Psychiatry
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Item Exploring The Lived Experiences of Soldiers with Combat Exposure in Ethiopia(Addis Ababa University, 2025-01-10) Ahlam Abdi; Engida Girma; Ikram AhmedBackground: 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.Item 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 DersehBackground: 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.Item 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 FekaduInternet 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.Item 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 AsaminewBackground፡- 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 servicesItem 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 MihretuBack 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.Item 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 FekaduTest 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 fieldsItem 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 GirmaDepression 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 itItem Conceptualization and Experience of Expressed Emotion among People with Schizophrenia and their Caregivers; Qualitative Study(Addis Ababa University, 2024-03-23) Estifanos Endalamaw; Wubalem FekaduSchizophrenia 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.Item 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 FekaduTest 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.Item 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 GirmaDepression 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.Item Conceptualization and Experience of Expressed Emotion among People with Schizophrenia and their Caregivers; Qualitative Study(Addis Ababa University, 2024-06) Estifanos Endalamaw; Wubalem FekaduSchizophrenia 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 relapseItem 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 GetachewSuicide 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 strategiesItem 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 FekaduPsychiatry 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 careItem 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; Advisors: Professor Charlotte Hanlon (Professor of Global Mental Health)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 impact s the life of the affected person but also those around them e specially the caregivers. Describing the impact of caring for a relative with schizophrenia in terms of social leisure, family relation s , 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 outcomeItem Unveiling the Intriguing World of Nonprescription Opioid Use: A CaptivatingExploration 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 MihretuOpioids 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.Item The Lived Experiences of Stress, Burnout and Coping Strategies of Burnout Among Residents in College of Health Sciences, Addis Ababa University: A Qualitative Study(Addis Ababa University, 2024-04-05) Rediat Solomon; Azeb AsaminewMedical Residents are more likely than the overall population to experience depression, suicide, and stress-related illnesses. Even if the burden and effect of burnout and work-related stress on residents is huge worldwide, qualitative studies on this subject are limited in Africa and specifically, Ethiopia. Therefore, understanding the coping strategies and lived experiences of residents will provide knowledge on this area for future development of interventions.Item Assessment of Professional Mental Health Help Seeking Attitude and Behavior And Associated Factors among Health Professionals at Tikur Anbessa Specialized Hospital from July to August 2023; Cross Sectional Study(Addis Ababa University, 2024-04-05) Ruth Abraham; Selam AberraHealth professionals are trained to care for others and to put their patients’ needs above their own. In addition to the work-related stress, they are faced with non-occupational issues related to work life balance and financial issues. Health professionals give less attention to their own health and they often find it hard to seek help when their suffering is a result of mental distress. Although the mental health help seeking attitude and behavior in the community has been studied, there is no study to assess professional mental health help seeking attitude and behavior among health professionals done in EthiopiaItem Assessment of School Enrollment and Associated Factors among Children and Adolescents with Neurodevelopmental Disorders on Follow up at TASH, ZMH, Y12HMC and AMSH. Addis Ababa,Ethiopia: A Cross Sectional Study(Addis Ababa University, 2024-04-10) Simret Gebre; Fikirte GirmaNeurodevelopment in children is a dynamic inter relationship between various components including genetic, brain, cognitive, emotional and behavioral processes throughout the developmental lifespan. Neurodevelopmental diseases and disabilities can be caused by a significant and ongoing interrupti on to this dynamic process caused by environmental and genetic risk. Impairments in personal, social, academic, or occupational functioning are hallmarks of these disorders . When these children reach school age, they are at greater risk of having special e ducational needs and experiencing difficulties in their learning or socialization at school. The number of children with disability attending school is extremely low in developing nations, and the overall enrollment rate is frequently under 10% in those na tions where statistics are available. Although some research in our country have attempted to study this, there is a shortage of information specifically related to neurodevelopmental diseases.Item Juvenille offenders‘ Perspective on their Violent offending Behavior, Exploratory Qualitative Study Lideta Remand Home, Addis Ababa, Ethiopia, 2024(Addis Ababa University, 2024-04-05) Tilahun Gizaw; Asnake LimenheThis study aimed to explore juvenile violent offenders' perspective about their offending behavior by using exploratory qualitative methodology. Fourteen participants convicted of violent behavior were recruited from the sites and consented to participate in the study. A semi-structured one to one in-depth interview was conducted to elicit the juvenile perspective and analyzed using both inductive and deductive thematic analysis. Data analysis subsequently revealed four common themes among participants. These themes are: (1) Perceived influence (2) Individual difference on process of offending, (3) response after violence l (4) consequence. The results of this study can be explained by cognitive, psychodynamic, general strain theory social learning theory and the violence abuse cycle model.Item Stigma among Help Seeking People with Alcohol use Disorder, Addis Ababa, Ethiopia: a Facility Based Qualitative Study(Addis Ababa University, 2024-04-10) Yodit Endalamaw; Awoke MihretuAlcohol use disorder (AUD) is one of the most highly stigmatized conditions. Stigma has several impacts on people with AUD such as decreasing their self-esteem, negatively affecting social relationships, and leading to maladaptive coping strategies like withdrawal and secrecy. Despite evidence indicating that individuals with AUD perceive and experience stigma in the healthcare system, leading to decreased help seeking behavior and diminished recovery in various contexts, there is a lack of understanding regarding the stigma of AUD in Ethiopia.