Abstract
BackgroundLittle is known about the prevalence of khat-induced psychotic disorders in East African countries, where the chewing of khat leaves is common. Its main psycho-active component cathinone produces effects similar to those of amphetamine. We aimed to explore the prevalence of psychotic disorders among the general population and the association between khat use and psychotic symptoms.MethodsIn an epidemiological household assessment in the city of Hargeisa, North-West Somalia, trained local interviewers screened 4,854 randomly selected persons from among the general population for disability due to severe mental problems. The identified cases were interviewed based on a structured interview and compared to healthy matched controls. Psychotic symptoms were assessed using the items of the WHO Composite International Diagnostic Interview and quantified with the Positive and Negative Symptoms Scale. Statistical testing included Student's t-test and ANOVA.ResultsLocal interviewers found that rates of severe disability due to mental disorders were 8.4% among males (above the age of 12) and differed according to war experiences (no war experience: 3.2%; civilian war survivors: 8.0%; ex-combatants: 15.9%). The clinical interview verified that in 83% of positive screening cases psychotic symptoms were the most prominent manifestations of psychiatric illness. On average, cases with psychotic symptoms had started to use khat earlier in life than matched controls and had been using khat 8.6 years before positive symptoms emerged. In most cases with psychotic symptoms, a pattern of binge use (> two 'bundles' per day) preceded the onset of psychotic symptoms, in contrast to controls of the same age. We found significant correlations between variables of khat consumption and clinical scales (0.35 to 0.50; p < 0.05), and between the age of onset of khat chewing and symptom onset (0.70; p <0.001).ConclusionEvidence indicates a relationship between the consumption of khat and the onset of psychotic symptoms among the male population, whereby not the khat intake per se but rather early onset and excessive khat chewing seemed to be related to psychotic symptoms. The khat problem must be addressed by means other than prohibition, given the widespread use and its role in Somali culture.
Highlights
Little is known about the prevalence of khat-induced psychotic disorders in East African countries, where the chewing of khat leaves is common
It was shown that the widespread use of khat is related to the large number of individuals with visible signs of psychosis who are either homeless or kept in hiding, e.g. in physical chains, by family members who afraid to expose them to the general public
Not khat intake per se but rather specific patterns of it are linked to the development of psychotic symptoms, like early onset in life, excessive chewing (> 2 bundles/day) and use as self-medication for war trauma related symptoms
Summary
Little is known about the prevalence of khat-induced psychotic disorders in East African countries, where the chewing of khat leaves is common. The traditional way of consumption was socially highly regulated: adult males (more seldom females) would gather and chew khat together at a so-called 'khat party', usually on weekends and afternoons until the time of the evening prayer [5,6]. Contrary to this formerly restricted use, current habits involve use by adolescents, chewing khat in tea-shops that operate day and night, early morning use, as well as "binging" and "speed runs" that may last for more than 24 hours. It was shown that the widespread use of khat is related to the large number of individuals with visible signs of psychosis who are either homeless or kept in hiding, e.g. in physical chains, by family members who afraid to expose them to the general public
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
