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Alemu WG, Mwanri L, Due C, Azale T, Ziersch A. Quality of life among people with mental illness attending a psychiatric outpatient clinic in Ethiopia: a structural equation model. Front Psychiatry 2024; 15:1407588. [PMID: 39188522 PMCID: PMC11345643 DOI: 10.3389/fpsyt.2024.1407588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 07/22/2024] [Indexed: 08/28/2024] Open
Abstract
Background Mental illness is one of the most severe, chronic, and disabling public health problems that affects patients' Quality of life (QoL). Improving the QoL for people with mental illness is one of the most critical steps in stopping disease progression and avoiding complications of mental illness. Therefore, we aimed to assess the QoL and its determinants in patients with mental illness in outpatient clinics in Northwest Ethiopia in 2023. Methods A facility-based cross-sectional study was conducted among people with mental illness in an outpatient clinic in Ethiopia. The sampling interval was decided by dividing the total study participants who had a follow-up appointment during the data collection period (2400), by the total sample size 638, with the starting point selected by lottery method. The interviewer-administered WHOQOL BREF-26 tool was used to measure the quality of life (QoL) of people with mental illness. The domains of QoL were identified, and indirect and direct effects of variables were calculated using structural equation modelling with SPSS-28 and Amos-28 software. A p-value of < 0.05 and a 95% CI were used to evaluate statistical significance. Results A total of 636 (99.7%) participants agreed to participate and completed the data collection. The mean score of overall QoL of people with mental illness in the outpatient clinic was 49.6 ± 10 Sd. The highest QoL was found in the physical health domain (50.67 ± 9.5 Sd), and the lowest mean QoL was found in the psychological health domain (48.41 ± 10 Sd). Rural residence, drug nonadherence, suicidal ideation, not getting counselling, moderate or severe subjective severity, family does not participate in patient care and a family history of mental illness had an indirect negative effect on QoL. Alcohol use and psychological health domain had direct positive effect on QoL. Furthermore, objective severity of illness, having low self-esteem, and having history of mental illness in the family had both direct and indirect effect on QoL. Furthermore, sociodemographic factors (rural residence, illiterate educational status, not married marital status), social support-related factors (poor self-esteem, family not participating in patient care), substance use factors (alcohol use, tobacco use) and clinical factors (high objective and subjective severity of illness, not getting counselling, suicidal ideation, higher number of episodes, comorbid illness, family history of mental illness, poor drug adherence) directly and indirectly affected QoL. Conclusions In this study, the QoL of people with mental illness was poor, with the psychological health domain the most affected. Sociodemographic factors, social support-related factors, drug use factors, and clinical factors, directly and indirectly affected QoL through the mediator variables of physical health domains, psychological health domains, social relation health domains, and environmental health domains. In order to improve the QoL of people with mental illnesses, we recommend that emphasis be given to addressing the QoL of those with mental illness, including the development of policy and practice responses that address the above identified factors.
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Affiliation(s)
- Wondale Getinet Alemu
- College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Lillian Mwanri
- Research Centre for Public Health, Equity, and Human Flourishing, Torrens University Australia, Adelaide, SA, Australia
| | - Clemence Due
- School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Telake Azale
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Anna Ziersch
- College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia
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Huang H, Shen H, Ning K, Zhang R, Sun W, Li B, Jiang H, Wang W, Du J, Zhao M, Yi Z, Li J, Zhu R, Lu S, Xie S, Wang X, Fu W, Gao C, Hao W. Quality of Life and Its Correlates in Alcohol Use Disorder Patients With and Without Depression in China. Front Psychiatry 2020; 11:627338. [PMID: 33551885 PMCID: PMC7862321 DOI: 10.3389/fpsyt.2020.627338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 12/28/2020] [Indexed: 02/05/2023] Open
Abstract
Objective: Alcohol use disorder (AUD) is a serious issue worldwide and frequently co-occurs with depression. However, the quality of life (QOL) of AUD patients with and without depression is not well studied in the Chinese Han population. The aim of this study was to investigate QOL and its correlates in AUD patients with and without depression in China. Methods: Five hundred and fifteen psychiatric patients diagnosed with AUD were recruited. All these patients completed the Beck Depression Inventory (BDI) to assess depression, the Medical Outcome Study 36-Item Short Form Health Survey (SF-36) to evaluate QOL and the Alcohol Use Disorders Identification Test (AUDIT) to measure the severity of drinking. Results: Compared with AUD patients without depression, those with depression had a lower QOL in all eight domains of the SF-36 (all P < 0.001), but were more willing to have alcohol-related treatment (P < 0.05). Negative correlations were noted between (i) the BDI total score and all eight domains of the SF-36 (all P < 0.001); and (ii) between the AUDIT total score and six domains of the SF-36 (all P < 0.05). Conclusions: Depression impairs QOL in patients with AUD in China. Early intervention in comorbid depression to improve QOL is needed.
