Browsing by Author "Getachew Meron"

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    Demographic, Clinical, and Treatment Profiles of Newly Diagnosed Patients with Bipolar Disorder in Amanuel Mental Specialized Hospital: A Retrospective Chart Review
    (Addis Abeba University, 2020-12) Asefa Abdulselam; Fekadu Abebaw ; Getachew Meron
    Background :Bipolar disorders are among the most common severe mental illnesses. They are characterized by episodes of mania, hypomania and depression of various severity. Worldwide the prevalence of the disorder is similar with little differences across ethnicity, gender or socioeconomic status.Antipsychotics, mood stabilizers and lithium are among the medications used to treat the disorder. Objective :The study aimed to identify and describe the clinical profiles, demographic characteristics, and treatment trends of newly diagnosed patients with bipolar and related disorders. Methodology :The study was conducted at Amanuel Mental Specialized Hospital (AMSH) focusing only on the newly diagnosed patients with bipolar disorders. All newly diagnosed patients with bipolar disorder who visited the hospital from January 1, 2019 – March 30, 2019 were included in the study. All the data were extracted from the charts of the patients. Results: Records of a total of 147 newly diagnosed patients with bipolar disorders were evaluated. The study showed a comparable proportion of male (47.6%) and female (52.4%) participants. The mean age of the patients during their visit to the hospital was 29.57 years with a standard deviationof 11.46 years. Aggressiveness 64(43.5%), urge to be on the move 23(15.6%), difficulty of sleeping 18 (12.2%) were the three most common presenting complaints. From the reviewed 147 records, 144 were shown to be bipolar I disorder and the rest 3 were not labelled at all- a simple“bipolar disorder” was recorded as a diagnosis. Most presented with manic episode with psychotic features (42.2%) followed by psychotic features, and depressive episode with psychotic features.More women (n=14) presented with depressive episodes than men (n=7). A total of 57 patients reported/showed various degrees of suicidality, 29 of them had suicidal ideation, while 26 had attempted suicide. All of the patients were prescribed with orally taken antipsychotics. Three quarter of them were also given mood stabilizing anticonvulsants. 59.2% of the patients were prescribed with a combination of antipsychotics and mood stabilizers. Conclusion:The sociodemographic characteristics found from this research is comparable to other studies around the world. Bipolar I disorder was the prevailing diaagnosis. Most were found to have psychotic features in the study and most had manic episodes at first presentation to the hospital. Most of the patients were administered antipsychotics and required emergency admission.
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    Demographic, Clinical, and Treatment Profiles of Newly Diagnosed Patients with Bipolar Disorder in Amanuel Mental Specialized Hospital: A Retrospective Chart Review
    (Addis Abeba University, 2020-12) Asefa Abdulselam; Fekadu Abebaw ; Getachew Meron
    Background :Bipolar disorders are among the most common severe mental illnesses. They are characterized by episodes of mania, hypomania and depression of various severity. Worldwide the prevalence of the disorder is similar with little differences across ethnicity, gender or socioeconomic status.Antipsychotics, mood stabilizers and lithium are among the medications used to treat the disorder. Objective :The study aimed to identify and describe the clinical profiles, demographic characteristics, and treatment trends of newly diagnosed patients with bipolar and related disorders. Methodology :The study was conducted at Amanuel Mental Specialized Hospital (AMSH) focusing only on the newly diagnosed patients with bipolar disorders. All newly diagnosed patients with bipolar disorder who visited the hospital from January 1, 2019 – March 30, 2019 were included in thestudy. All the data were extracted from the charts of the patients. Results: Records of a total of 147 newly diagnosed patients with bipolar disorders were evaluated. The study showed a comparable proportion of male (47.6%) and female (52.4%) participants. The mean age of the patients during their visit to the hospital was 29.57 years with a standard deviationof 11.46 years. Aggressiveness 64(43.5%), urge to be on the move 23(15.6%), difficulty of sleeping 18 (12.2%) were the three most common presenting complaints. From the reviewed 147 records, 144 were shown to be bipolar I disorder and the rest 3 were not labelled at all- a simple“bipolar disorder” was recorded as a diagnosis. Most presented with manic episode with psychotic features (42.2%) followed by psychotic features, and depressive episode with psychotic features.More women (n=14) presented with depressive episodes than men (n=7). A total of 57 patients reported/showed various degrees of suicidality, 29 of them had suicidal ideation, while 26 had attempted suicide. All of the patients were prescribed with orally taken antipsychotics. Three quarter of them were also given mood stabilizing anticonvulsants. 59.2% of the patients were prescribed with a combination of antipsychotics and mood stabilizers. Conclusion:The sociodemographic characteristics found from this research is comparable to other studies around the world. Bipolar I disorder was the prevailing diagnosis. Most were found to have psychotic features in the study and most had manic episodes at first presentation to the hospital. Most of the patients were administered antipsychotics and required emergency admission.
