Background Burden of caregivers of people with mental illness (PWMI) is considered to be a negative impact of the care provided by the family to the patient. However, little is known about the extent of the burden among caregivers of PWMI in Ethiopia. The aim of this study, therefore, is to assess the magnitude and associated factors of burden among caregivers of PWMI at Jimma University Medical Center, 2017. Methods Institution-based cross-sectional study design was employed among 406 conveniently selected caregivers of PWMI and interviewed using a structured questionnaire. Family burden interview schedule (FBIS) was used to assess burden of caregivers. Bivariate and multivariable linear regression analyses were performed to determine the predictors of burden among caregivers. Results Nearly two-thirds [264 (65.0%)] of the participants were male with a mean age of 38.45 ± 12.03 years. The mean score for burden among caregivers on family burden interview schedule was 23.00 ± 10.71. Age of the caregivers ( β = 0.18, p < 0.001), being female caregiver ( β = 2.68, p < 0.01), duration of contact hours with the patient per day ( β = 0.74, p < 0.001), perceived stigma by the caregiver ( β = 0.47, p < 0.001), and providing care for patients who had history of substance use in life ( β = 1.52, p < 0.05) were positive predictors of higher burden among caregivers. Whereas, caregivers’ income ( β = 7.25, p < 0.001), caregivers who had no formal education ( β = 4.65, p < 0.01), and caregivers’ social support ( β = 0.78, p < 0.001) were negatively associated with higher burden among caregiver. Conclusion Caregivers of people with mental illness experience enormous burden during providing care for their relatives with mental illness. Therefore, creating community awareness and targeted interventions in the area of treatment access, stigma, financial, and other social support for people with mental illness and their caregivers would help out to reduce these burdens.

Background. In health care, patient satisfaction is an attitudinal response and a pillar for quality assurance, but there is reluctance to measure it among mentally ill patients. Satisfied patients become more compliant. However, no study was done in this study area before. Therefore, this study was conducted to determine the magnitude of perceived patient satisfaction and associated factor at Jimma University Medical Center, outpatient psychiatry clinic. Methods. Cross-sectional study design was conducted, and systematic random sampling technique was used to get study participants. The 24-item Mental Health Service Satisfaction Scale (a validated tool in Ethiopia) was used to assess patient satisfaction. Data was entered using Epi-data 3.1 and exported to the Statistical Package for the Social Sciences 22.0 for analysis. Linear regression analysis (P<0.05) was used to identify the association between the outcome and independent variable. Result. 414 respondents participated in the study with response rate of 98%. The overall percentage of patient satisfaction was 50.3% (95% CI 48.4%–51.2%). Being male (β=−0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (β=−1.250, 95% CI (-1.765, -0.735)), living in a rural area (β=−1.358, 95% CI (-1.687, -1.030)), having a diagnosis of major depressive disorder (β=1.719, 95% CI (1.332, 2.106)) and bipolar disorder (β=1.203, 95% CI (0.890, 1.516)), far in distance from the hospital (β=−3.250, 95% CI (-4.662, -2.450)), having a history of current substance use (β=−1.719, 95% CI (-2.015, -1.423)), longer in waiting time (β=−3.853, 95% CI (-4.701, -2.205)), and strong social support (β=0.456, 95% CI (0.231, 0.654)) were variables significantly associated with patient satisfaction. Conclusion and Recommendation. This study found that half of the study participants are satisfied with the service. Distance from the hospital, current substance use, waiting time, and having good social support were identified as modifiable factors that can be improved through working with stakeholders to increase patient satisfaction.

Background Khat abuse and psychopathy are both strongly related to criminal activity. Higher rates of substance use in people with psychopathy are hypothesized to be related to psychopathic personality traits, which include high sensation seeking, low conscientiousness and neuroticism, impulsivity, and irresponsibility. Little is known, however, about the association between psychopathy and khat abuse among prisoners in Ethiopia. Therefore, we evaluated the presence of these two factors in prisoners in the correctional institution in Jimma, Southwest Ethiopia. Materials and methods We used a cross-sectional study design to collect data from 336 prisoners from June 5 to July 5, 2017. Study participants were selected by a systematic random sampling technique. Khat abuse was assessed with the Drug Abuse Screening Tool and psychopathy with the Psychopathy Checklist: Screening Version. We also assessed nicotine dependence with the Fagerstrom Test for Nicotine Dependence; alcohol use disorder, with the alcohol use disorder identification test; adverse traumatic life events, with the Life Events Checklist; and social support, with the Oslo 3-Item Social Support Scale. Data were entered into EpiData version 3.1 and analyzed in bivariate and multivariable logistic regression models. Variables with a P value < 0.05 in the final fitted model were declared to be significantly associated with the outcome variable. Results The overall prevalence of lifetime khat use was 59.9%, and the prevalence of khat abuse in prisoners with psychopathy was 78.0%. Prisoners with psychopathy had a three times higher odds ratio of abusing khat than those without psychopathy (AOR = 3.00 [1.17-7.67]). Among the confounders, a family history of substance use (AOR = 2.50 [1.45-4.31]), poor

Background: Information on the degree of internalized stigma experienced by patients with mood disorders in Ethiopia is limited. This study attempted to assess the levels of internalized stigma and factors associated with it in patients with mood disorders who were on follow-up as an outpatient in a Psychiatry clinic at

