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      Mental distress and associated factors among undergraduate students at the University of Hargeisa, Somaliland: a cross-sectional study

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          Abstract

          Background

          Mental distress is a common finding among University students. Empirical research has confirmed that the University student population has a higher prevalence of mental disorder than the general population. However, no previous study has examined the mental health conditions of students in Somaliland.

          Methods

          An institution based cross-sectional study was conducted on a sample of 570 undergraduate students at the University of Hargeisa in October, 2013. Study subjects were selected using a stratified random sampling. The Self-reporting questionnaire (SRQ-20) was used to assess mental distress. Multiple logistic regression analysis was carried out to identify factors independently associated with mental distress.

          Results

          The point prevalence of mental distress was found to be 19.8%. Mental distress was associated with being female (AOR = 3.52, 95% CI 1.94, 6.39), having a monthly income of 100 United States dollars (USD) or less (AOR = 2.19, 95% CI 1.12, 4.28), and not having a satisfying relationship with the family (AOR = 11.52, 95% CI 3.18, 41.72) and friends (AOR = 7.33, 95% CI 2.83, 18.93). Nearly one in five students (18.6%) has been using Khat in the previous 12 months. Khat use was also associated with greater likelihood of mental distress (AOR = 2.87, 95% CI 1.26, 6.56). In addition, financial difficulties and the poor prospect of finding a job were common sources of stress among the students.

          Conclusions

          A significant proportion of the students at the University of Hargeisa suffer from mental distress which might have a detrimental effect on their academic performance. The mental health needs of the University students require attention with special emphasis on female students, students experiencing financial hardships, students who use Khat and those who have interpersonal problems.

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          Most cited references22

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          Mental disorders in primary health care: a study of their frequency and diagnosis in four developing countries.

          1624 patients who were attending primary health facilities in 4 developing countries were examined to determine how many were suffering from mental disorder. Using stringent criteria to establish the presence of psychiatric morbidity, 225 cases were found, indicating an overall frequency of 13.9%. The great majority of cases were suffering from neurotic illnesses and for most the presenting complaint was of a physical symptom, such as headache, abdominal pain, cough or weakness. The health workers following their normal procedure correctly detected one third of the psychiatric cases.
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            Population level mental distress in rural Ethiopia

            Background As part of a situational analysis for a research programme on the integration of mental health care into primary care (Programme for Improving Mental Health Care-PRIME), we conducted a baseline study aimed at determining the broad indicators of the population level of psychosocial distress in a predominantly rural community in Ethiopia. Methods The study was a population-based cross-sectional survey of 1497 adults selected through a multi-stage random sampling process. Population level psychosocial distress was evaluated by estimating the magnitude of common mental disorder symptoms (CMD; depressive, anxiety and somatic symptoms reaching the level of probable clinical significance), harmful use of alcohol, suicidality and psychosocial stressors experienced by the population. Results The one-month prevalence of CMD at the mild, moderate and severe threshold levels was 13.8%, 9.0% and 5.1% respectively. The respective one-month prevalence of any suicidal ideation, persistent suicidal ideation and suicide attempt was 13.5%, 3.8% and 1.8%. Hazardous use of alcohol was identified in 22.4%, significantly higher among men (33.4%) compared to women (11.3%). Stressful life events were widespread, with 41.4% reporting at least one threatening life event in the preceding six months. A similar proportion reported poor social support (40.8%). Stressful life events, increasing age, marital loss and hazardous use of alcohol were associated with CMD while stressful life events, marital loss and lower educational status, and CMD were associated with suicidality. CMD was the strongest factor associated with suicidality [e.g., OR (95% CI) for severe CMD = 60.91 (28.01, 132.48)] and the strength of association increased with increase in the severity of the CMD. Conclusion Indicators of psychosocial distress are prevalent in this rural community. Contrary to former assumptions in the literature, social support systems seem relatively weak and stressful life events common. Interventions geared towards modifying general risk factors and broader strategies to promote mental wellbeing are required.
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              Psychiatric disorders in students in six French universities: 12-month prevalence, comorbidity, impairment and help-seeking.

