Substance Use Disorders and Associated Factors Among Adult Psychiatric Patients in Jimma Town, Southwest Ethiopia, 2017. Community-Based Cross-Sectional Study

Abstract

Background: Substance use disorders are more common among people with mental illness than in the general population. It makes recovery from mental illness more difficult, leads to frequent thoughts of suicide and re-hospitalization. Objective: Aimed to assess the prevalence of substance use disorders and associated factors among adult psychiatric patients in Jimma Town, Southwest, Ethiopia, 2017. Methods: A community-based cross-sectional study was conducted on a total of 300 patients with mental illness using the case tracing method. Participants were interviewed using the alcohol use disorder identification test questionnaire to assess Alcohol Use Disorder (AUD). Fagerstrom test tool for nicotine dependence and structured questionnaires were utilized to assess the socio-demographic characteristics of participants. Data were analyzed using SPSS version 20. The variable that showed association with AUD and nicotine dependence at P < .25 in the bivariate analysis was entered into multivariable logistic regressions to control confounders for both outcome variables independently. The significance of association was determined by P < .05 and strength was described using an adjusted odds ratio at a 95% confidence level. Results: The prevalence of alcohol use disorder and nicotine dependence was 14.3% and 23.3%, respectively. Female gender (AOR 0.15, 95% CI = 0.04-0.57), starting treatment within the first month of the onset of the illness (AOR 0.20, 95% CI = 0.05-0.82) and nicotine dependence(AOR 4.84, 95% CI = 1.85-12.67) associated with AUD. Additionally, being female (AOR 0.04, 95% CI = 0.01-0.25), joblessness (AOR 3.05, 95% CI = 1.30-7.16), absence of relapse of illness (AOR 0.18, 95% CI = 0.065-0.503), no improvement in illness (AOR 5.3, 95% CI = 1.70-16.50), and current khat use (AOR 3.09, 95% CI = 1.21-7.90) were associated with nicotine dependence. Conclusion: This study revealed a high prevalence of substance use disorders among psychiatric patients in the community. Being female, experiencing a shorter duration of illness before initiating treatment, and nicotine-dependence were significantly associated with AUD. On the other hand, female sex and absence of relapse of illness were negatively associated with nicotine dependence whereas, joblessness, less improvement of illness, and khat chewing were positively associated with it. Therefore, services on substance use disorders have to be extended to the community level with wide-scale training for the town’s health care providers, including health extension workers who have direct contact with these individuals. Accordingly, comprehensive and suitable interventions were advised to be provided on factors contributing to substance use disorders in general.

Is chewing khat associated with mental health disorders? A scoping review of the content and quality of the current evidence base

“…Chewing khat is one of the significant factors associated with an increased prevalence of alcohol use disorders (AOR = 3.26, CI:1.30, 8.15) among university undergraduate students [ 61 ]. Concerning nicotine dependence, the odds of nicotine dependence for people who use khat were three times higher (AOR 3.09, 95% CI:1.206–7.896) when compared to those who do not use khat among adult psychiatric patients [ 62 ]. Similarly, among people with a mental illness, there was a significant association between tobacco dependence and daily khat chewing (AOR = 13.51, 95% CI: 4.27, 42.74), chewing khat 2–3 times per week (AOR = 5.09, 95% CI = 1.37,18.95), or chewing khat once a week (AOR = 4.31, 95%CI: 1.04,17.78) [ 63 ].…”

Profiles and factors associated with schizophrenia in eastern Ethiopia: A matched case-control study

“…The fact that khat is widely available in lower cost and peer influence may commonly expose them to consuming it ( 7 , 49 , 50 ). Family attitude toward khat consumption may also be a risk factor for khat consuming ( 51 , 52 ).…”