Emilio Ovuga

The prevalence of depression in two districts of Uganda

Little information is available on the prevalence of depression in Uganda. Given the recent political history of Uganda, depression may be common. The aim was to estimate the point prevalence of probable clinical depressive disorder among the general population in two contrasting districts of Uganda. Translated versions (in Madi and Lusoga) of the 13-item Beck Depression Inventory (BDI) were administered to a systematic sample of adult residents in the Adjumani and Bugiri districts of Uganda. The overall prevalence of probably clinically significant depression (BDI score of 20–39) was 17.4%. Significantly higher rates were found in women and in Adjumani District. Depression is common in Uganda and particularly in the more troubled and less socially cohesive district of Adjumani.

Prevalence of Suicide Ideation in Two Districts of Uganda

ABSTRACT Suicide ideation is common in all communities but research on suicidal behavior in Sub-Saharan Africa is scarce. The aim of this study was to determine the prevalence of self-reported suicidal ideation in two contrasting districts of Uganda. The method employed was a systematic sample of 939 respondents residing in Adjumani and Bugiri districts, using the Beck Scale for Suicide Ideation (BSS). Results indicated a higher rate of suicidal ideation in females, the unemployed and in Adjumani district. Consistent with other international studies, high rates of suicidal ideation were found in the Ugandan population. The higher prevalence of suicide ideation in the Adjumani District appears to be a symptom of psychosocial distress related to many years of social and political turmoil and the poor socio-economic conditions. In-depth observational studies are needed to fully understand the process of suicide ideation in Uganda.

The Psychological Impact of War and Abduction on Children in Northern Uganda: A Review

Objectives: In more than two decades northern Uganda was affected by the war between the government and the LRA. Children were abducted and affected during the war, but what is the psychological and social impact of war on the children? Methods: In this study we reviewed 40 epidemiological trauma studies conducted in Uganda from 2004-2014 using databases. Results: The psychological impact was found in many different domains ranging from mental health problems like PTSD, depression, anxiety, and psychosis to suicidal ideation, alcohol abuse, partner violence, child abuse, and feelings of guilt and revenge, furthermore, many experienced problems when returning to their home communities. Uganda only has few mental health workers, few clinical facilities and lack medication to treat mental health problems. Conclusion: We therefore conclude that the prevalence of mental health problems continue to be high to this day, despite the war ending in 2007.

Alcohol, Substance Use and Psychosocial Competence of Adolescents in Selected Secondary Schools in Uganda: A Cross Sectional Survey.

Aims 1) To determine the nature and extent of alcohol and substance use and 2) To describe the relationship between alcohol use and psychosocial competence among secondary school youths in Northern and Central Uganda. Study Design This was a cross-sectional study. Place and Duration of study Departments of Mental Health, Gulu University (Northern Uganda) and Department of Psychiatry, Makerere University College of Health Sciences (Central Uganda) between September 2011 and April 2012. Methodology Four (4) and eight (8) secondary schools located in the rural and urban areas of Gulu and Kampala districts respectively were randomly selected to participate in the survey. A total of 3,200 students aged 12 to 24 years were recruited by proportionate multistage sampling. Data was collected using a socio-demographic questionnaire that included questions about nature and frequency of alcohol and substance use. A pre-tested self-administered survey questionnaire with scales to measure components of psychosocial competence (PSC) was administered. Data was entered in Epidata, and exported to SPSS version 16.0 for analysis. Psychosocial competence was classified as high or low depending on the responses in the sub-scales of decision making, self efficacy, empathy, emotional awareness, coping with stress and emotions, and accurate self-assessment and self-confidence. Results A total of 2,902 questionnaires comprising of 2,502, (86.2%) from Kampala district and 400 (13.8%)) from Gulu district were analyzed. Male to female ratio was 1:1 with an age range of 12 to 24 years and a mean of 16.5. About 70.1% had ever used alcohol and substances. Only 39.1% used substances regularly. The commonest substance used was alcohol (23.3%), followed by kuber (10.8%), khat (10.5%), aviation fuel (10.1%), cannabis (9.2%) and cigarettes (5.9%). Respondents from the Gulu district were twice more likely to use all substances. Users and regular users from the North Northern Uganda had lower psychosocial competence. Factors significantly associated with non-use of alcohol were high levels of self-confidence, non-use of cannabis and kuber and age. In the alcohol user groups, a high level of coping was associated with discontinued and experimental use of drugs of abuse. Conclusion More than two-thirds (70.1%) of young people in this study had ever used substances of abuse only once and slightly over a third had used it regularly. From the perspectives of service provision, mental health promotion and prevention of illicit substance use, school mental health programmes that target both non-users and users are recommended.

A narrative analysis of the link between modern medicine and traditional medicine in Africa: a case of mental health in Uganda

BACKGROUND Traditional Medicine Practices (TMP) which are premised on indigenous knowledge and experiences within a local context of the culture and environment, are common place in low income countries. In Africa and in Uganda specifically, nearly 80% of the Ugandan population relies on TMP for the care of their mental health but they also use Modern Medicine. There are areas of departure between Traditional and Modern Medical practices in Africa that have been cited. What has attracted less research attention, are the areas of convergence. OBJECTIVE This paper aims to critically examine the link between Modern Medicine and Traditional Healing Practices in Africa, citing Uganda as case example. METHOD A Narrative literature review with critical element assessment was undertaken to identify documented points of departure, areas of common practice, and ways in which the two models can co-exist and work together through a carefully thought out integration. RESULTS Points of departure between Modern Medicine and Traditional Medicine Practices are philosophical underpinnings of both practices, training of practitioners, and methods and ethics of work. Common areas of practice include human rights perspective, descriptions of mental illnesses, clinical diagnostic practice, particularly severer forms, intellectual property rights, and cross prescriptions. Exhibiting cultural humility and responsibility on the side of the Modern Medicine Practitioners is one of the ways to work together with TMPs. CONCLUSION Points of departure are more documented and explicit and overshadow areas of common practice while the links between the two are mainly implicit but sadly unrecognized. Mental disorders are disorders of the brain and in neuroscience; the brain is culturally and socially constructed. Sociocultural issues therefore cannot be divorced from disorders of the brain and their management. For better patient outcome and patient-centered approach of care, it is necessary to acknowledge and enhance the links in teaching, clinical and policy level and carry out research on how the links could be improved.