title: Magnitude and associated factors of aggressive behaviour among patients with bipolar disorder at Amanual Mental Specialized Hospital, outpatient department, Addis Ababa, Ethiopia: cross-sectional study.
abstract: BACKGROUND
  Aggressive behavior is a challenging behavior among bipolar patients that causes poor social interaction and hospitalization. But, there is no information regards of the magnitude and contributing factors for aggressive behaviour among bipolar patients in Ethiopia. Therefore, this study was designed to assess the prevalence and associated factors of aggressive behaviour among patients with bipolar disorder.
  
  
  METHODS
  An institutional based cross sectional study was conducted at Amanual Mental Specialized Hospital from May 1 to June 1, 2015 among 411 participants who were selected by systematic random sampling technique. Data was collected by interview technique by using Modified Overt Aggression Scale, entered and analyzed by using Epi Data 3.1 and Statistical Package for Social Science version 20, respectively. Adjusted Odd Ratio (AOR) with 95% Confidence Interval (CI) were used to show the odd and P-value <0.05 was considered as statistically significant.
  
  
  RESULTS
  A total of 411 bipolar patients were included in the study and the prevalence of aggressive behaviour was 29.4%. Significant associated factors for aggression were, having two or more episode [AOR = 2.35 95% CI (1.18, 4.69)], previous history of aggression, [AOR = 3.72, 95% CI (1.54, 8.98)], depressive symptoms [AOR = 3.63, 95% CI (1.89, 6.96)], psychotic symptoms [AOR = 5.41,95% CI (2.88, 10.1)], manic symptoms [AOR = 3.85,95% CI (2.06, 7.19)], poor medication adherence [AOR = 3.73 95% CI (1.71, 8.13)], poor social support [AOR = 2.99 95% CI (1.30, 6.91)] and current use of substance[AOR = 2.17 95% CI (1.16, 4.06)].
  
  
  CONCLUSIONS
  Prevalence of aggression is high among bipolar patients and associated with many factors. So it needs public health attention to decrease aggression among bipolar patients.
authors.affiliation: Psychiatry Department, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, PO box 79, Ethiopia. habte.belete@gmail.com.
authors.forename: Habte
authors.initials: H
authors.lastname: Belete
authors.affiliation: Psychiatry Department, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
authors.forename: Haregwoin
authors.initials: H
authors.lastname: Mulat
authors.affiliation: Amanual Mental Specialized Hospital, Addis Ababa, Ethiopia.
authors.forename: Tolesa
authors.initials: T
authors.lastname: Fanta
authors.affiliation: Psychiatry Department, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia.
authors.forename: Solomon
authors.initials: S
authors.lastname: Yimer
authors.affiliation: Felegehiwot Referral Hospital, Bahir Dar, Ethiopia.
authors.forename: Takele
authors.initials: T
authors.lastname: Shimelash
authors.affiliation: Psychiatry Department, College of Medicine and Health Science, Haromaya University, Harrer, Ethiopia.
authors.forename: Tilahun
authors.initials: T
authors.lastname: Ali
authors.affiliation: Nursing Department, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia.
authors.forename: Tilahun
authors.initials: T
authors.lastname: Tewabe
mesh_terms: D000328:Adult; D000374:Aggression / Q000523:psychology*; D001714:Bipolar Disorder / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010045:Outpatients / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D012944:Social Support; D055815:Young Adult
keywords: Aggressive behaviour; Bipolar disorder; Ethiopia