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In spite of the vulnerability of prisoners to depression and their increased number, the issue has not been thoroughly investigated in Ethiopia. In particular, the determining factors of depression have not been exhaustively identified. Thus, the purpose of this study is to assess the prevalence of depression and associated factors among prisoners in Mizan prison institute, southwest Ethiopia.

An institution-based cross-sectional study was conducted from April 6–27, 2020. A total of 340 randomly selected prisoners were included. Depression was assessed using the Patient Health Questionnaire-nine and participants were considered to be in a state of depression if they scored five and above. Binary logistic regression was used to assess the association between the outcome variable (depression) and the independent variables (factors). The odds ratio with a 95% confidence interval (CI) was used to measure the strength of association. The final significance was decided using a p-value < 0.05.

The prevalence of depression was 29.9% (95% CI: 25%, 34.8%). Prisoners whowere not participating in the duty work of the prison had 55% (adjusted odds ratio [AOR] = 0.45; 95% CI: 0.22, 0.93) less odds of depression compared to those who were participating in the duty work. Similarly, physically active respondents had 81% (AOR = 0.19; 95% CI: 0.10, 0.35) less odds of depression than physically inactive respondents. Moreover, undernourished participants had two times (AOR = 2.03; 95% CI: 1.08, 3.82) higher odds of depression than normal participants.

Considering their risk of exposure compared to the general population and the limitations of cross-sectional study design, special care should be provided to the prisoners’ mental health. Moreover, priority attention should be given to the undernourished, physically inactive and those who are participating in duty work in the prison.

This study demonstrated important and modifiable factors associated with prisoners’ depression. It also evaluated the contribution of new variables (such as participation in the duty work, nutritional status and physical activity) that were not considered in previous local studies.