] = 3.25, P = 0.01, confidence interval [CI] = 1.19 - 8.16).

Conclusion: More than one out of four mothers is suffering from depressive symptoms. The major factors associated with postpartum depressive symptoms are education of respondents and chronic disease in the family. Screening and timely management of depressive symptoms should be incorporated in routine maternal care so as to enhance maternal and child health. Likewise, concerned authority should plan and organize awareness-raising programs and provide attractive package to attract the female population for higher education.

Background: Psychiatric illnesses involve alterations in the brain or nervous system function and result in altered perception, responses to the environment, and daily functioning, which ultimately diminish the capacity to cope with the regular demands of life, including nutritional intake. Little is known about nutritional status in psychiatric patients in our setup, particularly in northeast Ethiopia. Thus, this study is aimed at assessing the nutritional status and associated factors among adult psychiatric patients in Dessie referral hospital, northeast Ethiopia.

Methods: A facility-based cross-sectional study was employed among 530 psychiatric patients using an interviewer-administered structured questionnaire, and anthropometric measurements were taken from April 10 to June 20, 2018. Multinomial logistic regression analysis was used to identify the associated factors with the nutritional status of adult psychiatric patients.

Results: The study revealed that the proportion of undernutrition and overnutrition was 20.0% (95% CI: 16.80-23.60) and 23.4% (95% CI: 19.80-27.00), respectively. Being male (AOR: 2.39, 95% CI: 1.28-4.47), private employed (AOR: 0.08, 95% CI: 0.02-0.31), and not consuming alcohol (AOR: 0.20, 95% CI: 0.56-0.74) were factors associated with undernutrition. Whereas not involved in physical activity (AOR: 2.98, 95% CI: 1.37-6.49), being newly diagnosed patient (AOR: 1.86, 95% CI: 1.01-3.42), and not chewing Khat (AOR: 3.92, 95% CI: 1.63-9.42) were factors associated with overnutrition of adult psychiatric patients.

Conclusion: The proportion of both undernutrition and overnutrition was above the national average. Notably, nutrition significantly affects the production and use of neurotransmitters, and this may result in significant effects on physical, mental, or emotional processes. This undoubtedly affects the stabilization processes of neuropsychiatric patients. Therefore, healthcare managers, supervisors, and policymakers identify those vulnerable groups early and thereby design effective nutritional strategies to intervene in malnutrition among adult patients with a psychiatric disorder.

Background: In health care, patient satisfaction is an attitudinal response and a pillar for quality assurance, but there is reluctance to measure it among mentally ill patients. Satisfied patients become more compliant. However, no study was done in this study area before. Therefore, this study was conducted to determine the magnitude of perceived patient satisfaction and associated factor at Jimma University Medical Center, outpatient psychiatry clinic.

Methods: Cross-sectional study design was conducted, and systematic random sampling technique was used to get study participants. The 24-item Mental Health Service Satisfaction Scale (a validated tool in Ethiopia) was used to assess patient satisfaction. Data was entered using Epi-data 3.1 and exported to the Statistical Package for the Social Sciences 22.0 for analysis. Linear regression analysis (P < 0.05) was used to identify the association between the outcome and independent variable.

Result: 414 respondents participated in the study with response rate of 98%. The overall percentage of patient satisfaction was 50.3% (95% CI 48.4%-51.2%). Being male (β = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (β = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (β = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (β = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (β = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (β = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (β = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (β = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (β = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (Conclusion and Recommendation. This study found that half of the study participants are satisfied with the service. Distance from the hospital, current substance use, waiting time, and having good social support were identified as modifiable factors that can be improved through working with stakeholders to increase patient satisfaction.

Background: Country-level epidemiological data about alcohol-related problems is useful for planning prevention and treatment services. Heavy Alcohol Consumption (HAC) and Alcohol Use Disorder (AUD) are two syndromes of alcohol-related problems that have been recognized worldwide. Study of the epidemiological determinants of HAC and AUD in different sociocultural contexts could inform hypotheses about the etiology or the consequences of alcohol-related problems.

Objectives: We assessed the prevalence and associations of HAC and AUD with sociodemographic variables adjusting for common mental disorders in a representative sample of the general population of Greece (N = 4894 participants). The period of data collection just preceded the emergence of the financial crisis in Greece.

Results: The majority of the population did not report HAC, AUD or abstinence from alcohol. HAC was reported by 12.7% (95% CI: 11.8-13.6) of the population while 3.1% (95% CI: 2.7-3.6) met criteria for AUD. Younger age, divorce, lower educational level, living in an urban area, physical health problems, and smoking were associated with a higher prevalence of both conditions. Presence of severe financial difficulties and never married family status were associated with a higher prevalence of HAC but not AUD. HAC was associated with nonspecific psychiatric morbidity while AUD was associated with more specific psychiatric disorders. Conclusion/Importance. Both alcohol-related problems are frequent in the general population and have common and distinct determinants. The comparison between the findings of our study and those of similar studies during or after the period of financial austerity in Greece, would offer the opportunity to assess the possible effects of changes in the economical context in the determinants of alcohol-related problems.

Brain imaging studies have identified multiple neuronal networks and circuits in the brain with altered functioning in patients with schizophrenia. These include the hippocampo-cerebello-cortical circuit, the prefrontal-thalamic-cerebellar circuit, functional integration in the bilateral caudate nucleus, and the salience network consisting of the insular cortex, parietal anterior cingulate cortex, and striatum, as well as limbic structures. Attributing psychotic symptoms to any of these networks in schizophrenia is confounded by the disruption of these networks in schizophrenic patients. Such attribution can be done with isolated dysfunction in any of these networks with concurrent psychotic symptoms. We present the case of a patient who presents with new-onset hallucinations and a stroke in brain regions similar to the salience network (insular cortex, parietal cortex, and striatum). The implication of these findings in isolating psychotic symptoms of the salience network is discussed.