A descriptive analysis of admissions to Amanuel Psychiatric Hospital in Ethiopia

Fekadu, Abebaw; Desta, Menelik; Alem, A; Prince, Martin

doi:10.4314/ejhd.v21i2.10046

Cited by 19 publications

(24 citation statements)

References 14 publications

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“…These exclusions do reduce the generalisability of the findings. However, comparison with a previous report describing the characteristics of patients admitted over a one year period in the same specialist hospital as our participants came from indicates general comparability with patients being admitted [56]. Finally, some of the outcomes were assessed with single questions, for example treatment adherence and suicide attempt.…”

Section: Discussionmentioning

confidence: 98%

Internalized stigma among patients with schizophrenia in Ethiopia: a cross-sectional facility-based study

Assefa¹,

et al. 2012

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BackgroundDespite the potential impact on treatment adherence and recovery, there is a dearth of data on the extent and correlates of internalized stigma in patients with schizophrenia in low income countries. We conducted a study to determine the extent, domains and correlates of internalized stigma amongst outpatients with schizophrenia in Ethiopia.MethodsThe study was a cross-sectional facility-based survey conducted at a specialist psychiatric hospital in Addis Ababa, Ethiopia. Consecutive consenting individuals with a diagnosis of schizophrenia were recruited and assessed using an Amharic version of the Internalized Stigma of Mental Illness (ISMI) scale.ResultsData were collected from 212 individuals, who were mostly single (71.2%), unemployed (70.3%) and male (65.1%). Nearly all participants (97.4%) expressed agreement to at least one stigma item contained in the ISMI; 46.7% had a moderate to high mean stigma score. Rural residence (OR = 5.67; 95% CI = 2.30, 13.00; p < 0.001), single marital status (OR = 3.39; 95% CI = 1.40, 8.22; p = 0.019) and having prominent psychotic symptoms (OR = 2.33; 95% CI = 1.17, 4.61; p = 0.016) were associated independently with a higher stigma score. Almost half of those who discontinued their treatment reported that they had done so because of perceived stigma. Those who had attempted suicide (45.3%) were more likely to have a high stigma score (OR = 2.29; 95% CI = 1.27, 4.11; p = 0.006). Over 60% of the variation in the experience of stigma was explained by four factors: social withdrawal (16.7%), perceived discrimination (14.1%), alienation (13.9%) and stereotype endorsement (12.7%).ConclusionInternalized stigma is a major problem among persons with schizophrenia in this outpatient setting in Ethiopia. Internalized stigma has the potential to substantially affect adherence to medication and is likely to affect the recovery process.

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Section: Discussionmentioning

confidence: 98%

Internalized stigma among patients with schizophrenia in Ethiopia: a cross-sectional facility-based study

Assefa¹,

et al. 2012

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“…Ethiopia follows that system of delivery of mental health care. For many years in Ethiopia, mental health services were limited to one hospital situated in the capital, Addis Ababa [ 8 , 9 ]. Recently, a small number of psychiatric inpatient facilities were established in different Ethiopian cities [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Two studies from acute psychiatric units of teaching hospitals in Nigeria reported LOS of 23 days and 28.7 days respectively [ 27 , 28 ]. LOS in the state mental hospital in Ethiopia is around 63 days [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…In addition to all above, various clinical and patient related factors have been found to be associated with long psychiatric hospitalizations. Schizophrenia or non-affective psychosis [ 9 , 23 , 24 ], the severity of mental illness [ 29 ], presence of comorbid physical illness [ 30 , 31 ] and comorbid substance use disorders [ 29 ], have been found to predict lengthier LOS. Involuntary admissions and a history of recurrent hospitalizations have also been linked to longer LOS [ 24 , 27 , 28 , 32 ].…”

Section: Introductionmentioning

confidence: 99%

“…Socio-demographic factors such as age, gender, marital status, and place of residence were also reported to influence LOS [ 9 , 27 , 28 , 31 , 32 ]. One study found that frequent visits by family members during patients’ psychiatric hospitalizations were associated with an early discharge [ 31 ].…”

Section: Introductionmentioning

confidence: 99%

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Length of stay of psychiatric admissions in a general hospital in Ethiopia: a retrospective study

Addisu

Wondafrash

Chemali

et al. 2015

Int J Ment Health Syst

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BackgroundIn sub-Saharan Africa, the number of psychiatric beds per population is disproportionately low. Moreover, there is a lack of data regarding the patterns of psychiatric admissions and the factors leading to long psychiatric hospitalization in this region. This study aimed to investigate the average length of stay (LOS) and the factors associated with prolonged hospitalizations.MethodsA ten-year retrospective chart review of patients admitted to the psychiatric facility of Jimma University Specialized Hospital in southwest Ethiopia was conducted. The medical charts of 846 admissions spanning the period from January 2001 to December 2010 were reviewed. LOS greater than 21 days was considered as a cut-off point for lengthier stay. Bivariate and multivariable logistic regression analyses were conducted to identify factors independently associated with LOS.ResultsThe most common discharge diagnoses were schizophrenia and other psychotic disorders (27.6%), and bipolar disorder (23.4%). A global clinical rating taken on discharge showed 90.3% improved outcome. The median (25th, 75th percentiles) LOS was 22 (15, 36) days. Patients with major depressive disorder [aOR = 0.51 (0.32 – 0.81)] and brief psychotic disorder [aOR = 0.52 (0.33 – 0.84)] were less likely than patients with schizophrenia and other psychotic disorders to have long hospital stays. Presence of extrapyramidal side-effects and out of pocket expenditures predicted LOS.ConclusionsPatients with psychoses and bipolar disorder have lengthier hospital stays burdening the cost of care of psychiatric treatment in a general hospital setting. Our findings call for identifying those cases quickly, attending to their needs with evidence-based efficient treatment and for improving and developing an aftercare system such that the utilization of acute inpatient beds, already a scarce resource, could achieve higher efficiency.

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Violence and violent victimization in people with severe mental illness in a rural low-income country setting: A comparative cross-sectional community study

Tsigebrhan¹,

Shibre²,

Medhin³

et al. 2014

Schizophrenia Research

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A descriptive analysis of admissions to Amanuel Psychiatric Hospital in Ethiopia

Cited by 19 publications

References 14 publications

Internalized stigma among patients with schizophrenia in Ethiopia: a cross-sectional facility-based study

Internalized stigma among patients with schizophrenia in Ethiopia: a cross-sectional facility-based study

Length of stay of psychiatric admissions in a general hospital in Ethiopia: a retrospective study

Violence and violent victimization in people with severe mental illness in a rural low-income country setting: A comparative cross-sectional community study

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