African Journal of Psychiatry | 09 October 2008
A Cross-Sectional Study of Khat-Induced Psychotic Disorder Among Chronic Users in Hargeisa, Somaliland: An African Perspective
L, e, i, l, a, S, a, a, d, i, ,, N, a, d, i, a, B, e, n, a, l, i, ,, K, a, r, i, m, A, m, r, o, u, c, h, e
Abstract
Khat (Catha edulis) chewing is a common cultural practice in parts of Africa. Chronic use is linked to adverse mental health outcomes, but evidence on khat-induced psychotic disorder (KIPD) from Somaliland is scarce. This study aimed to determine the prevalence of KIPD among chronic khat users in Hargeisa, Somaliland, and to identify associated socio-demographic and use-pattern factors. A community-based cross-sectional study was conducted. Adult chronic khat users were recruited via purposive and snowball sampling. Data were collected through structured interviews, including a socio-demographic questionnaire, the Composite International Diagnostic Interview psychosis module, and a khat use patterns questionnaire. Diagnosis of KIPD was made by trained clinicians according to ICD-10 criteria. Among 422 participants, the prevalence of khat-induced psychotic disorder was 18.7%. The disorder was significantly associated with longer daily chewing sessions and the concurrent use of other psychoactive substances. A substantial proportion of chronic khat users in this setting met criteria for a psychotic disorder induced by khat, indicating a considerable mental health burden associated with this practice. Public health initiatives should incorporate mental health screening and psychoeducation on KIPD risks for khat-using communities. Clinical services need improved capacity to diagnose and manage substance-induced psychoses. Further longitudinal research is required to establish causality and long-term outcomes. Khat, Catha edulis, psychotic disorder, substance-induced psychosis, Somaliland, Africa, cross-sectional study, prevalence This study provides original data on the prevalence and correlates of khat-induced psychotic disorder from an under-researched region, contributing an African perspective to the literature on substance-related mental health morbidity.