Lauren C Ng1, Girmay Medhin2, Charlotte Hanlon3,4, Abebaw Fekadu3,4. 1. Department of Psychiatry, Boston University School of Medicine, 720 Harrison Avenue, Boston, MA, 02118, USA. laurenng@bu.edu. 2. Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia. 3. Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. 4. Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Abstract
PURPOSE: To investigate exposure to traumatic and stressful events and their association with depression, suicidal ideation, and alcohol abuse in people with severe mental disorder (SMD) in Ethiopia. METHODS: As part of the Programme for Improving Mental health carE, 300 people with SMD (84% primary psychosis, 11% bipolar disorder, and 16% depression with psychotic features) in a rural district were identified by psychiatric nurses. A cross-sectional assessment included clinical characteristics, experience of being restrained, exposure to stressful events as measured by an adapted version of the List of Threatening Experiences scale, traumatic events as measured by endorsement of 13 locally relevant potentially traumatic events that occurred since the onset of the participant's mental illness, depression symptoms measured by the Patient Health Questionnaire, the Suicidal Behavior Module of the Composite International Diagnostic Interview, and hazardous drinking which was calculated as a sum score of eight or higher on the Alcohol Use Disorders Identification Test. RESULTS: Almost half of participants reported being restrained since becoming ill, which was associated with more suicidal ideation and less hazardous drinking. More than one-third experienced traumatic events since becoming ill, including being assaulted, beaten, or raped. Exposure to traumatic events was associated with hazardous drinking. CONCLUSIONS: In this rural Ethiopian setting, people with SMD experienced high levels of traumatic and stressful events which were associated with co-morbid conditions. Greater attention needs to be given to trauma prevention and integration of treatment for trauma sequelae in efforts to expand integrated mental health care.
PURPOSE: To investigate exposure to traumatic and stressful events and their association with depression, suicidal ideation, and alcohol abuse in people with severe mental disorder (SMD) in Ethiopia. METHODS: As part of the Programme for Improving Mental health carE, 300 people with SMD (84% primary psychosis, 11% bipolar disorder, and 16% depression with psychotic features) in a rural district were identified by psychiatric nurses. A cross-sectional assessment included clinical characteristics, experience of being restrained, exposure to stressful events as measured by an adapted version of the List of Threatening Experiences scale, traumatic events as measured by endorsement of 13 locally relevant potentially traumatic events that occurred since the onset of the participant's mental illness, depression symptoms measured by the Patient Health Questionnaire, the Suicidal Behavior Module of the Composite International Diagnostic Interview, and hazardous drinking which was calculated as a sum score of eight or higher on the Alcohol Use Disorders Identification Test. RESULTS: Almost half of participants reported being restrained since becoming ill, which was associated with more suicidal ideation and less hazardous drinking. More than one-third experienced traumatic events since becoming ill, including being assaulted, beaten, or raped. Exposure to traumatic events was associated with hazardous drinking. CONCLUSIONS: In this rural Ethiopian setting, people with SMD experienced high levels of traumatic and stressful events which were associated with co-morbid conditions. Greater attention needs to be given to trauma prevention and integration of treatment for trauma sequelae in efforts to expand integrated mental health care.
Entities:
Keywords:
Alcoholism; Depression; Life change events; Post-traumatic; Psychotic disorders
Authors: Laura A Bajor; Zongshan Lai; David E Goodrich; Christopher J Miller; Robert B Penfold; Hyungjin Myra Kim; Mark S Bauer; Amy M Kilbourne Journal: J Affect Disord Date: 2012-09-27 Impact factor: 4.839
Authors: Lisa A Duke; Daniel N Allen; Sylvia A Ross; Gregory P Strauss; Jason Schwartz Journal: J Clin Exp Neuropsychol Date: 2010-03-02 Impact factor: 2.475
Authors: T Shibre; A Negash; G Kullgren; D Kebede; A Alem; A Fekadu; D Fekadu; G Madhin; L Jacobsson Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2001-06 Impact factor: 4.328
Authors: Philip S Wang; Sergio Aguilar-Gaxiola; Jordi Alonso; Matthias C Angermeyer; Guilherme Borges; Evelyn J Bromet; Ronny Bruffaerts; Giovanni de Girolamo; Ron de Graaf; Oye Gureje; Josep Maria Haro; Elie G Karam; Ronald C Kessler; Viviane Kovess; Michael C Lane; Sing Lee; Daphna Levinson; Yutaka Ono; Maria Petukhova; José Posada-Villa; Soraya Seedat; J Elisabeth Wells Journal: Lancet Date: 2007-09-08 Impact factor: 79.321
Authors: T Shibre; D Kebede; A Alem; A Negash; N Deyassa; A Fekadu; D Fekadu; L Jacobsson; G Kullgren Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2003-01 Impact factor: 4.328
Authors: Crick Lund; Mark Tomlinson; Mary De Silva; Abebaw Fekadu; Rahul Shidhaye; Mark Jordans; Inge Petersen; Arvin Bhana; Fred Kigozi; Martin Prince; Graham Thornicroft; Charlotte Hanlon; Ritsuko Kakuma; David McDaid; Shekhar Saxena; Dan Chisholm; Shoba Raja; Sarah Kippen-Wood; Simone Honikman; Lara Fairall; Vikram Patel Journal: PLoS Med Date: 2012-12-27 Impact factor: 11.069
Authors: Jeremy C Kane; Peter Ventevogel; Paul Spiegel; Judith K Bass; Mark van Ommeren; Wietse A Tol Journal: BMC Med Date: 2014-11-24 Impact factor: 8.775