Jacobs Journal of Psychiatry and Behavioural Science

Assessment of Prevalence of Mental Distress and Associated Factors among Debre Markos University Regular Undergraduate Students, Debre Markos, Ethiopia

Dagninet Derebe
Department Of Pharmacology, Ethiopia

Published on: 2019-04-25

Abstract

Background: Significant proportion of the world’s population is affected by mental distress of which tertiary education students are the once. According to WHO mental health problems account to nearly one-third of disability in the world. Objectives: Methods: To assess the prevalence of mental distress among Debre Markos University regular undergraduate students. Cross sectional descriptive study design was conducted. Data was collected from May 05 to 07/2015.Atotal of 422 students was selected for self-administered questionnaire from DMU regular under graduate students. All colleges and school of law were included in the study. Lottery method was employed for selection of departments. The sample size in each college was determined proportionally to size of students in colleges and the sample size in colleges was directly the sample size in selected departments. Each year of study was included in selected departments and sample size in each year of study was determined proportional to size of students from each year of study. Then, systematic random sampling method was employed to select students from each year of study. Based on student’s record in their department, the first student was determined using simple random sampling method. Result: From 402 participants 130 (32.3%) were females. majority of participants 381 (94.8%) were between 18-25 age group, and age of respondents range between 17 to 29 years. three hundred seventy seven of participants (93.8%) were orthodox religious followers and 354 students (88.1%) were single and 353 of participants (87.8%) were Amhara in ethnicity. The prevalence of mental distress was found to be 49.3% from these 135(33.6%) were males and 63(15.7%) were females.

Keywords

Debre Markos; Mental Distress; Substance Use

Copyright: © 2019 Dagninet Derebe

Background:

A significant proportion of the world’s population is affected by mental distress of which tertiary education students are the once. According to WHO mental health problems account to nearly one-third of disability in the world.

Objectives:

To assess the prevalence of mental distress among Debre Markos University regular undergraduate students.

Methods:

The cross-sectional descriptive study design was conducted. Data were collected from May 05 to 07/2015. A total of 422 students was selected for the self-administered questionnaire from DMU regular undergraduate students. All colleges and school of the law were included in the study. Lottery method was employed for the selection of departments. The sample size in each college was determined proportionally to size of students in colleges and the sample size in colleges was directly the sample size in selected departments. Each year of study was included in selected departments and sample size in each year of study was determined proportionally to the size of students from each year of study. Then, the systematic random sampling method was employed to select students from each year of study. Based on student’s record in their department, the first student was determined using simple random sampling method.

Result:

From 402 participants 130 (32.3%) were females. majority of participants 381 (94.8%) were between 18-25 age group, and age of respondents range between 17 to 29 years. three hundred seventy-seven of participants (93.8%) were orthodox religious followers and 354 students (88.1%) were single and 353 of participants (87.8%) were Amhara in ethnicity.

The prevalence of mental distress was found to be 49.3% from these 135(33.6%) were males and 63(15.7%) were females.

Conclusion:

This study shows that the prevalence of mental distress in Debre Markos University is high, in which 5 in 10 students were suffered from mental distress. The prevalence is almost the same in males and females. Mental distress is more prevalent in the 4th year and less prevalent in the fifth year.

Background

Mental illness was not recognized as public health problems both in developed and developing countries until the recent period of time [1-5]. But there is evidence that mental illness can lead to increased mortality; in particular, the risk of death by suicide in persons with depression or substance abuse is well described [6]. It is both the direct cause of mortality and morbidity and significant risk factors for adverse health outcomes. This social, economic and health impact of mental illness is far-reaching, where they are associated with excess all-cause mortality, work-related disability, low quality of life and cardiovascular disease risk [7, 8]. Various factors were reported to be associated with the developing of mental distress among university students. Separation from pre-existing social support, frustration with academic challenges, social problems and threats due to high expectations from parents; teachers have reported attributes of mental distress which could present variably in different contexts [3, 9].