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Affiliation(s)
- Hui Huang
- Affiliated Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Hongxian Shen
- Key Laboratory of Psychiatry and Mental Health of Hunan Province, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Kui Ning
- Henan Mental Hospital, Xinxiang, China
| | | | - Wei Sun
- Peking University Sixth Hospital, Beijing, China
| | - Bing Li
- Peking University Sixth Hospital, Beijing, China
| | | | | | - Jiang Du
- Shanghai Mental Health Center, Shanghai, China
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai, China
| | - Zhihua Yi
- West China Hospital, Sichuan University, Chengdu, China
| | - Jing Li
- West China Hospital, Sichuan University, Chengdu, China
| | | | | | | | | | - Wei Fu
- The First Affiliated Hospital of Xian Jiaotong University, Xian, China
| | - Chengge Gao
- The First Affiliated Hospital of Xian Jiaotong University, Xian, China
| | - Wei Hao
- Key Laboratory of Psychiatry and Mental Health of Hunan Province, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
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3
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Kling JM, Sidhu K, Rullo J, Mara KC, Frohmader Hilsaca KS, Kapoor E, Faubion SS. Association Between Alcohol Use and Female Sexual Dysfunction From the Data Registry on Experiences of Aging, Menopause, and Sexuality (DREAMS). Sex Med 2019; 7:162-168. [PMID: 30674443 PMCID: PMC6525105 DOI: 10.1016/j.esxm.2018.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 11/27/2018] [Accepted: 11/29/2018] [Indexed: 11/09/2022] Open
Abstract
Introduction Sexual dysfunction is a common problem in women and the nature of its association with alcohol use remains unclear. Aim To explore the association between alcohol use and female sexual dysfunction (FSD). Methods Associations between self-reported drinking and sexual function were evaluated in 2,253 women presenting for consultation to a women’s health specialty clinic. A short version of the Alcohol Use Disorders Identification Test (AUDIT-C) was used to evaluate alcohol use. Women with an AUDIT-C ≥3 were considered at risk for hazardous drinking. Multivariable regression, controlling for depression, anxiety, and abuse (childhood and recent), was used to assess the association between alcohol consumption and FSD (defined as a Female Sexual Function Index [FSFI] ≤26.55 and Female Sexual Distress Scale [FSDS] ≥11) in sexually active women. Main Outcome Measure The main study outcome measure was the presence of FSD as defined by a score ≤26.55 on the FSFI and ≥11 on the FSDS. Results 57% of the 1,649 sexually active women were classified as having FSD; 80% reported any alcohol use and 38% reported drinking patterns with the potential to be hazardous. The women at risk for hazardous drinking had significantly higher FSFI domain scores indicating better sexual function (P ≤ .001). However, in multivariable analyses, there was no significant difference in the rates of FSD across alcohol use categories in women. Conclusion In women presenting for consultation to a women’s health specialty clinic, an association between alcohol use and FSFI scores was seen, in which greater risk of hazardous drinking was associated with better sexual function scores. However, when sexual distress was included to define sexual dysfunction, those with FSD were not at higher risk of hazardous drinking. Given the complex nature of FSD, additional study is needed to further clarify these relationships. Kling JM, Sidhu K, Rullo J, et al. Association Between Alcohol Use and Female Sexual Dysfunction From the Data Registry on Experiences of Aging, Menopause, and Sexuality (DREAMS). Sex Med 2019;7:162–168.
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Affiliation(s)
- Juliana M Kling
- Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, AZ, USA.