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    A Dissertation Submitted to the Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University in Partial Fulfillment of the Requirements for the Specialty Certificate in Psychiatry
    (Addis Ababa University, 2017-11) Getachew Meron; Pain Clare
    Introduction:Numerous studies have shown that mental distress is a common problem among medicalstudents. Factors associated varied across studies, however, the negative impact ofmental distress on medical students has been shown to be manifold. Mental distressprofiles may show variation over time, requiring periodic assessments so as to tailorinterventions that best suit the current situation. Objective:The objective of this study is to assess the level of mental distress and associated factorsamong medical students of Addis Ababa University. Methods:A facility-based, cross-sectional, quantitative study was conducted on medical students of Addis Ababa University. Stratified random sampling was employed & data was collected from consenting medical students (preclinical year 1 to internship) using a 2-partstructured, self-administered questionnaire (Part I: Background Data & Part II: The 20-item Self Reporting Questionnaire [SRQ-20] English version). SPSS version 20 was used fordata entry and univariate and multivariate analyses were carried out to assess factorsassociated with mental distress.vi Results:A total of 291 medical students participated in the study. The one-month prevalence of mental distress among medical students of Addis Ababa University was 64.9%, which isnearly double the prevalence 12 years ago. Suicidal ideation was reported by 14.1% of therespondents (6% in the original study). Female sex (AOR=2.187, 95% CI=1.131- 4.231),current feelings of dissatisfaction about having joined Medicine (AOR=2.839, 95%CI=1.278- 6.302) and having experienced a challenging life event in the preceding 30 days(AOR= 3.787 95% CI=1.179- 12.167) were associated independently with greater odds of mental distress. Lifetime substance use (X2= 10.658, df= 1, p=0.001) and currentsubstance use (X2=4.080, df=1, p=0.043) had significant associations with mental distressbut no such association was present in multivariate analysis. Other variables including ageand year of study showed no (significant) association with mental distress in univariate ormultivariate analyses. Conclusion:The study shows that the prevalence of mental distress among medical students of Addis Ababa University is higher than that reported 12 years ago. Continued supportive interventions for medical students and studies of a qualitative nature are recommended.
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    A dissertation submitted to the Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University in partial fulfillment of the requirements for the Specialty Certificate in Psychiatry
    (Addis Ababa University, 2017-11) Getachew Meron; Pain Clare
    Introduction:Numerous studies have shown that mental distress is a common problem among medical students. Factors associated varied across studies, however, the negative impact of mental distress on medical students has been shown to be manifold. Mental distress profiles may show variation over time, requiring periodic assessments so as to tailor interventions that best suit the current situation. Objective:The objective of this study is to assess the level of mental distress and associated factors among medical students of Addis Ababa University. Methods;A facility-based, cross-sectional, quantitative study was conducted on medical students of Addis Ababa University. Stratified random sampling was employed & data was collected from consenting medical students (preclinical year 1 to internship) using a 2-part structured, self-administered questionnaire (Part I: Background Data & Part II: The 20-item Self Reporting Questionnaire [SRQ-20] English version). SPSS version 20 was used for data entry and univariate and multivariate analyses were carried out to assess factors associated with mental distress.vi Results:A total of 291 medical students participated in the study. The one-month prevalence of mental distress among medical students of Addis Ababa University was 64.9%, which is nearly double the prevalence 12 years ago. Suicidal ideation was reported by 14.1% of the respondents (6% in the original study). Female sex (AOR=2.187, 95% CI=1.131- 4.231),current feelings of dissatisfaction about having joined Medicine (AOR=2.839, 95% CI=1.278- 6.302) and having experienced a challenging life event in the preceding 30 days(AOR= 3.787 95% CI=1.179- 12.167) were associated independently with greater odds of mental distress. Lifetime substance use (X2= 10.658, df= 1, p=0.001) and current substance use (X2=4.080, df=1, p=0.043) had significant associations with mental distressbut no such association was present in multivariate analysis. Other variables including age and year of study showed no (significant) association with mental distress in univariate or multivariate analyses. Conclusion:The study shows that the prevalence of mental distress among medical students of Addis Ababa University is higher than that reported 12 years ago. Continued supportive interventions for medical students and studies of a qualitative nature are recommended.