Modernization brought about a tremendous challenge in the life cycle among others prolongation in the adolescent period. Social scientists call this life period post-adolescence in which some of the characteristics of youths behavior are still similar to adolescent, whereas others are close to adulthood. Youths spend more and more time in higher education which may cause an unstable identity and many psychological challenges. The number of students is increasing all over the world and youths may have to leave the parental home and face a number of difficulties. Such as financial problem or increased achievement pressure. They must, therefore, adapt to the circumstance of the university environment. First-year students are particularly at risk since they have to face many behavioral challenges and develop the new psychological identity, whereas older students face greater achievement pressure geared to the job market. All these contribute to elevated vulnerability to mental distress among university students [10].

No previous study was conducted on the prevalence of mental distress in Debre Markos University. Therefore the study will fill this gap. The study will examine the prevalence of mental distress and associated factors according to sex, academic year, department and college. So that the result will help the concerned bodies like East Gojjam health department, Amhara region health bureau, university managers and college deans by showing the magnitude of mental distress in the university students and to carry out intervention activities. Therefore, to assesses the prevalence of mental distress and associated factors among DMU regular undergraduate students, Debre Markos, East Gojjam, Ethiopia, 2015

Methods and materials

Study design and study populations

Institution based cross-sectional study was conducted from May 5 to 7, 2017, in Debre Markos university students. Debre Markos University is a public university established in 2005 in Debre Markos Town. The town is located 280 km South East from Addis Ababa city. The university has total students of 11,082 (regular only), 6 colleges, 1 school and 34 departments in 2015.

Sample size determination and Sampling technique

The sample size was determined using a single population proportion formula. Taking the prevalence of mental distress ranging from 32.6% conducted in Addis Ababa university undergraduate university students to 49.1% conducted in Hawassa university medical students [5, 6]. By assuming 49.1% prevalence to obtain maximum sample size and maximum discrepancy of 5% between the sample and the underlying population, additional 10% was added to the sample size as a contingency to increase power gives a sample size of 422.

Stratified sampling technique was employed to select the study population. All colleges and school of the law were included in the study lottery method was employed for the selection of departments. The sample size in each college was determined proportionally to the size of students in colleges and the sample size in colleges was directly the sample size in selected departments. Each year of study was included in selected departments and sample size in each year of study was determined proportionally to the size of students from each year of study. Then, the systematic random sampling method was employed to select students from each year of study. Based on student’s record in their department, the first student was determined using simple random sampling method. 

Operational definition

Mental distress:

In our study students who were found to have 8 or more symptoms of the 20 items self-reporting questionnaire in the last 4 weeks was considered to have mental distress.

Current substance use:

Use of psychoactive substances like alcohol, chat, hashish, shisha for the last 30 days regardless of amount and frequency.

Current substance use:

Use of psychoactive substances like alcohol, chat, hashish, shisha for the last 30 days regardless of amount and frequency.

Substance abuse:

Two or more yes answer for CAGE (c=cut down, A=annoyed, G=guilty, and E=eye opener) AID screening questionnaire.

Data collection instrument

A pretested self-administered a structured questionnaire was used to collect data about sociodemographic characteristics and other variables associated with mental distress. The presence of mental distress was assessed using the 20 item version of the self-reporting questionnaire (SRQ20).

Data quality assurance

To assure the quality of the collected data, the appropriate designed and standard instrument which is validated in Ethiopia was used for data collection. Training and orientation for data collectors were used. The collected data were reviewed and checked for completeness and consistency of response every day

Statistical analysis

The collected data were checked for completeness. The data was tallied and analyzed by using manual collector and tally sheet for analysis. Descriptive analysis was used to describe important variables in the study. The final result then was presented using tables and diagrams.

