Psychiatry

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    Adaptation of Amharic Version of Vanderbilt Attention Deficit and Hyperactivity Disorder Diagnostic Parenting Scale In Addis Ababa, Ethiopia
    (Addis Ababa University, 2025-06-12) Ashenafi Tareku; Awoke Mihretu; Eyerusalem Solomon
    Background: Worldwide ADHD is the common neurodevelopmental disorder which is commonly diagnosed in children and adolescents with a significant global prevalence. In Ethiopia VADPRS and the scales full psychometric properties were not yet conducted. Adapting and validating screening tool for ADHD is crucial for facilitating early identification, assessing the severity of psychopathology, and guiding targeted interventions in contexts similar to the current study setting in Ethiopia Methods: A Pilot study was used to adapt VADPRS into the Amharic language. A purposive sampling technique was implemented to gather preliminary data for the study, with the sample size is 26 participants. To assess the clarity, comprehension, and cultural relevance cognitive interviewing was conducted and this data also helps to assess and determine face validity. To evaluate content validity of the experts was invited to review and rate the translated version. To determine internal consistency of the tool Cronbach alpha was used. Objectives: The main objective of this study was to adapt and evaluate the preliminary psychometric properties of the Vanderbilt Attention Deficit Hyperactive Disorder Diagnostic Parent Rating Scale (VADPRS) into Amharic language. Result: The cognitive interviewing conducted in 9 participants shows 37 items in the tool get the highest values this indicate that these items have linguistic clarity and cultural appropriateness and also the tool shows high face validity. The tools average content validity index was found 0.91 clarity, 0.93 cultural appropriateness and 0.94 relevance, these results meet the recommended threshold for content validity. Additionally, the total scale shows α = .95 value which indicates acceptable internal consistency. Conclusion: The adapted Amharic version of the VADPRS has demonstrated strong face and content validity in assessing ADHD in Ethiopian children. Recommendation: Conduct validation studies to determine the psychometrics properties of the adapted Amharic version of ADHD.
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    Mental Illness Perspectives and Healing Practices among Muslim Healers: Addis Ababa, Ethiopia
    (Addis Ababa University, 2025-06-12) Ekram Temkin; Enigda Girma; Fikir Getaneh
    Background: perception and treatment approaches toward mental illness differ across cultures, with traditional and religious healing practices playing a significant role in many communities. In Muslim societies religious healing practices influence how mental illness is perceived, diagnosed and managed. Despite their extensive use and huge influence, the perspectives of Muslim healers toward mental illness and religious healing practices remain unexplored. Objectives: The study aims to explore how Muslim healers understand and perceive mental illness. Specifically; the study aims to investigate the diagnostic and treatment approaches used by Muslim healers. Methods: A generic qualitative research method was used to explore the perception of Muslim healers regarding mental illness. Eight participants were recruited using purposive a snowballing sampling. Data were collected through semi-structured interviews, and then transcribed verbatim, translated into English. Thematic analysis was employed to identify recurring themes Results: From the data obtained five core themes emerged, including understanding and conceptualization of mental and spiritual illness, beliefs about the causes of mental and spiritual illness, assessment practices to identify illness, healing approaches and methods, and collaboration between health care practitioners. Finding highlights the centrality of spiritual beliefs in healers understanding and treating mental illness, despite some openness to psychological explanations, spiritual methods were preferred. Conclusion: The study highlights the significant role of Muslim healers in mental health care and indicates the need for culturally sensitive collaboration between spiritual and biomedical /psychological system to improve access and outcomes.
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    Marital Dynamics in the Face of Serious Mental Illness: Exploring Spousal Experiences, Addis Ababa, Ethiopia: Qualitative Study
    (Addis Ababa University, 2025-06-12) Hanna Beyene; Wubalem Fekadu; Asnake Limenhe
    Background: Serious mental illnesses (SMI) including schizophrenia, bipolar disorder, and major depressive disorder can severely disrupt marriage. In Ethiopia, limited mental health support and stigma future complicated how couples navigate marriage and stigma further complicate how couples navigate marriage in the face of SMI. While the impact of SMI on marital adjustment is acknowledged in global literature, little is known about how these challenges unfold in the Ethiopian context. Objectives: The study aimed to explore the marital dynamic and lived experience of couples managing SMI, with particular attention to emotional connection, communication, role functioning, and coping. Method: A descriptive phenomenological qualitative study was employed. Twelve participants (people with SMI and spouses of people with SMI) were recruited through purposive sampling from Amanuel Mental Specialized Hospital and Tikur Anbessa specialized hospital in Addis Ababa. Data were collected through in-depth semi-structured interviews and analyzed thematically. Result: Three major themes emerged: (1) perception and experience of marriage, (2) emotional and relational life within the marriage, and (3) disruptions caused by the SMI. Spouses reported strained marital adjustment, especially when their partner ‘s low self-efficacy limited emotional reciprocity and role sharing. Challenges included sexual dissatisfaction, parenting strain, financial hardship, and social stigma. Coping strategies ranged from spiritual practice to family role adaptation and efforts to maintain stability for the children. Conclusion: SMI places significant strain on marital relationships, challenging both emotional and structural aspects of marriage. Interventions should address communication, self-efficacy, and broader support systems to strengthen marital stability in families affected by SMI.
