Electrocardiogram Abnormalities and Associated Factors Among Psychiatric Patients Attending Follow-up at Jimma Medical Center, Psychiatry Clinic, Jimma, South-West Ethiopia, 2021

Abstract

Background: Psychiatric patients have a higher risk of cardiovascular morbidity and mortality as compared to the general population. Intrinsic biological changes caused by the disease and the adverse effects of psychotropic medications explain the high risk of cardiovascular disease in these patients. Early detection of subclinical cardiovascular disease using an electrocardiogram can improve the clinical outcomes of these patients. However, no previous study was done on electrocardiogram abnormalities among psychiatric patients in Ethiopia. Objective: The present study aimed to assess electrocardiogram abnormalities and associated factors among psychiatric patients attending follow-up at Jimma Medical Center, Psychiatry Clinic, South-west Ethiopia. Methods: An institution-based cross-sectional study was carried out among psychiatric patients attending Jimma Medical Center Psychiatry Clinic from October 14 to December 10. A consecutive sampling technique was employed to recruit the study participants. An Interviewer-administered structured questionnaire was used to collect socio-demographic data, behavioral factors, disease-related and medication-related data. Anthropometry, blood pressure, and random blood sugar were measured following the World Health Organization’s protocols. A resting 12 lead ECG was recorded according to the standard recording protocol of the Minnesota code. Data were entered into Epi data version 4.6 and exported to SPSS version 25. Descriptive statistics were carried out. Results of the descriptive analysis were summarized by frequencies, means, and proportions, and presented by using tables and figures. Bivariable and multivariable logistic regressions were performed to determine the association between dependent and independent variables. With a confidence interval of 95%, p-value ≤ 0.05 was considered statistically significant. Results: A total of 315 psychiatric patients were included in the present study. The mean age (SD) of the respondents was 36.27 ± 10.85 years. 191 (60.6%) (95% C.I. 55.6-66.3) participants had ECG abnormalities. The most prevalent ECG abnormality was arrythmia (27.6%). Age older than 40 [AOR=3.31:95% C.I.1.58-6.89], diabetes mellitus [AOR=3.35:95% C.I.1.19-9.42], treatment with antipsychotics [AOR=4.16:95% C.I.1.25-13.79], polytherapy [AOR=3.13:95% C.I.1.15-8.62], having schizophrenia [AOR=3.11:95%C.I.1.20-8.11], and illness duration of >10 years [AOR=4.25:95% C.I.1.72-10.49] were significantly associated with ECG abnormalities. Conclusion and recommendation: In the present study, six out of ten respondents had ECG abnormalities. Age of the respondents, diabetes mellitus, treatment with antipsychotics, having schizophrenia, polytherapy and illness duration of >10 years were significant predictors of ECG abnormalities. Routine ECG investigation should be performed in the JMC psychiatry treatment setup and further studies are recommended to delineate factors affecting ECG abnormalities