Prevalence and correlates of psychological distress symptoms among patients with substance use disorders in drug rehabilitation centers in urban Nepal: a cross-sectional study

Abstract

BackgroundThe burden of substance misuse in developing countries is large and increasing, with negative consequences for physical and psychological health. Substance use disorders and psychological distress commonly co-exist, however few studies have examined this relationship in developing countries, including Nepal. Our aim was to investigate the prevalence of psychological distress symptoms and associated factors among patients with substance use disorders attending drug rehabilitation centers in Nepal.MethodsWe conducted a cross-sectional study including 180 patients attending drug rehabilitation centers in the Kathmandu Valley region of Nepal. We used the 6-item Kessler scale (K6) to measure symptoms of psychological distress, and data on socio-demographics, behavioral and psychosocial factors. Multivariable analyses were used to identify factors associated with distress.ResultsThe prevalence of high psychological distress symptoms among patients with substance use disorder was 51.1 %. The mean score found on the K6 was 12.22 (SD = 5.87). Outcomes of multivariable analyses demonstrated various factors associated with symptoms of psychological distress, including age (β = −0.122, 95 % CI = −0.218; −0.026), education (β =2.694, 95 % CI = 0.274; 5.115), severity of drug abuse (Drug Abuse Screening Test-10-DAST10)(β = 0.262, 95 % CI = 0.022;0.502), and family functioning (Adaptability, Partnership, Growth, Affection and Resolve-APGAR) (β = −0.525, 95 % CI = −0.787; −0.264).ConclusionsHigh psychological distress symptoms are common in patients with substance use disorder in Nepal. Demographics (age, education), behavioral (drug abuse severity), and psychosocial factors (family functionality) were associated with psychological distress symptoms. If confirmed by future longitudinal studies such characteristics may assist in identifying groups at risk for co-morbid psychological distress symptoms among patients with substance use disorders. Future treatment approaches for substance use disorders should address co-existing mental illness in Nepal.

Patterns and sociodemographic characteristics of substance abuse in Al Qassim, Saudi Arabia: a retrospective study at a psychiatric rehabilitation center

“…Other characteristics of the present study were unemployment and unmarried single status which constituted 45% and 55% of abusers, respectively. 15 , 16 Our results were in agreement with other studies, such as a study in the United States that found the highest rate of drug abuse among youth ages 18 to 20 (22.7%) and 21 to 25 (21.5%). Another study found that those with the least schooling were more frequently heavy smokers and drinkers.…”

Socio-demographic and substance-related factors associated with mental distress among Wollo university students: institution-based cross-sectional study

“…Other studies also showed that a family history of mental illness was an associated factor for mental distress in students in Iraq [10], Pakistan [14], and Ethiopia [19, 28]. Besides, substance-related variables in France [27], Nepal [29] and Somaliland [30], Female gender in United States [26], Iran [10], Sweden [31], Australia [8] and Somaliland [30], poor worship practice in Ethiopia [19, 28] were some of the factors identified to account for mental distress in university students.…”

Prevalence and factors associated with psychological distress among key populations in Togo, 2017

“…Hazardous alcohol drinking (OR = 1.79) as well as HIV positive status (OR = 4.76) were associated with psychological distress as observed in our study. In another cross-sectional study among 180 patients conducted in drug rehabilitation centers in Nepal which used K-6 as psychological distress measurement tool, the prevalence of high psychological distress was 51.1% [35]. Factors associated with psychological distress were age, education level, severity of drug abuse.…”

“…Indeed, the population considered in our study is relatively young (median age = 25 years) unlike in other studies [35,36]. Also, different tools have been used in the other studies to measure PD as the Patient Health Questionnaire (PHQ) [19], the Center for Epidemiologic Studies Depression Scale (CES-D) [40] and K-6 [35]. Several studies in developed countries have reported that alcohol or drug consumption are closely associated with psychological distress.…”