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    Facilitators and Barriers of Substance Use Disorders Treatment In Addis Ababa, Ethiopia: A Qualitative Study
    (Addis Ababa University, 2025-04-01) Seadedin Mohammedali; Solomon Teferra,; Awoke Mihretu
    Back ground: Substance use disorders (SUDs) are becoming a significant public health concern in the Globe and particularly in Ethiopia. The problem particularly affects the youth resulting in undesirable health consequences, increased risk for disabilities, and loss of productivity. Despite the significant burden of SUDs, treatment service utilization remains poor among individuals with SUDs. The reason for the low utilization is not fully explored and understood. Objective: This study explored the facilitators and barriers to substance use disorders treatment from the perspectives of service users and care givers from both formal and informal treatment settings in Addis Ababa, Ethiopia. Methods: A descriptive qualitative study was conducted using in-depth interviews with 18 participants receiving treatment for SUDs at Amanuel Mental Specialized Hospital, Zewditu Memorial Hospital, Ferdows Cultural Medical and Rehabilitation Center and St. Urael holy water site. Participants were selected through purposive sampling. Frame work analysis was applied using the Socio-ecological model to categorize facilitators and barriers at different levels. Findings: Facilitators of treatment included personal motivation, prayer, positive family influence, former service users’ role in treatment seeking, good service provision by providers, and spiritually and culturally oriented treatment approaches. Barriers include include negative family and community influence on treatment access, stigma associated with mental health hospitalization, easy access to substances in treatment facilities and within communities, high treatment cost, lack of insurance coverage and limited-service availability. Conclusion: Our findings are crucial for understanding the context of substance use interventions, providing valuable insights to inform future intervention design.
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    Mental Health Care for Children with A History of Sexual Abuse: Perspectives from Parents and Clinicians
    (Addis Ababa Universtiy, 2025) Dawit Mesfin; Azeb Asaminew; Fikirte Girma
    Compared to their peers, CSA survivors had higher rates of internalizing, externalizing, and thought disorders, as well as higher rates of health risk behaviours, systemic inflammation, poor oral health, STDs, high-conflict relationships, benefit use, financial hardship, antisocial behaviour, and cumulative issues across several domains in adulthood. When seeking mental health care, parents of children who have experienced sexual abuse present particular difficulties. They frequently struggle with emotions of shame, guilt, and selfblame, which can make it difficult for them to ask for assistance for their child. Parents may also face obstacles like financial hardships, shame attached to sexual abuse, and restricted access to specialized treatments. Despite the well-established link between childhood sexual abuse and mental health problems, there remains a significant gap in the literature regarding the perspectives of parents and clinicians on mental health care for these children. Parents play a crucial role in advocating for their children's well-being and accessing appropriate services, while clinicians are responsible for providing evidence-based interventions and support. Understanding their perspectives is vital for the development of effective interventions and policies. Exploring the perspectives of parents can shed light on these challenges and inform strategies to enhance their engagement in their child's mental health care. Clinicians, on the other hand, are at the forefront of providing mental health care to children with a history of sexual abuse. Their experiences, knowledge, and attitudes significantly influence the quality of care delivered. However, research on clinicians' perspectives in this domain is limited. Understanding their viewpoints is crucial to identify gaps in knowledge, training, and resources, and to develop targeted interventions to improve the delivery of mental health care for the society. This study aims to fill the existing gap in the literature by exploring the perspectives of parents on mental health care for children with a history of sexual abuse. By examining the challenges, barriers, and opportunities, this research seeks to provide valuable insights into the development of effective interventions and policies.
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    Exploring The Lived Experiences of Soldiers with Combat Exposure in Ethiopia
    (Addis Ababa University, 2025-01-10) Ahlam Abdi; Engida Girma; Ikram Ahmed
    Background: Combat exposure presents profound psychological challenges for soldiers, with long lasting consequences on their mental health. While research has explored PTSD and other mental health issues among military personnel globally, little is known about the subjective experiences of Ethiopian soldiers who have been exposed to combat. This study seeks to fill the gap by exploring the lived experiences of soldiers at Throatlatch Armed Forces Hospital, Addis Ababa Ethiopia. Objectives: This qualitative study aimed to explore the thoughts, emotions and experiences of soldiers with combat exposure, focusing on their experiences before, during and after deployment to the war front. Method: A phenomenological approach was employed to gather an in-depth insight from 5 participants (4 males, 1 female) receiving treatment at Throatlatch Armed Forces Hospital. Semi -structured, individual interviews were conducted in Amharic with the data recorded, transcribed and analyzed using thematic analysis to identify emerging themes. Results: There are four major themes identified reflecting the multifaced nature of combat exposure. These include; impacts on interpersonal relationships, emotional responses, physical impact of injuries, spiritual reflections and future aspirations. Conclusion; This study provides a comprehensive understanding of the psychological impact of combat exposure on Ethiopian soldiers. It highlights the complexity of their experiences, emphasizing the need for culturally sensitive interventions to address the mental health needs of solider returning from combat.
