Research
Department of Psychiatry
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Research activities
The Department is extremely active in mental health research and recognized as a center of excellence within sub-Saharan Africa, second only to South Africa and Nigeria. When considering all published medical research in Ethiopia, mental health publications rank fourth. Past research activities include extensive epidemiological surveys of populations in rural and urban areas, children, perinatal women, commercial sex workers, pastoralists and residents in isolated island communities.
The Butajira study of the course and outcome of schizophrenia and bipolar disorder (funded by the Stanley Medical Research Institute) is a landmark study within low- and middle-income countries. Over 68,000 people were screened for the presence of severe mental illness using rigorous diagnostic procedures and over 900 people were identified as having schizophrenia, bipolar disorder or severe depression. This group of people with severe mental illness has been followed up regularly for over 10 years. The Butajira study findings have contributed to a growing international consensus that the course of severe mental illnesses is no better in LMICs than in high-income country settings. Poorer physical health (under-nutrition) and elevated mortality, disability, lost economic productivity, stigma and high levels of caregiver burden were shown to be associated with severe mental illness in the Ethiopia study. The importance of access to medication was underlined by the finding that those who took medication for more than 50% of the follow-up time had lower levels of symptoms, improved functioning and lower mortality.
A community-based cohort of 1065 pregnant women, and the children they gave birth to, was established in 2005/2006 in order to investigate the impact of perinatal and maternal mental health on child health, growth, development and survival (the ‘C-MaMiE’ study, funded by the Wellcome Trust). Symptoms of common mental disorders in the mothers were associated with impaired functioning, prolonged labour, delayed initiation of breastfeeding, increased diarrhoeal episodes in the infant, increased risk of injury in the infant and poorer child mental health at five years of age. The women and their children continue to be followed up and a PhD student (Habtamu Mekonnen) is investigating the impact of maternal common mental disorders on child educational outcomes at age 7.5 years.
The Department is now undertaking the following randomized, controlled clinical trials, intervention studies and mental health service evaluations:
(1) PRIME: the Programme for Improving Mental Health CarE(http://www.prime.uct.ac.za/)
PI: Dr. Abebaw Fekadu
Project co-ordinator: Dr. Girmay Medhin
AAU Co-investigators: Prof. Atalay Alem, Dr.. Charlotte Hanlon, Dr.. Solomon Teferra and Dr.. Teketel Tegegn
PhD students: Ayele Belachew, Telake Azale, Medhin Selamu, Maji Haile-Mariam, Kebede Tirfessa and TeseraBitew
Aim: To understand the best approaches for integrating mental health care into the primary care system in Ethiopia and four other low- and middle-income countries.
Funder: UK Department for International Development (UKAID)
(2) EMERALD: Emerging mental health systems in low-and middle-income countries (http://www.emerald-project.eu/)
Co-PIs: Professor Atalay Alem and Dr.. Charlotte Hanlon
AAU Co-investigators: Dr.. Abebaw Fekadu, Prof. Damen Haile-Mariam
PhD students: Fentie Ambaw, Yohannes Haile-Michael
Aim: To generate evidence to support (1) adequate, fair and sustainable resourcing (health system inputs), (2) integrated physical and mental health service provision (health system processes) and (3) improved coverage of care and goal attainment (health system outputs) for the mental health system in Ethiopia and five other low- and middle-income countries.
Funder: European Commission within the 7th Framework Programme
(3) AFFIRM: Africa Focus on Intervention Research for Mental Health (AFFIRM) (http://www.affirm.uct.ac.za/)
Overall cross-country co-PI: Professor Atalay Alem
Country co-PIs: Dr.. Charlotte Hanlon and Dr.. Abebaw Fekadu
AAU Co-investigator: Dr.. Girmay Medhin
PhD Student: Kassahun Habtamu
Aim: to carry out a non-inferiority randomized, controlled trial of task sharing for the care of severe mental illness in Ethiopia.
Funder: NIMH
(4) MINOS: Minocycline for schizophrenia
PI: Dr. Abebaw Fekadu
AAU co-investigators: Dr. Girmay Medhin, Prof. Atalay Alem, Dr. Solomon Teferra, Dr. Charlotte Hanlon
Aim: to carry out a randomized controlled trial of the effectiveness of adjunctive minocycline for treatment-resistant schizophrenia
Funder: Stanley Medical Research Institute
(5) The FOLATE trial
Country PI: Dr. Abebaw Fekadu
Study PI: Dr. Desalegn Bekele
AAU co-investigator: Dr. Solomon Teferra
Aim: to carry out a randomized controlled trial of the effectiveness of FOLATE and B12 for people who have schizophrenia with residual symptoms.
Funder: Stanley Medical Research Institute
(6) BIABER PROJECT: Scaling up Interpersonal Psychotherapy (IPT) for Common Mental Disorders in Ethiopia.
PI: Dr. Dawit Wondimagegn
AAU co-investigators: Prof. Atalay Alem, Yonas Baheretibeb, Abebaw Fekadu, Charlotte Hanlon
Aim: The Biaber Project will help tame the lion of Common Mental Disorders in Ethiopia by reducing the suffering of patients and improving access to culturally adapted Interpersonal Psychotherapy.
Funder: Grand Challenges Canada
(7) Traditional Healers: The oxen of the land: Exploring ways of working with traditional healers
PI: Dr. Dawit Wondimagegn
AAU co-investigator: Yonas Baheretibeb
Aim: The oxen of the land project aims to explore ways of working with traditional healers
Funder: Grand Challenges Canada
(8) RISE: Rehabilitation Intervention for people with Schizophrenia in Ethiopia
PI: Dr. Abebaw Fekadu
AAU co-investigators: Dr. Laura Asher, Dr. Girmay Medhin and Dr. Charlotte Hanlon
Aim: to carry out a randomized controlled trial of community-based rehabilitation for people with schizophrenia in rural Ethiopia.
Funder: Welcome Trust
(9) The HEAT+ project
Co-PIs: Dr. Yonas Baheretibeb and Dr. Charlotte Hanlon
AAU co-investigator: Dr. Abebaw Fekadu
PhD student: Dejene Tilahun
Aim: To increase awareness amongst health extension workers of mental health conditions with a particular focus on autism and other child developmental disorders.
Funder: Autism Speaks.
