Social psychiatry and psychiatric epidemiology functional impairment among people with severe and enduring mental disorder in rural Ethiopia: a cross-sectional study

Habtamu, Kassahun, Alem, Atalay, Medhin, Girmay, Fekadu, Abebaw and Hanlon, Charlotte (2018) Social psychiatry and psychiatric epidemiology functional impairment among people with severe and enduring mental disorder in rural Ethiopia: a cross-sectional study. Social Psychiatry and Psychiatric Epidemiology, 53 (8). pp. 803-814. ISSN 0933-7954

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Abstract

Purpose: Evidence regarding functional impairment in people with severe mental disorders (SMD) is sparse in low and middle-income countries. The aim of this study
was to identify factors associated with functional impairment in people with enduring SMD in a rural African setting.
Methods: A cross-sectional study was conducted at the baseline of a health service intervention trial. A total of 324 participants were recruited from an existing communityascertained cohort of people with SMD (n= 218), and attendees at the Butajira General Hospital psychiatric clinic (n= 106). Inclusion criteria defined people with SMD who had ongoing need for care: those who were on psychotropic medication, currently symptomatic or had a relapse in the preceding two years. The World Health Organization Disability Assessment schedule (WHODAS-2.0) and the Butajira Functioning Scale (BFS), were used to assess functional impairment. Multivariable
negative binomial regression models were fitted to investigate the association between demographic, socio-economic and clinical characteristics, and functional impairment.
Results: Increasing age, being unmarried, rural residence, poorer socio-economic
status, symptom severity, continuous course of illness, medication side effects and internalized stigma were associated with functional impairment across self reported and caregiver responses for both the WHODAS and the BFS. Diagnosis per se was not associated consistently with functional impairment.
Conclusion: To optimize functioning in people with chronic SMD in this setting, services need to target residual symptoms, poverty, medication side effects and internalized stigma. Testing the impact of community interventions to promote recovery will be useful. Advocacy for more tolerable treatment options is warranted.

Item Type: Article
Keywords: Severe mental disorder; Disability; Functional impairment; Schizophrenia; low and middle income countries
Schools and Departments: Brighton and Sussex Medical School > Global Health and Infection
Research Centres and Groups: Wellcome Trust Brighton and Sussex Centre for Global Health Research
Depositing User: emma louise Bertrand
Date Deposited: 28 Jun 2018 11:36
Last Modified: 16 Jul 2019 14:30
URI: http://sro.sussex.ac.uk/id/eprint/76779

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