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    Cost-Effectiveness Analysis of Inpatient Versus Outpatient Treatment Centers for Substance Use Disorder in Ethiopia: A Markov model from a Societal Perspective
    (Addis Ababa University, 2025-06-01) Addisu Tsehay; Adane Melka; Anagew Derseh
    Background: Substance use disorders are a growing burden in Ethiopia, accounting for 34% of NCDs burden and higher indirect costs (86%). The treatment of SUD in Ethiopia, which is traditionally facility based, Inpatient (ITC) and outpatient (OTC) interventions are the two treatment modalities, yet their cost-effectiveness remains uncertain. This study aims to evaluate the cost-effectiveness of Inpatient (ITC) versus Outpatient (OTC) treatment for SUD in Ethiopia. Methods: A retrospective cohort study design was used for conducting a full economic evaluation using a Markov model to assess the cost-effectiveness of SUDs treatment at inpatient (ITC) and outpatient (OTC) treatment centers in Addis Ababa, Ethiopia. A total of 282 SUD patients aged 18 and above was selected by simple random sampling. A bottom-up ingredient micro costing approach was employed to collect a relevant cost data. The primary cost and effectiveness data were collected from inpatient (ITC), outpatient (OTC) treatment centers and patient interviews to inform the Markov Model. Costs were evaluated from a societal perspective, and effectiveness was measured in terms of DALY averted, with both costs and effects discounted at 3%. The model, developed in Microsoft Excel, included six health states with start age of 18, and a one-year cycle length with a lifetime horizon. Data entry and analysis was also undertaken using Microsoft Excel. Caregiver costs were excluded due to data reliability concerns. Results: The estimated life time costs of SUD treatment was USD 33,626 for ITC and USD 27,036 for OTC. The Average Cost Effectiveness Ratio (ACER) indicates that USD 102 per DALY averted is required for ITC, while only USD 82 per DALY averted is needed for OTC. In this regard, OTC is deemed the preferred option. The analysis further revealed that SUD treatment at ITC is not a cost-effective, with an ICER of USD 3710 per DALY averted, exceeding Ethiopia’s cost-effectiveness threshold of one to three times the GDP per capita. In contrast, the study identified SUD treatment at OTC as a cost-effective alternative. Conclusion: The SUD treatment in Ethiopia is associated with a significant financial burden. While outpatient care (OTC) is more cost-effective than inpatient (ITC), it remains largely inaccessible and unaffordable. Integrating SUD services into primary health care could enhance access and reduce costs, with specialized care reserved for severe and complex cases.
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    Internet Addiction Among High School Students in Arada Sub City, Addis Ababa, Ethiopia: A Cross-Sectional Study
    (Addis Ababa University, 2025-06-01) Rehana Abdurahman; Yonas Bahiretibeb; Wubalem Fekadu
    Internet addiction is defined as “excessive and uncontrollable use of the internet, resulting in psychological distress and functional impairment”. While internet offers numerous advantages that encourage frequent use, it can also lead to significant negative consequences, especially among adolescents. Adolescents are specifically exposed due to their developmental stage, increased accessibility to digital technology, and susceptibility to peer influence. Factors directly and indirectly related to the individual, including mental health status and family environment, may contribute to the risk of internet addiction. Despite the growing concern globally, there is limited data on the extent and related factors of internet addiction among adolescents in Ethiopia. This study aimed to assess the prevalence of internet addiction and its associated factors among high school students in Arada sub-city, Addis Ababa, Ethiopia. A school-based cross-sectional study was conducted among 879 students enrolled in grade 9 to 11 in both public and private high schools. A multistage sampling technique was used to select study participants. Data were collected using a structured, self-administered questionnaire. Descriptive statistics summarized the data. Binary logistic regression was used to identify factors associated with internet addiction followed by multivariable logistic regression model. The overall prevalence of internet addiction was 53.1%. Among the students, 29.9% exhibited mild addiction, 21.8% moderate addiction, and 1.6% severe addiction. Additionally, 30% of the students were screened positive for depression. Multivariable logistic regression analysis revealed that being in Grade 10, daily internet use of 4–6 hours, using the internet during sleep and meal times, lack of parental control over the content accessed online, and the presence of depressive symptoms were significantly associated with internet addiction. The study highlights a high prevalence of internet addiction among adolescents. This study has some limitations that should be considered when interpreting the findings. The cross-sectional design limits the ability to establish causal relationships between internet addiction and associated factors. Additionally, the reliance on self-reported data may introduce reporting bias, as participants might underreport or over report their internet use and psychological symptoms. The study was also conducted in a single sub-city, which may limit the generalizability of the results to adolescents in other sub-city of Addis Ababa. The findings underscore the importance of addressing internet addiction as a public health concern among adolescents in Ethiopia. Targeted, context-specific interventions are urgently needed to reduce internet addiction and mitigate its psychological impacts. These may include school-based awareness programs, promoting healthy digital habits, enhancing parental supervision, and integrating mental health support services. Further research using longitudinal designs and broader geographic samples is recommended to explore causal relationships and inform evidence-based prevention and intervention strategies tailored to the Ethiopian context.
