Mental Wellbeing and its Determinants in People with Parkinson’s Disease in Ethiopia: A Mixed-Method Study

Abstract

Globally, the prevalence of Parkinson’s disease (PD) is increasing at an unprecedented rate. Therefore, it is imperative to provide evidence on the mental well-being of individuals with PD and identify context-specific determinants in sub-Saharan Africa to inform future interventions. An explanatory sequential mixed-methods design was employed, recruiting 304 individuals with PD who were receiving follow-up treatment. The prevalence of poor mental well-being among participants was 72.5%. Psychiatric manifestations included depression with suicidal ideation, anxiety, poor sleep quality, cognitive impairment, psychotic symptoms, and emotional and behavioral changes. Stigma was significantly associated with poor mental well-being, with an adjusted odds ratio of 1.13 (95% CI: 1.07-1.203, P < 0.001). A framework illustrating the vicious cycle of PD-related stigma, discrimination, and its impact on mental well-being was developed. Routine screening and treatment of mental disorders, along with community awareness campaigns to reduce stigma, are strongly recommended.

Plain language summary

Parkinson’s disease (PD) exerts a significant impact on mental well-being due to its disease process and associated social and economic consequences. Therefore, assessing the prevalence of poor mental well-being, identifying manifestations of mental illness, and examining context-specific determinants in sub-Saharan Africa are essential to informing current practices and future research. Findings from this study reveal that nearly three-fourths of individuals with PD experience poor mental well-being in Ethiopia. Additionally, they exhibit a range of psychiatric manifestations, including severe conditions such as hopelessness and suicidal ideation. PD-related stigma is an independent determinant of mental well-being. People with PD face significant stigma and discrimination, largely driven by societal misconceptions about the causes of the disease. Routine screening and treatment of mental disorders, alongside the integration of mental health care into routine PD management, are essential to addressing the mental health needs of individuals with PD. Community awareness initiatives on the causes of PD are critically needed to reduce stigma and promote mental well-being. Given the high burden of mental disorders and the impact of stigma and discrimination, mental health and psychosocial interventions should prioritize individuals with PD.