Assessments of Functional outcomes and its Determinants among Bipolar disorder patients on treatments in Northwest Ethiopia Comprehensive Specialized Hospitals: A multicentre hospital based study.

Abstract

Abstract Introduction: Bipolar disorder is severe and chronic mental illness that could be continue throughout the lifetime. Thought it is a leading cause of disability and impairments for significant numbers of patients, the levels of the functional outcomes have not been studied in Ethiopia. Objective: The aim of this study was to assess the functional outcome levels and associated factors among bipolar disorder patients treated with pharmacological therapy in Northwest Ethiopia Comprehensive Specialized Hospitals, 2021. Method: Hospital based cross-sectional study was employed on 423 bipolar disorder patients attending psychiatric clinics, northwest Ethiopia, from April to June 2021. Systematic random sampling was used to get respondents, descriptive and inferential statistics were done. Data was entered to Epi data version 4.6.02 and export to SPSS Version 22 for analysis. Bivariable and multivariable binary logistic regression analysis was used to identify the factors associated with functional outcome levels and p-value < 0.05 was considered as significant with 95% CI. Result: A total of 423 respondents were included in the final analysis making the response rate of 100%. The median (IQR) level of functional outcome was 6 (0-22) and 40% of the study subjects were impaired. Leisure time was the most normal functioning domain (92.2%), whereas cognitive (43.5%) and occupational (41.6%) domains were most impairment domains. Most commonly prescribed medications were mood stabilizer plus antipsychotics and more than half (52%) of participants were use traditional remedies. Unemployment (AOR (95%CI) =3.9 (1.46-10.49), obesity (AOR (95% CI) = 6.5 (1.22-34.58), depressed and manic mood phases (AOR (95%CI) =5.2 (2.84-9.35) and (AOR (95%CI) = 7.8 (3.31-18.34) respectively, medication non-adherence (AOR (95% CI) = 3.2 (1.71-6.05) and relapsed once or ? twice (AOR (95%CI) = 2.2 (1.25-3.98) (AOR (95%CI) = 8.3 (2.73-25.30), respectively, were some of the important predictor variables that were significantly associated to the functional impairments levels. Conclusion: Significant numbers of the bipolar patients were showed functional impairment; particularly, cognitive and occupational domains need unrestricted interventions .Mood stabilizer plus antipsychotics were most commonly prescribed medications. Unemployed, being obese, manic and depressive mood status, non-adherence, number of relapse, were significantly associate with functional impairment levels. Key words: Functional Outcomes, Impairment, Bipolar disorder, Northwest Ethiopia