Abstract
Individuals with substance use disorder are prone to develop different psychiatric disorders. Substance abuse and associated problems are of current global concern that leads to mental health disorders which contributed about 14% of the global burden of the disease. It has become an epidemic in some parts of the African region with adolescents being the main victims of the ill health and social effects of substance use. This study is aimed at assessing the prevalence of depression, anxiety, and stress and associated factors among khat chewers in the Amhara region, 2019. A community-based cross-sectional study was done from February 14 to April 15, 2019. A purposive sampling technique was used to enroll the subjects. Data was collected using the face-to-face interview technique using the Depression Anxiety Stress Scale 21 (DASS-21) questionnaire. Descriptive statistics and bivariate and multivariate logistic regression were used to summarize the results. p value < 0.05 was considered statistically significant. A total of 478 participants were enrolled in the study with a response rate of 94.1%. The overall prevalence of depression, anxiety, and stress was 27.4%, 40.6%, and 18.8%, respectively. Around 43% of the respondents develop dependency from khat chewing. Working in a private sector, being self-employed, being jobless, spending 90 to 180 minutes and more, chewing 51-100 g and more, and chewing khat more than once per week were positively associated with stress. On the other hand, being a private sector worker, being jobless, completing secondary education, earning 1001-5000 ETB per month, chewing khat more than once per week, being khat dependent, and the presence of chronic illness were positively associated with anxiety. History of chronic illness and being khat dependent were positively associated with depression. The prevalence of depression, anxiety, and stress was high among khat chewers in the Amhara region. Special attention has to be given to khat chewers since khat chewing will double the burden of mental illness. Proper awareness and evaluation activities will reduce the impact of the problem.
Highlights
Mental health disorders according to the World Health Organization (WHO) are one of the leading causes of disability worldwide
Occupation, education, number of days of chewing khat per week, monthly income, being dependent on khat, and presence of chronic illness were positively associated with anxiety
Those who work in the private sector were 2.51 times (AOR = 2:51, 95% CI: 1.16, 5.41) more likely to be anxious as compared to the government workers, and those who were jobless were 3.78 times (AOR = 3:78, 95% CI: 1.16, 8.55) more likely to be anxious as compared with the government workers
Summary
Mental health disorders according to the World Health Organization (WHO) are one of the leading causes of disability worldwide. Three of the ten leading causes of disability in people between the ages of 15 and 44 are mental disorders [1, 2]. Severe mental health problems interfere with individuals’ emotional, cognitive, and social abilities that can lead to underemployment and reduced productivity. Mental health problems affect society as a whole, and no group is immune to mental disorders [4]. In Africa, mental illness is an important public health challenge that is underrecognized as a public burden. Studies conducted in South Africa revealed that the prevalence of common mental disorders is 27% [5]. In Ethiopia, mental disorders account for 11% of the total burden of diseases [6].
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