Prodromal psychotic symptoms and its associated factors Among students attending high schools in jimma city, Ethiopia 2025

Abstract

Background: A prodrome is an early stage of psychosis that indicates a person's condition before full-blown symptoms appear. Detection of prodrome helps on integrating predictive indicators of early warning signs into clinical practice to prevent and mitigate the burden associated with full-blown psychotic disorders. Compared to adulthood, adolescence is a vulnerable period for developing psychosis and experiencing psychosis-like symptoms, because it is marked by physical, emotional and social changes. Over the past two decades, extensive study has been conducted into the early detection of prodrome but most research has been conducted in high-income countries with dearth of literature in sub-Saharan Africa like Ethiopia. Objective: The aim of this study was to assess the prevalence of prodromal psychotic symptoms and its associated factors among students attending high schools in Jimma city, Ethiopia 2025. Method: An institution based cross-sectional study was conducted on total of 603 high school students in Jimma city from January to February, 2025. Multistage sampling was used to select students. Data was collected by interviewer administered questionnaire using kobo tool box and was exported to SPSS for analysis. Bivariate and multivariable logistic regression were carried out to identify factors associated with prodromal psychotic symptoms. The Adjusted Odds Ratio (AOR) with 95% CI and p-value < 0.05 were used to determine statistical significance. Result: The prevalence of prodromal psychotic symptoms is 20.4 (95% CI=17.4-23.9) and being female was associated with more than double the odds (AOR=2.38) of experiencing prodromal psychosis compared to being male. Similarly, students with depression had nearly three times the odds (AOR=2.87) of experiencing prodromal psychosis compared to students without depression. The strongest association was observed for students with a family history of mental illness, who had over three-and-a-half times the odds (AOR=3.63) of prodromal psychosis compared to those without a family history of mental illness. Additionally, exposure to major life events increased the odds of prodromal psychosis by approximately 3.4-fold. Conclusion: This study reveals a prevalence of prodromal psychotic symptoms of 1 in 5 among high school students and identifies four significant risk factors: family history of mental illness, exposure to major life events, depression, and female sex.