title: Psychological morbidity and substance use among patients with hypertension: a hospital-based cross-sectional survey from South West Ethiopia.
abstract: BACKGROUND
  Psychological morbidity and substance use disorders have been linked to cardiovascular diseases; affecting patients' medical outcome and quality of life. However, little is known about psychological morbidity and substance use among patients with hypertension in Ethiopia. Therefore, we aimed to assess psychological comorbidity and substance use among hypertensive patients in Southwest Ethiopia.
  
  
  METHODS
  A cross-sectional study was conducted among 396 hypertensive patients on follow-up at Jimma University Teaching Hospital in Ethiopia during the study period. Structured questionnaires were used to assess alcohol use, khat chewing and cigarette smoking. Psychological morbidity was assessed using the Kessler-6 scale. Multiple logistic regression analysis was carried out to identify the independent association between outcome and explanatory variables.
  
  
  RESULTS
  The prevalence of psychological morbidity among hypertensive patients was 31.6%. Of the total participants, 31 (7.8%) of them had alcohol use disorders and 79 (19.9%) of them were using khat regularly at the time of the study. Singles were more likely to have psychological morbidity than married participants (AOR = 4.72; 95% CI 1.83, 12.20, p = 0.001), whereas those who were able to 'read and write' were less likely to have psychological morbidity than non-literate ones (AOR = 0.46; 95% CI 0.24, 0.89, p = 0.02). However, no association was seen between psychological morbidity and substance use (khat chewing, alcohol use and cigarette smoking), belief about hypertension, ever discontinuation of medication and lifestyle (exercise, salt consumption).
  
  
  CONCLUSIONS
  Psychological morbidity and substance use are prevalent among hypertensive patients on follow-up at the hospital. The findings of the study imply that there is a need for further studies to understand the effect of psychological morbidity on the clinical outcomes of hypertensive patients.
authors.affiliation: Department of Psychiatry, College of Health Sciences, Jimma University, Jimma, Ethiopia.
authors.forename: Matiwos
authors.initials: M
authors.lastname: Soboka
authors.affiliation: Department of Internal Medicine, College of Health Sciences, Jimma University, Jimma, Ethiopia.
authors.forename: Esayas Kebede
authors.initials: EK
authors.lastname: Gudina
authors.affiliation: Department of Psychiatry, College of Health Sciences, Jimma University, Jimma, Ethiopia.
authors.forename: Markos
authors.initials: M
authors.lastname: Tesfaye
keywords: Ethiopia; Hypertension; ‘Mental health service’; ‘Psychological morbidity’; ‘Substance use’