Prevalence of Self-Reported Psychotic Experiences and Associated Factors Among High School Students in Dire Dawa Ethiopia, 2025

Abstract

Background: Psychotic experiences (PEs) among high school students often represent early indicators of serious mental health risks. In low-resource settings such as Ethiopia, these experiences remain insufficiently studied despite their potential long-term effects on educational performance and social functioning. This study assessed the prevalence of psychotic experiences and associated factors among high school students in Dire Dawa, Ethiopia, in 2025.

Methods: A school-based cross-sectional study was conducted among 953 high school students selected using stratified random sampling from public and private schools. Data were collected using a structured questionnaire, including the Community Assessment of Psychic Experiences. Social and environmental factors were assessed using the Oslo-3 Social Support Scale and the Adverse Childhood Experience scale. Information on demographic characteristics, substance use, and family-related factors was also obtained. Data analysis was performed using multivariable logistic regression to identify predictors of psychotic experiences.

Results: The mean age of participants was 17.76 ± 1.74 years. The overall prevalence of psychotic experiences was 33.8%, with persecutory ideation being the most commonly reported symptom (40.4%). Significant predictors of psychotic experiences included khat chewing (AOR = 3.27; 95% CI: 2.01–5.33), cigarette smoking (AOR = 2.02; 95% CI: 1.07–3.83), physical neglect (AOR = 1.74; 95% CI: 1.16–2.60), emotional abuse (AOR = 5.05; 95% CI: 2.83–9.02), and parental absence (“left behind”) (AOR = 4.71; 95% CI: 3.20–6.92). Females reported more perceptual abnormalities, whereas males reported more bizarre thoughts.

Conclusion: The high prevalence of psychotic experiences underscores the urgent need for school- based mental health interventions focusing on substance use prevention, trauma-informed care, and strengthened social support to reduce future mental health burden among Ethiopian adolescents.