Population level mental distress in rural Ethiopia

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dc.contributor.authorFekadu, Abebawen_ZA
dc.contributor.authorMedhin, Girmayen_ZA
dc.contributor.authorSelamu, Medhinen_ZA
dc.contributor.authorHailemariam, Majien_ZA
dc.contributor.authorAlem, Atalayen_ZA
dc.contributor.authorGiorgis, Tedlaen_ZA
dc.contributor.authorBreuer, Ericaen_ZA
dc.contributor.authorLund, Cricken_ZA
dc.contributor.authorPrince, Martinen_ZA
dc.contributor.authorHanlon, Charlotteen_ZA
dc.date.accessioned2015-11-27T09:29:17Z
dc.date.available2015-11-27T09:29:17Z
dc.date.issued2014en_ZA
dc.description.abstractBACKGROUND: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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.en_ZA
dc.identifier.apacitationFekadu, A., Medhin, G., Selamu, M., Hailemariam, M., Alem, A., Giorgis, T., ... Hanlon, C. (2014). Population level mental distress in rural Ethiopia. <i>BMC Psychiatry</i>, http://hdl.handle.net/11427/15378en_ZA
dc.identifier.chicagocitationFekadu, Abebaw, Girmay Medhin, Medhin Selamu, Maji Hailemariam, Atalay Alem, Tedla Giorgis, Erica Breuer, Crick Lund, Martin Prince, and Charlotte Hanlon "Population level mental distress in rural Ethiopia." <i>BMC Psychiatry</i> (2014) http://hdl.handle.net/11427/15378en_ZA
dc.identifier.citationFekadu, A., Medhin, G., Selamu, M., Hailemariam, M., Alem, A., Giorgis, T. W., ... & Hanlon, C. (2014). Population level mental distress in rural Ethiopia. BMC psychiatry, 14(1), 194.en_ZA
dc.identifier.ris TY - Journal Article AU - Fekadu, Abebaw AU - Medhin, Girmay AU - Selamu, Medhin AU - Hailemariam, Maji AU - Alem, Atalay AU - Giorgis, Tedla AU - Breuer, Erica AU - Lund, Crick AU - Prince, Martin AU - Hanlon, Charlotte AB - BACKGROUND: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. METHODS: 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. RESULTS: 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. CONCLUSION: 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. DA - 2014 DB - OpenUCT DO - 10.1186/1471-244X-14-194 DP - University of Cape Town J1 - BMC Psychiatry LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 T1 - Population level mental distress in rural Ethiopia TI - Population level mental distress in rural Ethiopia UR - http://hdl.handle.net/11427/15378 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15378
dc.identifier.urihttp://dx.doi.org/10.1186/1471-244X-14-194
dc.identifier.vancouvercitationFekadu A, Medhin G, Selamu M, Hailemariam M, Alem A, Giorgis T, et al. Population level mental distress in rural Ethiopia. BMC Psychiatry. 2014; http://hdl.handle.net/11427/15378.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentCentre for Public Mental Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2014 Fekadu et al.; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceBMC Psychiatryen_ZA
dc.source.urihttp://www.biomedcentral.com/bmcpsychiatry/en_ZA
dc.subject.otherCommon mental disordersen_ZA
dc.subject.otherPsychosocial distressen_ZA
dc.subject.otherMental distressen_ZA
dc.subject.otherSuicidalityen_ZA
dc.subject.otherHazardous alcohol useen_ZA
dc.subject.otherWellbeingen_ZA
dc.subject.otherDeveloping countryen_ZA
dc.subject.otherAfrica South of the Saharaen_ZA
dc.subject.otherSub-Saharan Africaen_ZA
dc.subject.otherEthiopiaen_ZA
dc.titlePopulation level mental distress in rural Ethiopiaen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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