ObjectiveTrauma exposure and alcohol use are closely related, and large proportion of trauma-exposed individuals use alcohol. The data presented in this paper were obtained as part of a study on substance use disorder and associated factors among prisoners in the correctional institution in Jimma, Southwest Ethiopia. Therefore, in this study we examined comorbidity of traumatic life experiences and alcohol use disorder in inmates of correctional institution in Jimma, Southwest Ethiopia.ResultsThe overall prevalence of lifetime alcohol use disorder was 40.1%, and the prevalence of alcohol use disorder among prisoners with lifetime trauma exposure was 44.0%. Participants with multiple trauma exposures had 2.5-fold higher odds of association for alcohol use disorder than their counterparts (AOR = 2.47 [1.23–4.94]). Living in urban areas (AOR = 4.86 [2.38–9.94]), presence of psychopathy (AOR = 3.33 [1.25–8.86]), khat abuse (AOR = 7.39 [3.99–13.68]), and nicotine dependence (AOR = 2.49 [1.16–5.34]) were also positively associated with alcohol use disorder. The prevalence of alcohol use disorder was higher among prisoners with lifetime trauma exposure. Also, this study indicates that prisoners with multiple trauma exposures had higher odds of association for alcohol use disorder than those with no trauma exposure. A public health intervention targeting survivors of traumatic experiences needs to be designed and implemented.

Background. Catatonia is among the most mysterious and poorly understood neuropsychiatric syndrome. It is underresearched and virtually forgotten but still a frequent neuropsychiatric phenotype in both developed and low-income countries. Catatonia is associated with a number of medical complications like pulmonary embolism, dehydration, or pneumonia if it is not treated and managed adequately. In Ethiopia, however, almost no studies are available to describe the symptoms and the response to treatment in patients with catatonia. The aim of this retrospective study was therefore to describe the symptom profile of catatonia and to evaluate the treatment and outcome of catatonia in patients admitted to the psychiatric inpatient unit at Jimma University, Ethiopia. Method. Detailed treatment records of all inpatients were reviewed for the period from May 2018 to April 2019. All patients with catatonia at the inpatient unit of Jimma University Medical Center were assessed with the Bush-Francis Catatonia Rating Scale (BFCRS), and all comorbid psychiatric diagnoses were made according to the criteria of the Diagnostic Statistical Manual V. The presence and severity of catatonia were assessed by using the BFCRS at baseline and at discharge from the hospital. Result. In the course of one year, a total of 18 patients with the diagnosis of catatonia were admitted. The mean age of the participants was 22.8 years (SD 5.0; range: 15 to 34 years). The most common diagnosis associated with catatonia was schizophrenia (n=12; 66.7%), followed by severe depressive disorders (n=4; 22.2%). Mutism, posture, and withdrawal were registered in all patients (n=18, 100%). All patients received an injection of diazepam and had improved at discharge. Conclusion. Our study provides further evidence that catatonia is most commonly associated with schizophrenia, followed by major depressive disorder, and that mutism, posturing, and withdrawal are the most common signs and symptoms of catatonia.

Introduction Tuberculosis (TB) is a leading cause of morbidity and mortality in low and middle-income countries. Substance use negatively affects TB treatment outcomes. Our recent study has found that khat use predicted poorer adherence to anti-TB medications. However, there is scarce longitudinal study on predictors of khat use among outpatients with TB, and this study aimed at addressing this research gap. Methods From October 2017 to October 2018, 268 outpatients with tuberculosis on DOTs were enrolled in a longitudinal study from 26 health institutions in Southwest Ethiopia. Structured questionnaires translated into local languages (Afaan Oromoo and Amharic) were used to assess khat use. Patients were followed for six months, and data were collected on three occasions during the follow-up. A generalized linear mixed model was used to identify the relation between khat use and predictors. Model fitness was checked using the Bayesian Information Criterion (BIC). Odds ratio (OR) and 95% CI were used to describe the strength of association between the outcome variable and predictors. Results The overall prevalence of khat use at baseline and first follow up was 39.2% while it was 37.3% at second follow up. Of this, 77.1% and 96.2% of them believed that khat use reduces the side effects of anti-TB medications and symptoms of tuberculosis respectively. In the final model, being male (aOR = 7.0, p-value = 0.001), being government employee (aOR = 0.03, p-value�0.001) and presence of alcohol use disorders (AUD) (aOR = 2.0, p-value�0.001) predicted khat use among outpatients with tuberculosis.

Introduction. The case after exposure to intense traumatic events manifests signs and symptoms of dissociative amnesia with a dissociative fugue and schizophrenia. The psychotic symptoms we found, in this case, were very complicated and mimicking primary psychotic disorders. Therefore, this might be a good forum for the scientific world to learn from this case report, how psychotic disorders coexist with dissociative disorders, since the literatures in this area are too rare. Main Symptoms and/or Important Clinical Findings. This case report focuses on the case of dissociative amnesia with dissociative fugue and psychosis in a 25-year-old Ethiopian female who lost her husband and three children at the same time during the nearby ethnic conflict. Associated with amnesia, she lost entire autobiographical information, and she also had psychotic symptoms like delusions and auditory hallucination which is related to the traumatic event she faced. The Main Diagnoses, Therapeutic Interventions, and Outcomes. The diagnosis of dissociative amnesia with a dissociative fugue comorbid with schizophrenia was made, and both pharmacological and psychological interventions were given to the patient. After the intervention, the patient had a slight improvement regarding psychotic symptoms but her memory problem was not restored. Conclusions. The observation in this case report brings to the fore that individuals with dissociative amnesia with dissociative fugue can have psychotic symptoms, and it takes a longer time to recover from memory disturbances.