Cognitive impairment and associated factors among patients with mood disorders receiving care at public hospitals in Gedeo zone, Southern Ethiopia

Abstract

BACKGROUND: Cognitive impairment is characterized by difficulty in attention, memory, problem-solving, and decision-making. It is strongly linked to mood disorders and affects work performance, social interactions, medication adherence, and overall quality of life. Despite the high burden of the problem, evidence on its prevalence and contributing factors remains scarce in low- and middle-income countries. This study aimed to determine the prevalence and associated factors of cognitive impairment among individuals with mood disorders. METHOD: A cross-sectional study was conducted at Gedeo Zone public hospitals. A systematic sampling technique was used to select a total of 422 individuals receiving care for mood disorders. The outcome variable was assessed using the Montreal Cognitive Assessment (MoCA). The data were entered into Epi Data version 4.2 and analyzed using STATA version 17. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with cognitive impairment. The presence of an association was examined with an adjusted odd ratio with a 95% confidence interval and variables with P values less than 0.05 were considered a statistically significant association. RESULT: The prevalence of cognitive impairment among individuals with bipolar disorders and depressive disorders was 34.5% (95% CI: 32.7-36.9) and 38.7% (95% CI: 36.4-40.8), respectively. Having a longer duration of treatment [AOR = 1.87 (95% CI: 1.57, 2.94)], a duration of illness 10 years and above [AOR = 2.13 (95% CI 1.23, 4.48)], and severe depressive symptoms [AOR = 2.15 (95% CI 1.14, 4.97)] were significantly associated with cognitive impairment among individuals with depressive disorders. Medication non-adherence [AOR = 1.48 (95% CI: 1.34, 2.78)], a long duration of illness [AOR = 1.42 (95% CI: 1.09, 2.48)], and severe manic symptoms [AOR = 2.16 (95% CI: 1.18, 5.28)] were significantly associated with cognitive impairment among participants with bipolar disorders. CONCLUSION: This study revealed a high prevalence of cognitive impairment in patients with mood disorders. Therefore, early screening and intervention for cognitive impairment in mood disorder patients are essential to deliver holistic care and improve treatment outcomes. Integrating cognitive assessments into routine mental health evaluations can help identify early deficits and enable tailored interventions. Additionally, cognitive remediation strategies such as structured patient education, side-effect management, and medication adjustments should be prioritized to enhance adherence and overall recovery.