Depressive disorder, bipolar disorder, and associated factors among adults, in the Eastern part of Ethiopia

Bete et al. BMC Psychiatry (2024) 24:17 https://doi.org/10.1186/s12888-023-05466-5 BMC Psychiatry Open Access RESEARCH Depressive disorder, bipolar disorder, and associated factors among adults, in the Eastern part of Ethiopia Tilahun Bete1*, Tadesse Misgana1, Kabtamu Nigussie1, Kemal Aliye1, Tilahun Abdeta1, Dawud Wedaje1, Gari Hunduma1, Abduselam Assefa2, Dejene Tesfaye1, Henock Asfaw1, Abdulkarim Amano1, Mandaras Tariku1, Jerman Dereje1, Tilahun Ali4, Fethia Mohammed1, Mekdes Demissie1, Ahmed Mohammed2, Nejiba Hayru1, Birhanu Assefa1, Tara Wilfong3 and Daniel Alemu1 Abstract Background Depressive disorder is one of the severe and common mental illnesses in the general population. Bipolar disorder is a severe, persistent mental illness associated with significant morbidity and mortality. However, there is a paucity of data on the prevalence of depressive disorder, and bipolar disorder in our study area. Objective This study aimed to assess the prevalence of depressive and bipolar disorders among adults in Kersa, Haramaya, and Harar Health and Demographic Surveillance Sites in Eastern Ethiopia. Methods A community-based cross-sectional study was conducted among 1,416 participants. A multi-stage sampling was employed to select the participants. DSM-5 diagnostic criteria was used to assess depressive disorder and bipolar disorder. Data was collected using a standard questionnaire. Data were entered into Epi-Data 3.1 and analyzed using SPSS version 26. Both binary and multivariate logistic regression analyses were done. Those with a p-value < 0.05 in the final model were considered statistically significant. Results The overall prevalence of depressive and bipolar disorders among our study participants was 6.7% (95% CI: 5.40, 8.20) and 2.1% (95% CI: (1.40, 3.00), respectively. The independent predictors of depressive disorder included a family history of mental illness, chronic medical illnesses, unemployment, low educational status, divorced or widowed, poor social support, and current alcohol use or khat chewing. Single, males, divorced or widowed, and current consumers of alcohol were independent predictors for bipolar disorder. Conclusions and recommendation The results of our investigation showed that bipolar illness and depression were significant public health issues. It was shown that although bipolar disorder is highly prevalent in the society, depression is a widespread concern. As a result, it is imperative that the relevant body grow and enhance the provision of mental health services. Furthermore, research on the effects and burdens of bipolar disorder in the community is required. *Correspondence: Tilahun Bete Full list of author information is available at the end of the article © The Author(s) 2023. 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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 in a credit line to the data. Bete et al. BMC Psychiatry (2024) 24:17 Page 2 of 11 Keywords Depression, Bipolar disorder, Poverty, Unemployment, Social support, Substance abuse, Eastern part of Ethiopia Introduction Worldwide, depressive disorder is widespread, and a leading cause of disability [1]. Depressive disorder is characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness, and poor concentration among these symptoms five or more symptoms persist for at least two weeks [2]. In its most severe form, depressive disorder can lead to suicide [3]. Whereas, bipolar disorder (BPD) is a mood disturbance Characterized by persistent and abnormally expansive, irritable, and elated mood; increased energy and goal-directed activity, decreased sleep, talkative, easily distractibility, and excessive risky activity, among these symptoms three or more symptoms persist or lasting for at least one- week duration [2]. Globally, Depressive disorder is rising at an alarming rate and more than 350 million people are affected by depressive disorder [4, 5]. More than 183.9 million disability-adjusted life years (DALY) are attributable to substance abuse and mental illness, according to statistics on the global burden of disease; depressive disorders accounting for more than 40.5% of these [6]. It is one of the most pressing public health problems associated with substantial poor quality of life, and interaction with others, comorbidity with other illnesses, impairment in cognition and emotion, and high mortality [7]. It is the leading cause of suicide. Depressive disorder leads individuals to health-related problems like suicide, diabetes, arthritis, and substance [5], and increases the mortality rate by four times compared to healthy individuals [7]. Costing more than 183.9 million is the report on the worldwide burden of disease linked to substance abuse and mental disorders. Beyond 7% of DALY cases have bipolar disorder [6]. In addition to the expense of treatment, bipolar disorder also raises the risk of unemployment, reduced productivity, and increased mortality [8]. Furthermore, risky sexual behavior, low quality of life, functional disability, suicide, and interpersonal interactions are all significantly impacted by bipolar disease [9–12]. Since BPD is a chronic condition and has an early onset, it accounts for more disability-adjusted life-years (DALYs) than neurological and other chronic medical (e.g. cancer) [13]. It significantly affects the emotions, mental health, self-care, and interpersonal relationships of the patient [14]. Because of the significant financial losses associated with receiving mental health services and patient care, it also places a heavy burden on the partner and their family [15]. According to a systematic review and meta-analysis of 90 publications, the combined lifetime and annual community prevalence of depressive disorder in the six continents and 30 countries studied was 10.8% and 7.32%, respectively [16]. In Ethiopia, the prevalence of depressive disorder was between 7.4–41% [17–20]. Risk factors of depressive disorder include t (...truncated)