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    Exploring the Experience of Electro-Convulsive Therapy (ECT) Among Service Users at Amanuel Mental Specialized Hospital
    (Addis Ababa University, 2025-02-01) Bethelhem Zerihun; Wubalem Fekadu; Beakal Amare; Azeb Asaminew
    Background፡- Electroconvulsive therapy is a treatment option for serious mental illness. However, little is known about service users’ experiences with regarding ECT in Ethiopia. Objectives፡- To explore the experience of people who get ECT treatment and their recommendations for future improvement. Methods፡- The study used a qualitative phenomenological descriptive approach to explore the experience of service users receiving ECT at Amanuel Mental Specialized Hospital in Addis Ababa. The study included nine participants who had received ECT within the past year, selected through purposive sampling to ensure diverse experiences. Data were collected through semi structured in-depth interviews, conducted in Amharic, and analyzed thematically using Open Code version 10. Ethical approval was obtained and confidentiality was maintained. The discussions held with the supervisor ensured the data quality. Results; In the thematic analysis our theme were developed; (1) Knowledge about ECT and consent process, where many participants lacked prior knowledge ECT, had limited involvement in decision-making, and received minimal information from healthcare providers. (2) Journey through ECT treatment; participants shared their experiences from preparation to post-ECT care. They appreciated the organized preparation and post-ECT care though some faced anxiety, long wait times and challenges related to the procedure. (3) Perspective on ECT, where most found ECT beneficial, noting improvements in mental health, sleep, and social engagement. Some experienced side effects like forgetfulness or temporary physical discomfort but found them manageable. (4) Recommendations for ECT, Suggestions included providing more pre-treatment information, increasing ECT room to minimize waiting times, and ensuring gender-specific ECT rooms. Conclusions; This study examined the experience of individuals undergoing ECT, focusing on informed consent, experience of each step of the procedure, perceptions and attitudes. It found that many participants lacked prior knowledge of ECT, but found it beneficial treatment. Family and healthcare support played key roles in treatment acceptance. Participants suggested improving ECT services
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    Facilitators and Barriers of Substance use Disorders Treatment in Addis Ababa, Ethiopia: A Qualitative Study
    (Addis Ababa University, 2025-04-01) Seadedin Mohammedali; Solomon Teferra; Awoke Mihretu
    Back ground: Substance use disorders (SUDs) are becoming a significant public health concern in the Globe and particularly in Ethiopia. The problem particularly affects the youth resulting in undesirable health consequences, increased risk for disabilities, and loss of productivity. Despite the significant burden of SUDs, treatment service utilization remains poor among individuals with SUDs. The reason for the low utilization is not fully explored and understood. Objective: This study explored the facilitators and barriers to substance use disorders treatment from the perspectives of service users and care givers from both formal and informal treatment settings in Addis Ababa, Ethiopia. Methods: A descriptive qualitative study was conducted using in-depth interviews with 18 participants receiving treatment for SUDs at Amanuel Mental Specialized Hospital, Zewditu Memorial Hospital, Ferdows Cultural Medical and Rehabilitation Center and St. Ureal holy water site. Participants were selected through purposive sampling. Frame work analysis was applied using the Socio-ecological model to categorize facilitators and barriers at different levels. Findings: Facilitators of treatment included personal motivation, prayer, positive family influence, former service users’ role in treatment seeking, good service provision by providers, and spiritually and culturally oriented treatment approaches. Barriers include in clude negative family and community influence on treatment access, stigma associated with mental health hospitalization, easy access to substances in treatment facilities and within communities, high treatment cost, lack of insurance coverage and limited-service availability. Conclusion: Our findings are crucial for understanding the context of substance use interventions, providing valuable insights to inform future intervention design.
