Browsing by Author "Okello, Elialilia S."

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    Alcohol, Substance Use and Psychosocial Competence of Adolescents in Selected Secondary Schools in Uganda: A Cross Sectional Survey
    (International neuropsychiatric disease journal, 2016) Abbo, Catherine; Okello, Elialilia S.; Muhwezi, Wilson; Akello, Grace; Ovuga, Emilio; Makinodan, Manabu
    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.
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    Assessment of the relationship between life events with psychosocial competence of students in selected secondary schools in Northern and Central Uganda
    (African Health Sciences, 2020) Muhwezi, Wilson Winstons; Abbo, Catherine; Okello, Elialilia S.; Akello, Grace; Ovuga, Emilio B. L.
    As they grow, young people transit through adolescence; a particularly challenging phase. Many go through without difficulties but some experience maladaptive responses in form of conduct and adjustment problems, pubertal challenges and life stress. Published research from the developed societies demonstrates consistent associations between young people’s exposure to life events, psychosocial competence (PSC) and mental health problems. However, comparable research from income-constrained societies remains scarce. The purpose of this study was to determine the prevalence of life events in secondary school students and describe the relationship between life events and PSC in the same population. Methods: This was a cross-sectional study. Participants were 2,902 randomly selected in Central and Northern Uganda. They responded to self-administered questionnaires on socio-demographics, life events and PSC. Results: Northern Ugandan students were more likely to be susceptible to stress-related illness associated with major life events (p = < 0.01). Among students with a high susceptibility to stress related illness, those with low scores on self-efficacy (p = < 0.001), accurate self-assessment (p = < 0.001) and self-confidence (p = < 0.001) were mostly from the North. Students from Northern Uganda had experienced more negative events. Students with higher scores on empathy, emotional awareness, accurate self- assessment and self-confidence tended to have low distress. Students that had a low susceptibility to stress related illness (AOR = 1.97; 95% CI: 1.57 - 2.48); high scores on self-efficacy (AOR 1.37; 95% CI: 1.09 - 1.74), self-confidence (AOR 1.32; 95% CI: 1.02- 1.72), and accurate self-assessment (AOR 2.19; 95% CI: 1.70 - 2.80) were mostly from northern Uganda. Conclusion: It is important to help students to cope with negative life events since an association exists between negative life events and PSC domains. PSC domains of empathy, emotional awareness, accurate self-assessment and self-confidence seem to be associated with lower distress levels, implying that these should be reinforced.
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    Explanatory Models and Help-Seeking Behavior: Pathways to Psychiatric Care Among Patients Admitted for Depression in Mulago Hospital, Kampala, Uganda
    (Qualitative health research, 2007) Okello, Elialilia S.; Neema, Stella
    In this article, the authors present findings from a qualitative study exploring how people diagnosed with depression conceptualize their condition and how their conceptualization shaped their efforts to seek help. They used an interview guide based on an explanatory model framework for data collection. Four major themes emerged from the analysis: (a) somatization, social meaning of illness, and help seeking; (b) meaning and perceived consequences of illness; (c) How did I get here? Making sense of psychiatric admission; and (d) variations in the causal attribution and the role of significant others in help seeking. Somatization of emotional problems, variations in causal attribution between patients and their significant others, the nature of the available health care system, and burden of infectious disease complicate access to care. These findings suggest the need to raise the awareness of primary care providers on how to recognize and help people with depression appropriately in this setting.
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    Is the glass half full or half empty? A qualitative exploration on treatment practices and perceived barriers to biomedical care for patients with nodding syndrome in post-conflict northern Uganda
    (BMC Research Notes, 2015) Mwaka, Amos Deogratius; Okello, Elialilia S.; Abbo, Catherine; Odwong, Francis Okot; Olango, Willy; Etolu, John Wilson; Oriyabuzu, Rachel; Lagoro, David Kitara; Mutamba, Byamah Brian; Idro, Richard; Opar, Bernard Toliva; Aceng, Jane Ruth; Lukwago, Assuman; Neema, Stella
    Nodding syndrome has increasingly become an issue of public health concern internationally. The etiology of the disorder is still unknown and there are yet no curative treatments. We explored perceptions about treatment practices and barriers to health seeking for nodding syndrome in Pader and Kitgum districts in northern Uganda in order to provide data necessary for informing policy on treatment adherence and rehabilitations.We used focus group discussions and individual interviews to gain deep insights into help-seeking and treatment practices for nodding syndrome. Purposive sampling was used to identify information-rich participants that included village health teams, community members not directly affected with nodding syndrome, district leaders, healthcare professionals, and caregivers of children affected with nodding syndrome. We used qualitative content analysis to analyze data and presented findings under distinct categories and themes.Caregivers and communities sought care from multiple sources including biomedical facilities, traditional healers, traditional rituals from shrines, and spiritual healing. Nodding syndrome affected children reportedly have showed no enduring improvement with traditional medicines, traditional rituals, and prayers. A substantial minority of participants reported minimal improvements in symptoms of convulsions with use of western medicines. Challenges involved in health seeking included; (1) health system factors e.g. long distances to facilities, frequent unavailability of medicines, few healthcare providers, and long waiting times; (2) contextual and societal challenges e.g. lack of money for transport and medical bills, overburdening nature of the illness that does not allow time for other activities, and practical difficulties involved in transporting the physically deformed and mentally retarded children to the health facilities.Help-seeking for nodding syndrome is pluralistic and include use of traditional and biomedical practices. Western medicines admittedly showed at least short term control on nodding syndrome symptoms, especially convulsions and led in a few cases to regain of functional abilities. However, multiple barriers hinder health seeking and interfere with adherence to biomedical treatments. Regarding cure, there are hitherto no treatments participants perceive cure nodding syndrome.
