Abstract
This study reports on the prevalence and demographic correlates of substance use among individuals with mental illness in the Eastern Cape, South Africa. This cross-sectional study was conducted in the Outpatient Clinic of a large hospital in the Eastern Cape, South Africa. A pre-validated tool on alcohol and psychoactive drug use was administered to 390 individuals with mental illness. Multivariable logistic regression models were fitted to explore the demographic correlates of alcohol and psychoactive drug use. Of the total participants (N = 390), 64.4% and 33.3% reported lifetime (ever used) and past-year use of alcohol, respectively, but the prevalence of risky alcohol use was 18.5%. After adjusting for relevant covariates, only male sex, younger age, and rural residence remained significantly associated with risky alcohol use. The prevalence of ever-use and past-year use of psychoactive substances was 39.7% and 17.4%, respectively. The most common substance ever used was cannabis (37.4%). Male sex, younger age, owning a business, and being unemployed were significantly associated with higher odds of lifetime and past-year use of psychoactive substances. Findings highlight the need for dedicated infrastructure and staff training in the management of these dual diagnoses in the region.
Highlights
Substance use is an important risk factor for morbidity, disability, and premature death globally [1]
A national survey of South African adults showed a prevalence of 33.1% for past-year alcohol use, which was higher than the global average of 32.5% [4,5]
This study reports on the prevalence and correlates of substance use among individuals with mental illness attending the Outpatient Clinic of the Cecilia Makiwane Hospital Mental Health Unit (CMHMHU) in East London, Eastern Cape, South Africa
Summary
Substance use is an important risk factor for morbidity, disability, and premature death globally [1]. It was estimated that in 2017, 271 million people (5%) of the global population between 15 and 64 years of age had used psychoactive drugs in the previous twelve months [3]. A national survey of South African adults showed a prevalence of 33.1% for past-year alcohol use, which was higher than the global average of 32.5% [4,5]. Several studies have reported a higher prevalence (range of 21.3–55.6%) of substance use disorders in individuals with mental illness compared to three to four percent reported in the general population [7,8]. In Nigeria, two studies on the use of psychoactive substances in mentally ill individuals showed prevalences between 21.3% and 29.3% [9,10]
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