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    Outcomes of Clozapine Treatment in Ethiopia: A Retrospective Study
    (Addis Abeba University, 2020-10) Kebede Mekitew; Getachew Meron; Girma Engida
    Background:- Clozapine is a second-generation antipsychotic drug which was introduced in1961. It has wide clinical utility particularly for patients with treatment-resistant schizophrenia.Prescription of clozapine shows a considerable variation across countries. There is a general delayin its initiation partly because of its adverse effectsunavailability of clozapine and psychiatristattitudes towards the medication. Many studies have investigated clinical characteristics, adverse effect profile and treatment outcomes over time internationally. However, to the best of our knowledge, there is only one institution based study in Ethiopian. Objective: To assess the outcomes of clozapine treatment in five health facilities in Ethiopia. Method: A retrospective chart review was conducted from May to October, 2020 on patients who have been treated with clozapine between 2017 to 2020. Data extraction sheet was used toextract secondary data to assess indications, adverse effects and treatment outcomes of patientstreated with clozapine . SPSS version 25 was used for data entry andanalysis. Results: A total of 84 patients treated with clozapine were recruited and the main indications weretreatment resistant schizophrenia(TRS) n=60 (71%), treatment resistant schizophrenia withtardive dyskinesia (TD) n=13(15.5%) and tardive dyskinesia n=10(11.9%). Seventy two (85.7%) patients had improvement of admission complaints upon discharge. The main improved symptoms were positive psychotic symptoms n=67(79.8%), negative symptoms n=52(61.9%), aggressionn=33(39.3%), suicidal behavior n= 11(13.1%), depressive symptoms n=20(23.8%) andimprovement of cognitive function n= 22(26. 2%). In case of TD patients, a mean AIMS scoreof 17.3 at admission reduced to 5.5 upon discharge. The most common side effects were sedation n=46(54.8%),sialorrhea n=31(36.9),constipation n=24(28.6%),weight gain n=18(21.4%) andtransient hematological abnormalities n=14(16.7%). Serious side effect found were seizure n=4(4.8%), persistent tachycardia n= 2(2.3%) and myocarditis n= 1(1.2%) Conclusion and Recommendation:Clozapine was indicated for treatment of TRS and TD, which resulted in improvement ofadmission complaints. Most of the side effects were tolerable and manageable. The main identified reason for discontinuation of the medication was unavailability. Having seen the indications,tolerable adverse effects and better treatment outcomes of clozapine, we recommend that patientswith TRS and TD to be enrolled in clozapine treatment as soon as treatment-resistance isconfirmed.
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    Outcomes of Clozapine Treatment in Ethiopia: A Retrospective Study
    (Addis Abeba University, 2020-10) Kebede Mekitew; Getachew Meron; Girma Engida
    Background:- Clozapine is a second-generation antipsychotic drug which was introduced in1961. It has wide clinical utility particularly for patients with treatment-resistant schizophrenia.Prescription of clozapine shows a considerable variation across countries. There is a general delayin its initiation partly because of its adverse effects, unavailability of clozapine and psychiatristattitudes towards the medication. Many studies have investigated clinical characteristics, adverseeffect profile and treatment outcomes over time internationally. However, to the best of our knowledge, there is only one institution based study in Ethiopian. Objective: To assess the outcomes of clozapine treatment in five health facilities in Ethiopia. Method: A retrospective chart review was conducted from May to October, 2020 on patientswho have been treated with clozapine between 2017 to 2020. Data extraction sheet was used to extract secondary data to assess indications, adverse effects and treatment outcomes of patients treated with clozapine . SPSS version 25 was used for data entry and analysis. Results: A total of 84 patients treated with clozapine were recruited and the main indications weretreatment resistant schizophrenia(TRS) n=60 (71%), treatment resistant schizophrenia withtardive dyskinesia (TD) n=13(15.5%) and tardive dyskinesia n=10(11.9%). Seventy two (85.7%) patients had improvement of admission complaints upon discharge. The main improved symptomswere positive psychotic symptoms n=67(79.8%), negative symptoms n=52(61.9%), aggressionn=33(39.3%), suicidal behavior n= 11(13.1%), depressive symptoms n=20(23.8%) and improvement of cognitive function n= 22(26. 2%). In case of TD patients, a mean AIMS score of 17.3 at admission reduced to 5.5 upon discharge. The most common side effects were sedationn=46(54.8%),sialorrhea n=31(36.9),constipation n=24(28.6%),weight gain n=18(21.4%) and transient hematological abnormalities n=14(16.7%). Serious side effect found were seizure n=4(4.8%), persistent tachycardia n= 2(2.3%) and myocarditis n= 1(1.2%) Conclusion and Recommendation:Clozapine was indicated for treatment of TRS and TD, which resulted in improvement ofadmission complaints. Most of the side effects were tolerable and manageable. The main identified reason for discontinuation of the medication was unavailability. Having seen the indications,tolerable adverse effects and better treatment outcomes of clozapine, we recommend that patients with TRS and TD to be enrolled in clozapine treatment as soon as treatment-resistance is confirmed.