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    Prevalence of Test Anxiety and Associated Factors among Addis Ababa University Graduating Students: Cross-Sectional Study
    (Addis Ababa University, 2024-10-13) Adamu Gudina; Wubalem Fekadu
    Introduction: Test anxiety is a psychological and emotional factor that affects students. Studies about test anxiety, including previous research in Ethiopia, have primarily focused on medical and health science students, leaving a gap in understanding test anxiety across fields. Objective: To investigate the prevalence of test anxiety and identify associative factors with it among Addis Ababa University final-year undergraduate (graduating) students. Method: A cross-sectional research and stratified random sampling techniques were utilized to select a sample of participants. Test anxiety was assessed by the Westside Test Anxiety Inventory. Oslo Social Support Scale-3 was utilized to measure social support. The Rosenberg Self-Esteem Scale was utilized to measure self-esteem. GAD-7 utilized to measure anxiety level, and questionnaires developed by the researcher after reviewing different literature to measure students` perceptions about exit exam, course load, and the new curriculum. Data were analyzed using the SPSS 26. To identify associative factors from multivariable data, ordinal logistic regression analysis was performed. Result: A total of 380 students participated. Of these, the prevalence of test anxiety is 50.5% (95% CI: 45.4-55.7). The most common symptoms found in this study were: wandering thoughts during exams (28.4%), difficulty concentrating as the exam approached (26.6%), worrying about remembering material (24.7%), and fear of poor performance or failure (18.5%). In this finding 20.8% of participants had low self-esteem, 31.3% had poor social support, and 5.0% of participants had severe anxiety levels. This study found multiple factors that are significantly associated with high test anxiety. The result reported that social science field of study (AOR: 1.96, 95% CI: 1.29-2.98), minimal and mild anxiety level (AOR: 0.34, 95% CI: (0.11, 0.97) respectively, students` positive and neutral perception about exit exams, course load and new curriculum (AOR: 0.18, 95% CI: 0.10-0.33), and (AOR: 0.33, 95% CI: 0.21-0.54) respectively were most significantly associated with test anxiety p-value < 0.05. Conclusion: Test anxiety was a significant problem among Addis Ababa University final-year undergraduate (graduating) students. The most often linked associated factors for test anxiety were perception, and field of study. This result emphasizes the necessity of focused intervention to address particular issues and lessen test anxiety. Key words: Graduating students, test/exams, and test anxiety
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    Prevalence and Associated Factors of Sexual Dysfunction in Patients with Depressive Disorders Receiving Outpatient Care in Hospitals in Addis Ababa, Ethiopia
    (Addis Ababa University, 2024-02-23) Azeb Solomon; Engida Girma
    Background: Depression is a prevalent mental health illness that significantly affects sexual function in both men and women. The purpose of this study was to investigate how common sexual dysfunction is in people with depressive illnesses and factors that are contributing to it. Methods: A cross sectional study with a sample size of 385 was carried out using consecutive sampling. The information was gathered using a structured questionnaire. Socio demographic questioners, CSFQ and clinical information extraction tool was employed in combination to determine sexual dysfunction prevalence and associated factors. SPSS version 26 was used to enter, clean and run statistical analysis. Results: majority were female (58.7%), aged 18-30 (40%), and married (46.5%). Occupational diversity included 34% in private work and 27.8% employed. Educational attainment was high (91.9% attended school, 47% completed high school). Among the depressive disorders, most participants were diagnosed with major depressive disorder (86%) and took medications, with fluoxetine (61.1%) and amitriptyline (25.1%) common. Sexual dysfunction prevalence was higher in males (88.7%) than females (81.4%), with pleasure, desire, orgasmic and arousal disorder prevalent in males and pleasure and arousal disorders in females. Factors like age, sex, occupation, living arrangement, marital disharmony/relational problem and comorbid medical conditions showed significant associations. Conclusion: The study finds that a significant proportion of individuals with depressive illnesses have sexual problems, with notable gender differences and associated factors such as age, sex, occupation, living arrangement, marital disharmony/relational problem and comorbid medical conditions. For a more successful and inclusive approach, integrating open and non-judgmental discussions about sexual health into routine psychiatric evaluations, tailoring interventions based on socio-demographic factors and recognizing the bidirectional link between depression and sexual dysfunction, while considering cultural influences is recommended.
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    Conceptualization and Experience of Expressed Emotion among People with Schizophrenia and their Caregivers; Qualitative Study
    (Addis Ababa University, 2024-03-23) Estifanos Endalamaw; Wubalem Fekadu
    Background- Schizophrenia and schizoaffective disorder are psychotic disorders and severe mental illnesses manifested by positive and negative symptoms. High expressed emotion, which comprised of criticism, emotional oveinvolvement and hostility of care givers towards people with those mental illnesses has been implicated as a reason for frequent relapse. OBJECTIVE- to explore conceptualization and Experience of expressed emotion among people with severe mental health condition and their caregivers at Amanuel mental specialized hospital Sitota center for mental health care and rehabilitation and. METHOD- qualitative study was conducted among 16 participants; eight were from Amanuel Mental Specialized Hospital and others from Sitota center for mental health care and rehabilitation. Half of them were people with severe mental health condition and the remaining eight were caregivers. After in-depth interview conducted and audiotaped the primary author repeatedly listened the interviews and made the transcription and translation. As the conceptualization was mainly related with the well-established conceptualization of expressed emotion, the analysis was guided by established frameworks specially related to expressed emotion and while still being open to any new themes that emerged. RESULT- Six themes were identified; Quality of relationship, hostility; criticism; overinvolvement; warmth and positive regards and coping strategies. Caregivers consider people with SMHC they are caring for are lazy, dependent, lack confidence, and they lack motivation. They also show their criticism and hostility in different circumstances. Participants reported overinvolvement is beyond EOI, and they have justifications for that. People with SMHC also reported different coping strategies, like keeping quiet, decrease level of contact and so on CONCLUSION- the way people conceptualize expressed emotion matches what previous research has shown. Caregiver‟s experience of high expressed emotion correlates with the way they understand the symptoms, their understanding of the illness in general. With this, it will be important to raise awareness about the negative impact of high expressed emotion and develop and evaluate interventions to address these issues as the care givers did not understand the impact of their action possibly by incorporating family psychoeducation plan as a part management.