Ethical consideration

Ethical clearance was obtained from DMU, College of Medicine and Health Science, Department of Nursing. Informed consent was obtained from each study subject prior to an interview and after the purpose of the study were explained to respondents. Confidentiality of the information was assumed and the privacy of the respondents was maintained. The instruments and procedures were not causing any harm by any means to the study subjects.

 

 

 

Results

Socio-demographic characteristics of respondents

Out of 422 questionnaires, 402 were returned back, the response rate was 95.3%. From 402 participants 130 (32.3%) were females. majority of participants 381 (94.8%) were between 18-25 age group, and age of respondents range between 17 to 29 years. three hundred seventy-seven of participants (93.8%) were orthodox religious followers and 354 students (88.1%) were single and 353 of participants (87.8%) were Amhara in ethnicity.

According to a year of study, the first year accounts 124(30.8%) and 5th year constitutes 37(9.2%) which is the least. Concerning their monthly income, 131(32.6%) has monthly no income, 200(49.6%) has monthly income greater than or equal to 100 Birr and the remaining has monthly income less than 100. 329(81.8%) of respondents have married parents and 228 (50.7%) of respondents have illiterate plants and 18(4.5%) of have parents with educational status of degree and above. the details are shown in table 1.

Regarding their expression of social support 193 (48%) express their support as good and 28 (7%) as the low majority of respondents 355(88.3%) on to red to their department by choice and 58(14.4%) of respondents are interested in their department. Majority 222(55.2%) of respondents sometimes participate in spiritual life.

Regarding problems faced in the university, 158(39.3%) of respondents reported that poor quality of the educational system and 129(32.1%) of them reported that administrative problem and 12(3%) of respondents reported that health problem.

Table 1: Description of socio-demographic characteristics of draw undergraduate students, Debre Markos, Ethiopia, 2015. n=402

 Table 2: Description of DMU undergraduate students based on college, department and sex, Debre Markos, Ethiopia, 2015. n=402

Regarding their department, sex, and college, the majority of students 93(23.2%) are electrical engineering students. For details see table 2.

According to the current mental health status of respondents, 146 (36.3%) have ever got mental illness in their lifetime and 114(28.4%) have mental illness currently. Thirty-seven (19.2%) of respondents have family members with mental illness or treated for mental illness.

Regarding their substance use history, 81(20.1%) are ever use of a substance, 62(15.4%) are current substance users and 63(77.8%) out of 81 respondents are substance abused according to CAGE screening questionnaire. Thirty-nine (48.1) of them experienced physical illness in the past 30 days (for details see table 3 below)

Table 3: Description of history substance use among DMU undergraduate students Debre Markos, Ethiopia, 2015. n=402

 

Prevalence Of Mental Distress

The prevalence of mental distress in DMU undergraduate students was found to be 49.3% from these 135(33.6%) were males and 63(15.7%) were females. According to sex, the prevalence of mental distress among males was 135 (49.6%) one of 272 males and females were 63(48.5%) among 130 females included in the study

According to college, social science and humanities college students (64.7%) were more affected by mental distress, followed by natural and computational science (61.1%) and technology college (for details see table 4.

According to their substance use, 81(20.5) of respondents were using the substance in their lifetime. From these 17(21%) do not you substance in the past 30 days. From those respondents who do not use the substance in the past 30 days, but use the substance in their lifetime 6(35.5%) developmental distress. The produce of mental distress in respondents who use alcohol, cigarette, chat, hashish, and shishas in past 30days was 35(56.5), 15(62.5%), 5(83.3%) 1(50%) , 1(100%) respectively.(Refer table 3).

According to their response on self-reporting questionnaires, 20,198(49.3%) greater than equal to 8 yes answers, 148(36.8%) reported less than 6 yes answers and the rest 54(14%) reported 6 or 7 yes answers.

