Psychiatry Department, Jimma, Ethiopia.
External consultant for Center for International Health at the hospital of the Ludwig Maximilians-University (CIHLMU), Munich, Germany.
Subst Abuse Treat Prev Policy. 2020 Apr 3;15(1):27. doi: 10.1186/s13011-020-00268-4.
Khat (Catha edulis) is a stimulant leaf khat comes from a tree which grows in countries bordering the Red Sea which are along the east coast of Africa and in west Asia. The psycho- active component within these leaves is cathinone. In Ethiopia, Khat is chewed routinely by users for its euphoric effects and as a recreational drug, and chewing khat has an important role as well in both traditional and religious ceremonies. In this case report, we describe the case of a 33-year-old male patient presented with psychotic symptoms after prolonged and heavy khat chewing.
Findings on psychiatric evaluation encompassing detailed history and mental state examination suggest khat induced psychotic disorder severe in full remission; khat use disorder, severe, in early remission.
This case demonstrates that the use of excess khat above 2 bundles for prolonged duration can manifest with psychotic episodes. A small number of case studies had supported a causal relationship between heavy khat use and psychosis or psychotic symptoms. There have been suicidal attempts and homicidal acts in those who used excess and prolonged use of khat. In our case, the improvement attributed to stopping the khat rather than taking antipsychotics. Therefore, we recommend an urgent social intervention to change the community norms regarding Khat use through psycho-education in media, institution and in person about the relationship between khat use and mental illness. In addition, we suggest the role of religious institutions on the management of khat use not be overlooked. Finally, this study makes a powerful argument for researchers and policy makers to do clinical study to settle a causal effect relation of khat on mental health.
阿拉伯茶(Catha edulis)是一种兴奋剂叶子,来自一种生长在红海国家的树,这些国家位于非洲东海岸和西亚。这些叶子中的精神活性成分是卡西酮。在埃塞俄比亚,人们经常咀嚼阿拉伯茶来获得其兴奋作用,并将其作为一种娱乐性药物,咀嚼阿拉伯茶在传统和宗教仪式中也具有重要作用。在本病例报告中,我们描述了一名 33 岁男性患者的病例,该患者在长时间和大量咀嚼阿拉伯茶后出现精神病症状。
精神科评估的结果包括详细的病史和精神状态检查,提示为阿拉伯茶诱导的精神病性障碍,严重度完全缓解;阿拉伯茶使用障碍,严重度,早期缓解。
本病例表明,过量咀嚼阿拉伯茶超过 2 束并持续长时间可能会出现精神病发作。少数病例研究支持大量使用阿拉伯茶与精神病或精神病症状之间存在因果关系。那些过度和长期使用阿拉伯茶的人曾有过自杀企图和杀人行为。在我们的病例中,改善归因于停止咀嚼阿拉伯茶,而不是服用抗精神病药物。因此,我们建议通过媒体、机构和个人进行有关阿拉伯茶使用与精神疾病之间关系的心理教育,紧急进行社会干预以改变社区对阿拉伯茶使用的规范。此外,我们建议不应忽视宗教机构在管理阿拉伯茶使用方面的作用。最后,这项研究有力地呼吁研究人员和政策制定者进行临床研究,以确定阿拉伯茶对心理健康的因果关系。