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    Prevalence of Test Anxiety and Associated Factors among Addis Ababa University Graduating Students: Cross-Sectional Study
    (Addis Ababa University, 2024-10-13) Adamu Gudina; Wubalem Fekadu
    Introduction: Test anxiety is a psychological and emotional factor that affects students. Studies about test anxiety, including previous research in Ethiopia, have primarily focused on medical and health science students, leaving a gap in understanding test anxiety across fields. Objective: To investigate the prevalence of test anxiety and identify associative factors with it among Addis Ababa University final-year undergraduate (graduating) students. Method: A cross-sectional research and stratified random sampling techniques were utilized to select a sample of participants. Test anxiety was assessed by the Westside Test Anxiety Inventory. Oslo Social Support Scale-3 was utilized to measure social support. The Rosenberg Self-Esteem Scale was utilized to measure self-esteem. GAD-7 utilized to measure anxiety level, and questionnaires developed by the researcher after reviewing different literature to measure students` perceptions about exit exam, course load, and the new curriculum. Data were analyzed using the SPSS 26. To identify associative factors from multivariable data, ordinal logistic regression analysis was performed. Result: A total of 380 students participated. Of these, the prevalence of test anxiety is 50.5% (95% CI: 45.4-55.7). The most common symptoms found in this study were: wandering thoughts during exams (28.4%), difficulty concentrating as the exam approached (26.6%), worrying about remembering material (24.7%), and fear of poor performance or failure (18.5%). In this finding 20.8% of participants had low self-esteem, 31.3% had poor social support, and 5.0% of participants had severe anxiety levels. This study found multiple factors that are significantly associated with high test anxiety. The result reported that social science field of study (AOR: 1.96, 95% CI: 1.29-2.98), minimal and mild anxiety level (AOR: 0.34, 95% CI: (0.11, 0.97) respectively, students` positive and neutral perception about exit exams, course load and new curriculum (AOR: 0.18, 95% CI: 0.10-0.33), and (AOR: 0.33, 95% CI: 0.21-0.54) respectively were most significantly associated with test anxiety p-value < 0.05. Conclusion: Test anxiety was a significant problem among Addis Ababa University final-year undergraduate (graduating) students. The most often linked associated factors for test anxiety were perception, and field of study. This result emphasizes the necessity of focused intervention to address particular issues and lessen test anxiety. Key words: Graduating students, test/exams, and test anxiety.
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    Prevalence and Associated Factors of Sexual Dysfunction in Patients with Depressive Disorders Receiving Outpatient Care in Hospitals in Addis Ababa, Ethiopia
    (Addis Ababa University, 2024-04-19) Azeb Solomon; Engida Girma
    Background: Depression is a prevalent mental health illness that significantly affects sexual function in both men and women. The purpose of this study was to investigate how common sexual dysfunction is in people with depressive illnesses and factors that are contributing to it. Methods: A cross sectional study with a sample size of 385 was carried out using consecutive sampling. The information was gathered using a structured questionnaire. Socio demographic questioners, CSFQ and clinical information extraction tool was employed in combination to determine sexual dysfunction prevalence and associated factors. SPSS version 26 was used to enter, clean and run statistical analysis. Results: majority were female (58.7%), aged 18-30 (40%), and married (46.5%). Occupational diversity included 34% in private work and 27.8% employed. Educational attainment was high (91.9% attended school, 47% completed high school). Among the depressive disorders, most participants were diagnosed with major depressive disorder (86%) and took medications, with fluoxetine (61.1%) and amitriptyline (25.1%) common. Sexual dysfunction prevalence was higher in males (88.7%) than females (81.4%), with pleasure, desire, orgasmic and arousal disorder prevalent in males and pleasure and arousal disorders in females. Factors like age, sex, occupation, living arrangement, marital disharmony/relational problem and comorbid medical conditions showed significant associations. Conclusion: The study finds that a significant proportion of individuals with depressive illnesses have sexual problems, with notable gender differences and associated factors such as age, sex, occupation, living arrangement, marital disharmony/relational problem and comorbid medical conditions. For a more successful and inclusive approach, integrating open and non-judgmental discussions about sexual health into routine psychiatric evaluations, tailoring interventions based on socio-demographic factors and recognizing the bidirectional link between depression and sexual dysfunction, while considering cultural influences is recommended
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    Conceptualization and Experience of Expressed Emotion among People with Schizophrenia and their Caregivers; Qualitative Study
    (Addis Ababa University, 2024-06) Estifanos Endalamaw; Wubalem Fekadu