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    Prevalence of Depressive Symptoms among HearingImpaired Students of Addis Ababa University: A Cross- sectional Study
    (Addis Ababa University, 2022-03) Damtew Rekik; Getachew Meron; Araya Mesfin
    Introduction: Being Deaf or Hard of Hearing (DHH) has been linked withincreased social isolation, negative self-concept, low perceived competence and stigma, higher prevalence of physical and sexual abuse among DHH youth andchildren.(Knutson, Johnson, and Sullivan 2004)(Mekonnen et al. 2016). This alcan predispose DHH individuals to depressive disorders. Furthermore, thcommunication barriers create a challenge in the evaluation and treatment omental health conditions of DHH individuals. Objective: The study aims to study the prevalence of depressive symptomamong hearing impaired students in AAU. Methods: An institution based cross-sectional study was done to assess thprevalence of depressive symptoms in all DHH students of Addis AbabUniversity (AAU) from August 9- October 11, 2021 using the Patient HealthQuestionnaire-9 (PHQ-9). Data cleaning and analysis with descriptive statisticwere done using SPSS version 26. Results; 138 out of 142 students responded to the study. The prevalence odepressive symptoms was found to be 42%. The severity level of depression based on the PHQ-9 scoring was found to be 1.4%, 26.8%, 9.4% and 4.3% fominimal, mild, moderate and severe depressive symptoms Conclusion; The prevalence of depressive symptoms is higher than thresults of hearing students done at Addis Ababa, Debrebirhan, Haramaya and Jimma Universities. This study calls for having further studies to know more about the mental health service needs of DHH individuals.
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    Prevalence of Depressive Symptoms among HearingImpaired Students of Addis Ababa University: A Cross- sectional Study
    (Addis Ababa University, 2022-03) Damtew Rekik; Getachew Meron; Araya Mesfin
    Introduction: Being Deaf or Hard of Hearing (DHH) has been linked withincreased social isolation, negative self-concept, low perceived competence and stigma, higher prevalence of physical and sexual abuse among DHH youth andchildren.(Knutson, Johnson, and Sullivan 2004)(Mekonnen et al. 2016). This alcan predispose DHH individuals to depressive disorders. Furthermore, thcommunication barriers create a challenge in the evaluation and treatment omental health conditions of DHH individuals. Objective: The study aims to study the prevalence of depressive symptomamong hearing impaired students in AAU. Methods: An institution based cross-sectional study was done to assess thprevalence of depressive symptoms in all DHH students of Addis Abab University (AAU) from August 9- October 11, 2021 using the Patient HealthQuestionnaire-9 (PHQ-9). Data cleaning and analysis with descriptive statisticwere done using SPSS version 26. Results; 138 out of 142 students responded to the study. The prevalence odepressive symptoms was found to be 42%. The severity level of depressionbased on the PHQ-9 scoring was found to be 1.4%, 26.8%, 9.4% and 4.3% fominimal, mild, moderate and severe depressive symptoms Conclusion; The prevalence of depressive symptoms is higher than thresults of hearing students done at Addis Ababa, Debrebirhan, Haramaya andJimma Universities. This study calls for having further studies to know more about the mental health service needs of DHH individuals.