title: Major depressive disorder and suicidal behavior among urban dwelling Ethiopian adult outpatients at a general hospital.
abstract: BACKGROUND
  We sought to evaluate the prevalence and correlates of major depressive disorder (MDD) and suicidal behavior among urban dwelling Ethiopian adults.
  
  
  METHODS
  This was a cross-sectional study of 1097 outpatient adults (≥18 years of age) in a major hospital in Addis Ababa, Ethiopia. Sociodemographic and lifestyle characteristics were collected via structured interviews. MDD and suicidal behavior were assessed using the Composite International Diagnostic Interview (CIDI) among all study participants. Multivariable logistic regression models were fitted to estimate odds ratios (OR) and 95% confidence intervals (95% CI).
  
  
  RESULTS
  Prevalence estimates for lifetime and 12-month MDD were 18.0% and 6.7%, respectively. The prevalence of suicidal behavior during the previous year (i.e., suicidal ideation, plan or attempt) was 15.2% with approximately 4% having reported attempts. Overall, women were more likely to report suicidal behavior (17.8%) than men (11.3%). MDD odds were 1.53-fold higher among women as compared with men (aOR=1.53, 95% CI 1.05-2.23). Lifetime MDD was significantly associated with age, sex, marital status, and self-reported physical health. Participants reporting poor mental health had approximately 3-fold increased odds of MDD (OR=2.93; 95%CI: 1.05-2.23); those between 35 and 44 years old (aOR=1.92; 95%CI: 1.06-3.49) and those older than 55 years (aOR=2.54; 95%CI: 1.16-5.57) had higher odds of MDD. Similarly suicidal behavior was significantly associated with sex, marital status, and self-reported physical and mental health.
  
  
  CONCLUSIONS
  This cross-sectional study utilized self-reported data from outpatients. Causality cannot be inferred, and results may not be fully generalizable.
  
  
  CONCLUSIONS
  Overall results show that MDD and suicidal behavior are highly prevalent among urban-dwelling Ethiopian adults. Women and middle-age adults constitute a high-risk group and may therefore benefit from targeted interventions.
authors.affiliation: Department of Psychiatry, University of Cambridge, Cambridge, UK. Electronic address: abw25@cam.ac.uk.
authors.forename: Anjalene B
authors.initials: AB
authors.lastname: Whittier
authors.affiliation: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Bizu
authors.initials: B
authors.lastname: Gelaye
authors.affiliation: Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.
authors.forename: Negussie
authors.initials: N
authors.lastname: Deyessa
authors.affiliation: Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.
authors.forename: Yonas
authors.initials: Y
authors.lastname: Bahretibeb
authors.affiliation: Horizon Health Network, Zone 3, New Brunswick, Canada.
authors.forename: Teshome Shibre
authors.initials: TS
authors.lastname: Kelkile
authors.affiliation: Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
authors.forename: Yemane
authors.initials: Y
authors.lastname: Berhane
authors.affiliation: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Williams
mesh_terms: D000328:Adult; D000368:Aged; D044383:Black People / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000523:psychology*; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D015438:Health Behavior; D006769:Hospitals, General; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010045:Outpatients / Q000523:psychology* / Q000706:statistics & numerical data; D015995:Prevalence; D057566:Self Report; D059020:Suicidal Ideation; D014505:Urban Population / Q000706:statistics & numerical data*
keywords: Africa; Depression; Ethiopia; Prevalence; Sociodemographic correlates; Suicide