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    Mental health literacy among secondary school students in North and Central Uganda: a qualitative study
    (Journal of World Association of Cultural Psychiatry, 2014) Okello, Elialilia S.; Abbo, Catherine; Muhwezi, Wilson W.; Akello, Grace; Ovuga, Emilio
    There has been limited effort to explore young people’s perceptions about mental illness in Uganda. For mental health programs targeting young people to succeed, it is important to incorporate their understanding of mental illness, their perceptions about causes of mental illness and their attitudes about mentally ill people. The objective of this study was to explore the mental health of young people in secondary schools in Northern and Central Uganda. Subjects and Methods—This was a qualitative study where 24 focus group discussions (FGDs) were held with young people in secondary schools. Respondents aged 14-24 years were purposively selected from 4 secondary schools in the two regions. During the FGDs, young people’s perceptions and understanding of three areas listed below were explored: meaning of mental health/mental illness; causes of mental illness and attitudes toward mental illness. Data management and analysis was done with the help of Atlas.ti, a-qualitative-analysis software. Thematic analysis approach was employed. Results—FGD participants used concepts like a sound and normal mind, right thinking, normal behavior and normal thoughts to define mental health. Mental illness on the other hand was defined as loss of sense of reality, malfunctioning of the brain, impaired thinking and bizarre behavior. Young people attributed mental illness to; substance abuse (Marijuana, alcohol), witnessing traumatic events (seeing ones your relatives being killed, or being forced to participate in killing-frequently mentioned by young people in Northern Uganda); witch craft, effect of physical illness e.g. HIV/epilepsy, thinking too much, accidents and genetic explanations. They had mixed opinions about interacting with mentally ill individuals. Unpredictability and dangerousness were known to be a recurrent theme among people with negative views about mentally ill. Nonetheless, some FGD participants believed that the level of interaction with mentally ill persons depended on familiarity with mental illness and the severity of the symptoms. Similarly, there were mixed opinions regarding mental illness and work. Three main clusters of responses emerged. These were: i) “mentally ill people should not work”; ii) “mentally ill people should work but..”; iii) “mentally ill people should work like everyone else”. Conclusions—Findings point to key gaps in the knowledge and attitudes of young people that need to be targeted by young-people-focused-interventions for mental health. In order for such interventions to succeed, young people must be able to recognize and respond appropriately to signs of distress, reduced functioning, and other early signs of poor mental health.
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    Naturalistic outcome of treatment of psychosis by traditional healers in Jinja and Iganga districts, Eastern Uganda – a 3- and 6 months follow up
    (International Journal of Mental Health Systems, 2012) Abbo, Catherine; Okello, Elialilia S.; Musisi, Seggane; Waako, Paul; Ekblad, Solvig
    To determine the naturalistic outcome of treatment of psychosis by traditional healers in Jinja and Iganga districts of Eastern Uganda. Method: A cohort of patients with psychosis receiving treatment from traditional healers’ shrines were recruited between January and March 2008 and followed up at three and six months. The Mini International Neuropsychiatry Interview (MINI Plus) was used for making specific diagnosis at the point of contact. For specific symptoms, Positive and Negative Symptom Scale (PANSS), Young Mania Rating Scale (YMRS) and Montgomery Asberg Depression Rating Scale (MADRS) were used to measure severity of schizophrenia, mania and psychotic depression, respectively. The Clinical Global Impression (CGI) and Global Assessment of Functioning (GAF) were used for objective assessments. The Compass Mental Health Index measured well being. Mean scores of the scales were computed using one way ANOVA for independent samples. Associations between outcome and categorical variables were examined at bivariate and multivariate levels.