Table 4: Prevalence of mental distress by sex college, DMU Debre Markos, Ethiopia, 2015. n=402

Figure 1: Prevalence of mental distress by respondent’s sex and year of study, Debre Markos, East Gojjam, Amhara Ethiopia, 2015

Based on the year of study, from 198(49.3%) who had developmental distress, fourth-year students account 23(59%) among these 21(61.8%) were males and 2(40%) were females. Fifth-year students account the least 11(29.7%). (For details see graph below).

 Associated factors of mental distress

 Comparison between cases having mental distress and those who do not have was made using chi-square(x2) test for three variables (sex, department and year of study). Accordingly, there was no significant association between sex and mental distress (x2calculated (x2cal)=0.045, but x2 tabulated(x2 tab) at the degree of freedom(df)1 and at the level of significance 0.05 is 3.841).

Regarding department and year of study, there was no again significance association with mental distress and department (x2cal=10.137, but x2tab at df 7 and level of significance 0.05 is 14.067). For the year of study also, there was no again significance association between year of study with mental distress (x2cal=7.57,butx2tab at df 4 and level of significance 0.05 is 9.488).

Discussion

A total of 402 students participated in the study from undergraduate students of Debre Markos University. Majority of respondents were in the younger age group. This study tests the prevalence of mental distress among Debre Markos university undergraduate students. In doing, the participants were selected by systematic random sampling from departments selected by lottery method and from each year of study in those departments and found to have similarity in female to male ratio to source population, which was 7800 to 3282(1:2.4) in source population and 272 to 130(1:2.1). Accordingly, there was no significant difference observed regarding the sex of the sample population. This similarity may enhance the generalizability of the finding of the study to source population.

This study revealed that the Prevalence of mental distress in DMU undergraduate students was 198(49.3%). This finding was consistent with the Prevalence of mental distress done using the same instrument in a Malaysian university, among Malaysia medical students which were 41.9%. But it was found higher than the prevalence study using the same instrument in Addis Ababa and Butajira rural community, which was 17.4% and 17.7% respectively [14].

The difference in this study that of Addis Ababa and butajira rural community could be as a result of the existence of social support and less stressful life in rural communities. On the other hand, higher prevalence in this student community could be as a result of competition. And stressful academic life and environmental factors such as economic problem, separation from a family member and any problem arise from the university.

In our study, the prevalence of mental distress in males and females were 49.6% and 48.5% respectively. This study is not similar to the study done among working adults in Ethiopia, which was 25.8% and 12.4% in females and males respectively [15]. This study also not similar to research conducted at Mekele University, which shows the prevalence of mental distress in males and females were 33.7% and 27.6% respectively [16]. This difference may be due to the reason that some stressors and gradually minimized by gender issue of the university and humanities college student are with a high prevalence of mental distress (64.7%), followed by natural and computational science (61.1%). There was no literature to discuss these, but this high prevalence in their colleges could be due to, social science college students were having examination during data collection, which can increase mental distress.

In our study mental distress is more prevalent in fourth year (59%) followed by third year (51.7%) and 2nd year (51.3%) and it is less prevalent in the fifth year in (29.7%) but a study done in Adam university shows mental is more prevalent in first year and 5th year. The reason for this may be due to a high non-response rate and the resulting small sample size in our study among the fourth year.

In our study, factors such as sex, department and year of study are not associated with mental distress. This result is not similar to studies done in working adults in Ethiopia and in Mekele university [15, 16]. This difference may be due to low sample size. This may also due to the real absence of association of mental distress and those factors in university

 

Conclusion

This study shows that the prevalence of mental distress in Debre Markos University is high, in which 5 in 10 students were suffered from mental distress. The prevalence is almost the same in males and females. Mental distress is more prevalent in 4th-year student and less prevalent in the fifth year. Mental distress is not associated with sex, department and year of study. Therefore a student counseling service should strengthen itself to counsel those factors that could increase these mental distresses.

Data availability

Data can be accessed via my email that is dagninet37@yahoo.com at any time.

Funding

No fund was obtained to conduct this research.

Disclosure

The authors report no conflicts of interest in this work.

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