Nguata Monica, Orwa James, Kigen Gabriel, Kamaru Edith, Emonyi Wilfred, Kariuki Symon, Newton Charles, Ongeri Linnet, Mwende Rehema, Gichuru Stella, Atwoli Lukoye
Department of Post Traumatic Stress Disorder (PTSD) Tnx, Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
Department of Population Health, Medical College of East Africa Aga Khan University, Nairobi, Kenya.
Front Psychiatry. 2024 Feb 29;15:1301976. doi: 10.3389/fpsyt.2024.1301976. eCollection 2024.
Substance use is prevalent among people with mental health issues, and patients with psychosis are more likely to use and misuse substances than the general population. Despite extensive research on substance abuse among the general public in Kenya, there is a scarcity of data comparing substance use among people with and without psychosis. This study investigates the association between psychosis and various substances in Kenya.
This study utilized data from the Neuro-GAP Psychosis Case-Control Study between April 2018 and December 2022. The KEMRI-Wellcome Trust Research Programme recruited participants from various sites in Kenya, including Kilifi County, Malindi Sub-County, Port Reitz and Coast General Provincial Hospitals, and Moi Teaching and Referral Hospital, as well as affiliated sites in Webuye, Kapenguria, Kitale, Kapsabet, and Iten Kakamega. The collected data included sociodemographic information, substance use, and clinical diagnosis. We used the summary measures of frequency (percentages) and median (interquartile range) to describe the categorical and continuous data, respectively. We examined the association between categorical variables related to psychosis using the chi-square test. Logistic regression models were used to assess the factors associated with the odds of substance use, considering all relevant sociodemographic variables.
We assessed a total of 4,415 cases and 3,940 controls. Except for alcohol consumption (p-value=0.41), all forms of substance use showed statistically significant differences between the case and control groups. Cases had 16% higher odds of using any substance than controls (aOR: 1.16, 95%CI: 1.05-1.28, p=0.005). Moreover, males were 3.95 times more likely to use any substance than females (aOR:3.95; 95%CI: 3.43-4.56). All the categories of living arrangements were protective against substance use.
The findings of this study suggest that psychotic illnesses are associated with an increased likelihood of using various substances. These findings are consistent with those of previous studies; however, it is crucial to investigate further the potential for reverse causality between psychosis and substance abuse using genetically informed methods.
物质使用在有心理健康问题的人群中很普遍，并且精神病患者比普通人群更有可能使用和滥用物质。尽管在肯尼亚对普通公众的物质滥用进行了广泛研究，但比较有精神病和无精神病者物质使用情况的数据却很匮乏。本研究调查了肯尼亚精神病与各种物质之间的关联。
本研究利用了2018年4月至2022年12月期间神经精神障碍全球行动规划（Neuro-GAP）精神病病例对照研究的数据。肯尼亚医学研究协会 - 惠康信托研究项目从肯尼亚的多个地点招募参与者，包括基利菲县、马林迪次县、雷茨港和海岸省总医院、莫伊教学与转诊医院，以及韦布耶、卡彭古里亚、基塔莱、卡普萨贝特和伊滕卡卡梅加的附属地点。收集的数据包括社会人口统计学信息、物质使用情况和临床诊断。我们分别使用频率（百分比）和中位数（四分位间距）的汇总指标来描述分类数据和连续数据。我们使用卡方检验来检查与精神病相关的分类变量之间的关联。考虑所有相关社会人口统计学变量，使用逻辑回归模型来评估与物质使用几率相关的因素。
我们共评估了4415例病例和3940名对照。除饮酒情况外（p值 = 0.41），所有形式的物质使用在病例组和对照组之间均显示出统计学上的显著差异。病例使用任何物质的几率比对照高16%（调整后的比值比：1.16，95%置信区间：1.05 - 1.28，p = 0.005）。此外，男性使用任何物质的可能性是女性的3.95倍（调整后的比值比：3.95；95%置信区间：3.43 - 4.56）。所有居住安排类别都对物质使用有保护作用。
本研究结果表明，精神病性疾病与使用各种物质的可能性增加有关。这些发现与先前的研究一致；然而，使用基因信息方法进一步研究精神病与物质滥用之间潜在的反向因果关系至关重要。