    BACKGROUND- Schizophrenia and schizoaffective disorder are psychotic disorders and severe mental illnesses manifested by positive and negative symptoms. High expressed emotion, which comprised of criticism, emotional oveinvolvement and hostility of care givers towards people with those mental illnesses has been implicated as a reason for frequent relapse. OBJECTIVE- to explore conceptualization and Experience of expressed emotion among people with severe mental health condition and their caregivers at Amanuel mental specialized hospital Sitota center for mental health care and rehabilitation and. METHOD- qualitative study was conducted among 16 participants; eight were from Amanuel Mental Specialized Hospital and others from Sitota center for mental health care and rehabilitation. Half of them were people with severe mental health condition and the remaining eight were caregivers. After in-depth interview conducted and audiotaped the primary author repeatedly listened the interviews and made the transcription and translation. As the conceptualization was mainly related with the well-established conceptualization of expressed emotion, the analysis was guided by established frameworks specially related to expressed emotion and while still being open to any new themes that emerged. RESULT- Six themes were identified; Quality of relationship, hostility; criticism; overinvolvement; warmth and positive regards and coping strategies. Caregivers consider people with SMHC they are caring for are lazy, dependent, lack confidence, and they lack motivation. They also show their criticism and hostility in different circumstances. Participants reported overinvolvement is beyond EOI, and they have justifications for that. People with SMHC also reported different coping strategies, like keeping quiet, decrease level of contact and so on CONCLUSION- the way people conceptualize expressed emotion matches what previous research has shown. Caregiver‟s experience of high expressed emotion correlates with the way they understand the symptoms, their understanding of the illness in general. With this, it will be important to raise awareness about the negative impact of high expressed emotion and develop and evaluate interventions to address these issues as the care givers did not understand the impact of their action possibly by incorporating family psychoeducation plan as a part management.
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    Prevalence and Associated Factors of Suicidal Ideation and Attempt among University Students at Addis Ababa University; A Cross-Sectional Study
    (Addis Ababa University, 2024-03) Etsubdink Mekbib; Meron Getachew
    Introduction: Suicide is a self-inflicted harm to oneself with the intent of dying. Suicidal ideation is the act of considering, contemplating, or intending to commit suicide; while suicidal attempt is when someone harms themselves with the intention of ending their life but does not pass away because of their acts. It affects people in all age groups across the world. Suicide is one of the major public health concerns affecting many people around the world. The contributing factors to the rise in suicide rates among university students in Ethiopia, as well as in Addis Ababa could be availability of mental health resources and support, the stigma surrounding mental health and lack of awareness and education about suicide prevention. Understanding the prevalence and contributing factors to suicide among university students is crucial in developing effective prevention strategies. Objective: To determine the prevalence and associated factors of suicide among undergraduate university students attending AAU. Methods: A cross-sectional study was conducted among a sample of 413 students attending 3 campuses of AAU. Data was collected through structured self-administered questionnaires. Result: The prevalence of any form of suicidal behavior was 16%. Age (p-value 0.005), frequent alcohol use over the past 3 months (p-value 0.05), feeling about the past year’s result (p-value 0.05), higher depression scores on PHQ-9 (p-value 0.02) and emotional abuse (p-value Conclusion: The findings in our study showed that suicidal outcomes are high among university students attending AAU. The factors associated with suicidal outcomes were age, emotional abuse during childhood, recent alcohol use history, depression and feeling about the past year’s result. The associated factors were also in line with previous literature regarding suicide as well as with scientific knowledge
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    Experiences of Patients Attending the Psychiatry Emergency outpatient Department of Amanuel Mental Specialized Hospital: Qualitative Study
    (Addis Ababa University, 2024-04-19) Hawi Wondimu; Abebaw Fekadu
    Psychiatry emergency departments often serve patients who have complex and severe mental health conditions which are meant to relieve the emergent mental health crisis. However, the experiences of the service users at the place of the psychiatry emergency were poorly explored especially from a setting of low-income country. Understanding their experience would help in identifying areas for improvement in the provision of care. Objective- To explore the experience of patients who had treatment at the psychiatry emergency department of Amanuel Mental Specialized Hospital. Methods- Qualitative research with phenomenological approach and in-depth interview was employed. The source population included those who had visited the emergency OPD psychiatric unit Participants were recruited using purposive sampling technique. Sampling continued until theoretical saturation was achieved and twelve in depth interviews were done. The interviews were audio recorded, transcribed in Amharic and translated into English. The data were coded using Open code software 4.03. Thematic analysis was used to identify key themes. Result- A total of four themes emerged from the data. These were participants journey to the ER, positive experiences, negative experiences and future desires and suggestions. Key elements for participants regarding their experience were relief from illness, information and explanation about clinical decisions. Participants also stressed on the importance of participation in their own care, being heard, and making changes in handling the emergency client. Conclusion- The study examines psychiatry emergency treatment experiences, revealing both positive and negative experiences during psychiatric emergency care, with favorable experiences being connected with good communication with professionals and collaborative treatment. Negative experiences included disregard for emotions, stigma, and a loss of self-governance. Therefore, it is highly recommended to have person centered care for people coming to emergency psychiatry Key words:Psychiatry emergency,Experience,Patients, Qualitative study
