Factors associated with depression among prisoners in southern Ethiopia: a cross-sectional study

BMC Research Notes Bedaso et al. BMC Res Notes (2018) 11:637 https://doi.org/10.1186/s13104-018-3745-3 Open Access RESEARCH NOTE Factors associated with depression among prisoners in southern Ethiopia: a cross‑sectional study Asres Bedaso1*, Gemechu Kediro1 and Tebikew Yeneabat2 Abstract Objective: To assess the prevalence of depression and associated factors among prisoners in Hawassa Central Correctional Institution, Hawassa, SNNPR, Ethiopia. Result: 56.4% of study participants had significant depressive symptoms. During Multiple logistic regression, depression was significantly associated with not participating in income generating activities inside the prison [AOR = 0.531 95% CI (0.32, 0.87)], History of Chronic disease [AOR = 2.62 95% CI (1.29, 5.32)] and history of Khat chewing [AOR = 2.47, 95% CI (1.04–5.85)]. Keywords: Prevalence, Depression, Prisoner, PHQ-9 Introduction Major depressive disorder (MDD), also known as depression, expressed by at least 2 weeks of low mood that is present across most situations; it is often accompanied by low self-esteem, loss of interest in normally enjoyable activities, loss of energy, pain without clear cause [1]. Depression is a significant contributor to the global burden of disease and affects all communities across the world. The World Mental Health Survey conducted in 17 countries found that on average 1 in 20 people reported having an episode of depression [2]. World Health Organization (WHO) states that depression is the leading cause of disability as measured by years lived with disability (YLDs) and it is the fourth leading contributor to the global burden of disease. By 2020 it is projected to reach second place in ranking [3]. Risk factors of depression include a family history of a condition; major life changes, chronic health problems and substance abuse [4]. To be sentenced to prison is among the most stressful depressive events in prisoner’s life. Also the possible cause of depression in prison is, *Correspondence: 1 School of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, SNNPR, Ethiopia Full list of author information is available at the end of the article memorizing past illegal acts, the prisoners try to relieve the moments of their crime, and this makes them feel guilty and sorrow. Constantly having these thoughts may result in severe depression and prolonged stay in the prison may lead to intense depression. In addition; prisoners feel loneliness, as they are isolated from their family and loved ones. Mostly life with other prisoner and the prison environment by itself to be confined to restricted space also leads to depression [5]. The prevalence of psychiatric illness in correctional setting is significantly elevated; with higher than community rates reported for most mental disorder [6]. Epidemiological studies conducted among prisoners have shown a high prevalence of psychiatric morbidity. The magnitude of severe mental disorder was five to ten times higher among prisoners compared to general population [7]. As important as correctional facilities are for correctional purposes, the institutions could be destructive too. Local as well as international evidence firmly established that incarceration has severe negative public health consequences. Accordingly, the much intended action to promote correction could be a cause for severe physical and mental health deterioration among the incarcerated and the society at large [8]. Depression is especially prevalent in prison populations [9]. In our society the disproportional high rate of © The Author(s) 2018. This 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. Bedaso et al. BMC Res Notes (2018) 11:637 mental disorders in prisons is related to several factors starting from a misconception that all people with mental disorders are a danger to the public. The increased risk of suicide in prisons (often related to depression) is unfortunately, one common manifestation of the cumulative effect of these factors [10]. Globally depression is the second leading cause of disability, with slightly more than 4% of the world’s population diagnosed with it. More than 5% of the population suffers from depression in the Middle East, North Africa, sub-Saharan Africa, eastern Europe and the Caribbean. The most depressed country is Afghanistan, where more than 1 in 5 people suffer from the disorder. The least depressed is Japan, with a diagnosed rate of less than 2.5% [11]. The world health organization estimates that about 350 million people affected by depression, with an increase of more than 18% between 2005 and 2015. The national institute for mental health (NIMH) estimates that in the United States, 16 million adults had at least one major depressive episode (MDE) in 2012. On the other hand, the prevalence of depression in Ethiopia was reported to be 5% according to the Ethiopian federal ministry of health report of 2012, and WHO survey in collaboration with Jimma University shows that the prevalence of depression in Ethiopia was 9.1% [12]. National survey of 2014 states the pooled prevalence of depression from 8 studies in Ethiopia was 11% [13]. A systematic review of 62 surveys in 12 countries prisons involving 22,790 inmates found that, among males, 26% were violent offenders, 3.7% had psychotic illnesses, 10% suffered from major depression and 65% had a personality disorder, of which 47% had antisocial and among female prisoners 4% had a psychotic illness, 12% had a major depression and 42% had a personality disorder, of which 21% has antisocial [14]. Despite scanty evidence regarding the situation of mental health in Ethiopia, there is enough evidence to worry about and act accordingly. In a survey of federal prisons in Addis Ababa and Kaliti, 61.9% of prisoners were found to have different levels of mental distress [15]. There were no sufficient studies conducted in Ethiopia, especially in southern region to determine prevalence of depression and its associated factors among inmates in prison. Therefore this research aimed at determining the prevalence of depression and its associated factors among prisoners in Hawassa central correctional institution, SNNPR, Ethiopia. Main text Study design Institution based cross sectional study design was employed. Page 2 of 6 Study area and period The study was conducted in Hawassa Central Correctional Institution from March 1–30, 2018. Hawassa Central Correctional Ins (...truncated)