| | | | - Jordan Rullo
- Women's Health Clinic, Division of General Internal Medicine, Mayo Clinic Rochester, Rochester, MN, USA
| | - Kristin C Mara
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Karla S Frohmader Hilsaca
- Women's Health Clinic, Division of General Internal Medicine, Mayo Clinic Rochester, Rochester, MN, USA
| | - Ekta Kapoor
- Women's Health Clinic, Division of General Internal Medicine, Mayo Clinic Rochester, Rochester, MN, USA; Division of Endocrinology, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, USA
| | - Stephanie S Faubion
- Women's Health Clinic, Division of General Internal Medicine, Mayo Clinic Rochester, Rochester, MN, USA
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Palma-Álvarez RF, Rodríguez-Cintas L, Abad AC, Sorribes M, Ros-Cucurull E, Robles-Martínez M, Grau-López L, Aguilar L, Roncero C. Mood Disorders and Severity of Addiction in Alcohol-Dependent Patients Could Be Mediated by Sex Differences. Front Psychiatry 2019; 10:343. [PMID: 31214056 PMCID: PMC6554686 DOI: 10.3389/fpsyt.2019.00343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 05/01/2019] [Indexed: 12/15/2022] Open
Abstract
Background: Alcohol dependence is highly prevalent in the general population; some differences in alcohol use and dependence between women and men have been described, including outcomes and ranging from biological to social variables. This study aims to compare the severity of alcohol dependence with clinical and psychopathological characteristics between sexes. Methods: A cross-sectional descriptive study was conducted in alcohol-dependent outpatients; the recruitment period was 7 years. The assessment of these patients was carried out by obtaining sociodemographic characteristics and using the Semi-structured Clinical Interview for Axis I and II (SCID-I and SCID-II), European version of the Addiction Severity Index (EuropASI), Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory (STAI) scales. Variables were compared and analyzed. Results: The sample was composed of 178 patients (74.2% males and 25.8% females) with a mean age of 46.52 ± 9.86. No sociodemographic differences were found between men and women. Females had a higher rate of suicide attempts and depression symptoms at the treatment onset. When results of EuropASI were compared, females had worse psychological and employment results than males. According to consumption variables, males had an earlier onset of alcohol use, had more regular alcohol use, and develop alcohol dependence earlier than females. Conclusions: According to results, there are sex-dependent differences (severity and other variables such as mood or suicide) in alcohol dependence. Thus, this may implicate the need of future specific research and treatment programs based on the specific necessities of each sex.
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Affiliation(s)
- Raul F Palma-Álvarez
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital-Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònomade Barcelona, Barcelona, Spain
| | - Laia Rodríguez-Cintas
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital-Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònomade Barcelona, Barcelona, Spain
| | - Alfonso C Abad
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital-Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain
| | - Marta Sorribes
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital-Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain
| | - Elena Ros-Cucurull
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital-Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònomade Barcelona, Barcelona, Spain
| | | | - Lara Grau-López
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital-Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònomade Barcelona, Barcelona, Spain
| | - Lourdes Aguilar
- Psychiatry Service, Salamanca University Health Care Complex, Institute of Biomedicine, University of Salamanca, Salamanca, Spain
| | - Carlos Roncero
- Psychiatry Service, Salamanca University Health Care Complex, Institute of Biomedicine, University of Salamanca, Salamanca, Spain
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Palamar JJ, Griffin-Tomas M, Acosta P, Ompad DC, Cleland CM. A comparison of self-reported sexual effects of alcohol, marijuana, and ecstasy in a sample of young adult nightlife attendees. PSYCHOLOGY & SEXUALITY 2018; 9:54-68. [PMID: 29430277 DOI: 10.1080/19419899.2018.1425220] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Alcohol, marijuana, and ecstasy (3,4-methylenedioxymethamphetamine [MDMA], 'Molly') are among the most prevalent substances used by young adults; however, few studies have focused on the specific sexual effects associated with use. Examining subjective sexual effects (e.g. increased libido) associated with use can inform prevention efforts. Data were analysed from 679 nightclub and dance festival attendees in New York City (ages 18-25) to examine and compare self-reported sexual effects associated with use of alcohol, marijuana, and ecstasy. Results suggest that compared to marijuana, alcohol and ecstasy were more strongly associated with heightened perceived sexual effects (i.e. perceived sexual attractiveness of self and others, sexual desire, length of intercourse, and sexual outgoingness). Increased body and sex organ sensitivity and increased sexual intensity were most commonly associated with ecstasy use. Sexual dysfunction was most common while using alcohol or ecstasy, especially among males, and females were more likely to report sexual dysfunction after using marijuana. Post-sex regret was most common with alcohol use. Alcohol, marijuana, and ecstasy each have different sexual effects; therefore, each is associated with different risks and benefits for users. Findings can inform prevention and harm reduction as young adults are prone to use these substances.
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Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University Langone Medical Center, New York, NY, USA.,Center for Drug Use and HIV/HCV Research, New York University Rory Meyers College of Nursing, New York, NY, USA
| | - Marybec Griffin-Tomas
- Center for Health, Identity, Behavior, and Prevention Studies, New York University, New York, NY, USA.,College of Global Public Health, New York University, New York, NY, USA
| | - Patricia Acosta
- Department of Population Health, New York University Langone Medical Center, New York, NY, USA
| | - Danielle C Ompad
- Center for Drug Use and HIV/HCV Research, New York University Rory Meyers College of Nursing, New York, NY, USA.,Center for Health, Identity, Behavior, and Prevention Studies, New York University, New York, NY, USA.,College of Global Public Health, New York University, New York, NY, USA
| | - Charles M Cleland
- Center for Drug Use and HIV/HCV Research, New York University Rory Meyers College of Nursing, New York, NY, USA.,Rory Meyers College of Nursing, New York University, New York, NY, USA
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