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    Lived Experience of Caregivers of People with Schizophrenia at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia: A Qualitative Study
    (Addis Ababa University, 2024-04-10) Martha Gobena; Barkot Milkias
    Background- Schizophrenia can be one of the most disabling of all mental health conditions, due to the effects of psychotic symptoms, associated cognitive impairment and substantial disturbance to psychosocial functioning. Schizophrenia not only impacts the life of the affected person but also those around them, especially the caregivers. Describing the impact of caring for a relative with schizophrenia in terms of social leisure, family relations, work and financial difficulty of care givers is important. In addition to this, exploring their coping mechanisms is also important to develop or improve intervention programs that could improve patient and family outcomes. Objective: To explore the lived experience of care givers of people with schizophrenia and their priorities and preferences for intervention Methods- The study was done at Amanuel Mental Specialized hospital. A qualitative study design was used. Purposive sampling was carried out. Data was collected by in depth interview from caregivers of people with schizophrenia who were admitted to the wards and who visited the hospital for follow up during the study period. The interview was directly transcribed into Amharic, then translated into English. The data were coded using Open code software 4.03. Thematic analysis was used to identify key themes. Results- The subjective experiences of 13 caregivers of people with schizophrenia were summarized in to four major themes with subordinate subthemes. The four major themes are:- Challenges of caregivers; this includes problems related to work and finance, social relation, health, personal life and goals. Responsibilities of caregivers; this includes care giving responsibility, non-care giving responsibility and additional distress. Coping, support and good experience; religious activity, getting help from other relatives, seeing the improvement of their relative as a rewarding experience. Preferences for intervention: help from other relatives, mental health education, experience sharing Conclusion- Multiple areas of challenges and multiple areas of responsibility of caregivers were identified. Although there are multiple areas of challenges for caregivers of people with schizophrenia, there are also positive experiences associated with caregiving. Caregivers were also able to provide direction on intervention to reduce the difficulties they faced.
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    Unveiling the Intriguing World of Nonprescription Opioid Use: A Captivating Exploration at St. Paul's Hospital Millennium Medical College (Sphmmc) and Zewditu Memorial Hospital (Zmh), Addis Ababa, Ethiopia
    (Addis Ababa University, 2024-04-19) Melaku Tesfaye; Awoke Mihretu
    Background: Opioids are psychoactive chemicals, including those that are synthetic, semi-synthetic, and naturally occurring. They are prescribed by doctors to treat both acute and chronic pain. Problematic Opioid use can be associated with different negative consequences including addiction, overdose death, and infectious diseases like Human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) associated with injectable opioid use, as a result of repeated use or sharing of injection. In Ethiopia, there is a lack of understanding regarding the non-medical use of opioids. Objectives: This study mainly aimed to explore the experiences of opioid users for non prescription purposes at SPHMMC & ZMH, Addis Ababa, Ethiopia. Methods: The study particularly employed a phenomenological qualitative design triangulated by descriptive-method study design. A total of 16 participants for the qualitative study were selected using a purposive sampling technique. Data were also gathered through semi-structured interviews and reviewing of three years of opioid users of the hospital data records. Thematic analysis method and descriptive statistics were utilized to analyze the qualitative and quantitative data respectively. Result: In the quantitative data a total of 47 opioid users were found from both hospitals, with the most prominent number 40 (85.1%) being male, single 35 (74.5%), a first degree in education 22 (46.8) health professional 20 (42.6%). Regarding the patterns of use; the majority 31 (65.96%) of participants were using only one type of opioid with a higher percentage of tramadol use 18 (38.3%), 16 (34.04%) were using at least two types, the majority 36 (76.6%) of them use opioids in a daily basis. 24 (51.06%) of participants were polysubstance users. In the qualitative findings, 5 themes and 15 subthemes were emerged. Risky opioid use patterns were identified, such as bingeing, mixing with other substances, and repeated relapses with increased dose and frequency. Participants turned to opioids for reasons like medical prescriptions, recreation, experimentation, and expected benefits such as improved work performance and concentration. Prolonged use aimed to relieve psychosocial distress from iii bereavement, breakup, civil war exposure, unemployment, etc. Withdrawal symptoms, pleasure retention, and perceived performance enhancement were factors. Due to financial constraints and prescription prohibition, users employ various strategies, including illegal acts, to access opioids. Non-medical opioid use can lead to social, psychological, financial, and functional impairments. Participants' motivations for quitting opioids may vary, with obstacles like lack of awareness of services, perceived detox limitations, and financial constraints hindering treatment-seeking behavior. Conclusions: Both the qualitative and quantitative findings found non prescribed opioid use in Ethiopia. This finding also indicated the seriousness of opioid misuse and its adverse consequences on different life aspects of the users