              Few studies have explored the prevalence of psychiatric disorders (PD) among university students. This article aims to study 12-month prevalence of PD in university students, their socio-economic correlates, impairment in daily life and help-seeking behaviours. Cross-sectional study of randomly selected first-year students aged 18-24 years, enrolled in one of the six universities in south-eastern France in 2005-2006. We used the WHO CIDI-Short Form to derive DSM-IV diagnoses and the Sheehan disability scale to evaluate impairment. We studied their correlates with multiple logistic regressions. The 12-month prevalence of major depressive disorder (MDD), anxiety disorders (AD) and substance use disorders (SUD) were 8.9% (95% CI: 7.2-10.9), 15.7% (95% CI: 13.5-18.2) and 8.1% (95% CI: 6.7-9.8), respectively. MDD was associated with precarious economic situation (OR = 1.83; 95% CI: 1.03-3.23), AD with a precarious job or unemployment of the father (OR = 2.08; 95% CI: 1.04-4.14) and SUD with higher educational level of father (OR = 2.17; 95% CI: 1.28-3.67) or having a paid job (OR = 1.82; 95% CI: 1.06-3.13). "Marked" or "extreme" impairment (score > or =7 for at least one of the domains in the Sheehan scale) was noted for 51.7% of students presenting a PD and was even more frequent in the presence of MDD/AD comorbidity. Only 30.5% of the students with a PD had sought professional help in the past 12 months. This study provides new results regarding university students suggesting a link between precarious economic situations and MDD. The frequent impairment arising from PD alongside low rates of help-seeking suggests that PD could be one of the factors in academic failure in first year of university. These results should be used to improve prevention and care of PD in university students in France.
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                Author and article information

                Contributors
                libxirsi@gmail.com
                kinfetesfay@gmail.com
                hailushepi@gmail.com
                drwkrahl@yahoo.de
                medicine@hargeisauniversity.com
                markos.tesfaye@ju.edu.et , tesmarkos@yahoo.com
                Journal
                Int J Ment Health Syst
                Int J Ment Health Syst
                International Journal of Mental Health Systems
                BioMed Central (London )
                1752-4458
                8 June 2017
                8 June 2017
                2017
                : 11
                : 39
                Affiliations
                [1 ]GRID grid.449725.9, Faculty of Medicine, , University of Hargeisa, ; Hargeisa, Somaliland
                [2 ]ISNI 0000 0001 1539 8988, GRID grid.30820.39, Department of Psychiatry Nursing, , Mekelle University, ; Mekelle, Ethiopia
                [3 ]ISNI 0000 0001 2034 9160, GRID grid.411903.e, Department of Epidemiology, , Jimma University, ; Jimma, Ethiopia
                [4 ]ISNI 0000 0004 0367 2697, GRID grid.1014.4, Discipline of Public Health, , Flinders University, ; Adelaide, Australia
                [5 ]Department of Forensic Psychiatry, Isar Amper Klinikum, Munich, Germany
                [6 ]ISNI 0000 0001 2034 9160, GRID grid.411903.e, Department of Psychiatry, College of Health Sciences, , Jimma University, ; Jimma, Ethiopia
                [7 ]ISNI 0000 0004 1936 973X, GRID grid.5252.0, Center for International Health, , Ludwig Maximillians University, ; Munich, Germany
                Article
                146
                10.1186/s13033-017-0146-2
                5465570
                7a15bcf3-f4d3-49c2-8ad8-b771b40235bd
                © The Author(s) 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 17 October 2016
                : 25 May 2017
                Categories
                Research
                Custom metadata
                © The Author(s) 2017

                Neurology
                mental distress,undergraduate students,self-reporting questionnaire,low-income country,somaliland

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