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Social Psychiatry and Psychiatric Epidemiology

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14.06.2018 | Original Paper

Functional impairment among people with severe and enduring mental disorder in rural Ethiopia: a cross-sectional study

verfasst von: Kassahun Habtamu, Atalay Alem, Girmay Medhin, Abebaw Fekadu, Charlotte Hanlon

Erschienen in: Social Psychiatry and Psychiatric Epidemiology | Ausgabe 8/2018

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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 community-ascertained 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 2 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.

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Titel: Functional impairment among people with severe and enduring mental disorder in rural Ethiopia: a cross-sectional study
verfasst von: Kassahun Habtamu
Atalay Alem
Girmay Medhin
Abebaw Fekadu
Charlotte Hanlon
Publikationsdatum: 14.06.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Social Psychiatry and Psychiatric Epidemiology / Ausgabe 8/2018
Print ISSN: 0933-7954
Elektronische ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-018-1546-6

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Functional impairment among people with severe and enduring mental disorder in rural Ethiopia: a cross-sectional study

Abstract

Purpose

Methods

Results

Conclusion

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