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埃塞俄比亚东部哈拉里地区州成年居民中常见精神疾病的患病率及其决定因素。

Prevalence and determinants of common mental illness among adult residents of Harari Regional State, Eastern Ethiopia.

作者信息

Hunduma Gari, Girma Mulugeta, Digaffe Tesfaye, Weldegebreal Fitsum, Tola Assefa

机构信息

Haramaya University, College of Health and Medical Sciences, School of Nursing and Midwifery, Harar, Ethiopia.

Haramaya University, College of Health and Medical Sciences, Department of Medical Laboratory Science, Harar, Ethiopia.

出版信息

Pan Afr Med J. 2017 Nov 24;28:262. doi: 10.11604/pamj.2017.28.262.12508. eCollection 2017.

Abstract

INTRODUCTION

Common mental disorders include depression, anxiety and somatoform disorders are a public health problem in developed as well as developing countries. It represents a psychiatric morbidity with significant prevalence, affecting all stages of life and cause suffering to the individuals, their family and communities. Despite this fact, little information about the prevalence of common mental illness is available from low and middle-income countries including Ethiopia. The aim of this study was to determine the magnitude of common mental disorders and its associated factors among adult residents of Harari Region.

METHODS

Comparative cross-sectional, quantitative community-based survey was conducted From February 1, 2016 to March 30, 2016 in Harari Regional State using multi-stage sampling technique. A total of 968 residents was selected using two stage sampling technique. Of this 901 were participated in the study. Validated and Pretested Self reported questionnaire (SQR_20) was used to determine the maginitude of common mental disorders. Data was entered and analyzed using Epi-info version 3.5.1 and SPSS-17 for windows statistical packages. Univirate, Bi-variate and multivariate logistic regression analysis with 95% CI was employed in order to infer associations.

RESULTS

The prevalence of common mental illnesses among adults in our study area was 14.9%. The most common neurotic symptoms in this study were often head ache (23.2%), sleep badly (16%) and poor appetite (13.8%). Substance use like Khat chewing (48.2%), tobacco use (38.2%) and alcohol use (10.5%) was highly prevalent health problem among study participant. In multivariate logistic regression analysis, respondents age between 25-34 years, 35-44 years, 45-54 years and above 55years were 6.4 times (AOR 6.377; 95% CI: 2.280-17.835), 5.9 times (AOR 5.900; 95% CI: 2.243-14.859), 5.6 times (AOR 5.648; 95% CI: 2.200-14.50) and 4.1 times (AOR 4.110; 95% CI: 1.363-12.393) more likely having common mental illnesses than those age between 15-24 years, respectively. The occurrence of common mental illness was twice (AOR: 2.162; 95% CI 1.254-3.728) higher among respondents earn less than the average monthly income than those earn more than average monthly income. The odds of developing common mental illnesses were 6.6 times (AOR 6.653; 95% CI: 1.640-6.992) higher among adults with medically confirmed physical disability than those without physical disability. Similarly, adults who chewed Khat were 2.3 times (AOR 2.305; 95% CI: 1.484-3.579) more likely having common mental illnesses than those who did not chew Khat. Adults with emotional stress were twice (AOR 2.063; 95% CI: 1.176-3.619) higher chance to have common mental illnesses than adults without emotional stress.

CONCLUSION

This study had reveals that common mental disorders are major public health problems. Advancing age, low average family monthly income, Khat chewing and emotional stress were independent predictors of common mental illnesses. Whereas sex, place of residence, educational status, marital status, occupation, family size, financial stress, taking alcohol, tobacco use and family history of mental illnesses were not statistically associated with common mental illnesses.

摘要

引言

常见精神障碍包括抑郁症、焦虑症和躯体形式障碍,在发达国家和发展中国家都是一个公共卫生问题。它是一种具有显著患病率的精神疾病,影响生命的各个阶段,给个人、其家庭和社区带来痛苦。尽管如此,包括埃塞俄比亚在内的低收入和中等收入国家关于常见精神疾病患病率的信息却很少。本研究的目的是确定哈勒尔地区成年居民中常见精神障碍的严重程度及其相关因素。

方法

2016年2月1日至2016年3月30日在哈勒尔地区使用多阶段抽样技术进行了比较横断面定量社区调查。采用两阶段抽样技术共选取了968名居民。其中901人参与了研究。使用经过验证和预测试的自填问卷(SQR_20)来确定常见精神障碍的严重程度。数据使用Epi-info 3.5.1版本和用于Windows的SPSS-17统计软件包进行录入和分析。采用单变量、双变量和多变量逻辑回归分析以及95%置信区间来推断关联性。

结果

我们研究区域内成年人中常见精神疾病的患病率为14.9%。本研究中最常见的神经症症状通常是头痛(23.2%)、睡眠差(16%)和食欲不佳(13.8%)。在研究参与者中,使用恰特草(48.2%)、吸烟(38.2%)和饮酒(10.5%)等物质使用是高度普遍的健康问题。在多变量逻辑回归分析中,年龄在25 - 34岁、35 - 44岁、45 - 54岁和55岁以上的受访者患常见精神疾病的可能性分别是年龄在15 - 24岁受访者的6.4倍(调整后比值比[AOR] 6.377;95%置信区间:2.280 - 17.835)、5.9倍(AOR 5.900;95%置信区间:2.243 - 14.859)、5.6倍(AOR 5.648;95%置信区间:2.200 - 14.50)和4.1倍(AOR 4.110;95%置信区间:1.363 - 12.393)。月平均收入低于平均水平的受访者患常见精神疾病的几率是月平均收入高于平均水平受访者的两倍(AOR:2.162;95%置信区间1.254 - 3.728)。经医学确认有身体残疾的成年人患常见精神疾病的几率比无身体残疾的成年人高6.6倍(AOR 6.653;95%置信区间:1.640 - 6.992)。同样,咀嚼恰特草的成年人患常见精神疾病的可能性比不咀嚼恰特草的成年人高2.3倍(AOR 2.305;95%置信区间:1.484 - 3.579)。有情绪压力的成年人患常见精神疾病的几率比没有情绪压力的成年人高两倍(AOR 2.063;95%置信区间:1.176 - 3.619)。

结论

本研究表明常见精神障碍是主要的公共卫生问题。年龄增长、家庭月平均收入低、咀嚼恰特草和情绪压力是常见精神疾病的独立预测因素。而性别、居住地点、教育程度、婚姻状况、职业情况、家庭规模、经济压力、饮酒、吸烟和精神疾病家族史与常见精神疾病在统计学上无关联。

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