Improving mental health outcomes for bipolar disorder in Ethiopia
Mekdes Demissie is an AMARI Fellow based at Addis Ababa University in Ethiopia. The African Mental Health Research Initiative (AMARI) research program is supported by the Developing Excellence, Leadership and Training in Science in Africa (DELTAS Africa), a programme of the African Academy of Sciences. AMARI is one of the 11 programmes funded through the African Academy of Sciences’ Developing Excellence, Leadership and Training in Science in Africa (DELTAS Africa) programme. DELTAS Africa funds collaborative networks/consortia led by Africa-based scientists to amplify Africa-led development of world-class research and scientific leaders on the continent, while strengthening African institutions. DELTAS Africa is implemented through AESA (The Alliance for Accelerating Excellence in Science in Africa), a funding and agenda setting platform created by the AAS in partnership with the African Union Development Agency (AUDA-NEPAD) and with the support of Wellcome and the UK’s Department for International Development (DFID).
Mental disorders are a neglected health concern in Africa. Bipolar disorder affects about 45 million people worldwide, according to the World Health Organization (WHO). It typically consists of both manic and depressive episodes separated by periods of normal mood. Manic episodes involve elevated or irritable mood, over-activity, rapid speech, inflated self-esteem and a decreased need for sleep. People who have manic attacks but do not experience depressive episodes are also classified as having bipolar disorder.
There is a huge treatment gap in bipolar disorder partly because of the stigmatization of mental health in Africa but also because there is limited data reflecting the burden of mental health diseases in low-and middle-income countries (LMICs). In Ethiopia, it is estimated that 15% of people are affected by major mental illness or substance abuse disorders.
Description of study
Dr Mekdes Demissie an AMARI fellow and mental health professional focused her doctoral study on developing and piloting adjunctive psychosocial interventions such as psychoeducation and stigma reduction strategies for bipolar disorder that can be delivered by non-specialist health care workers in primary health care settings in Ethiopia.
She was motivated to carry out this study because studies conducted in other LMICs and in Ethiopia showed that the disorder is linked to health, social, economic and functional problems. In addition, her clinical experience in working with people with severe mental illness revealed that patients would often relapse.
Social and psychological intervention such as psychoeducation, cognitive and behavioral therapy have proved to be effective in preventing relapse and improving outcomes compared to when pharmacotherapy treatments are used alone. However, in LMICs, evidence about adaptation, effectiveness, and implementation of contextually appropriate psychosocial intervention is rare. Dr Mekdes study aims to adapt a feasible and acceptable psychosocial intervention for people with bipolar disorder in Ethiopia.
Results so far