Prevalence and social determinants of psychological distress among people who use drugs in Cambodia

Chan Hang Saing,Ponha Uk,Pheak Chhoun,Sovannary Tuot,Phalkun Mun,Kiesha Prem,Siyan Yi,Navy Chann

doi:10.1186/s13033-020-00411-5

Abstract

BackgroundPeople who use drugs are at a disproportionately higher risk of mental disorders due to prolonged exposure to psychosocial challenges. However, studies on mental health among people who use drugs in resource-constrained countries are scarce. This study sheds light on the prevalence and correlates of psychological distress among people who use drugs in Cambodia.MethodsWe conducted this cross-sectional study in the capital city and 11 provinces in 2017. The Respondent Driven Sampling method was adapted to recruit 1677 people who used drugs for face-to-face interviews using a structured questionnaire. Psychological distress was measured using the General Health Questionnaire (GHQ-12). A total score of GHQ-12 > 2 indicated high psychological distress. We performed a multiple logistic regression analysis to identify factors associated with psychological distress.ResultsWe included 1598 participants in the analyses, with a mean age of 28.6 years (SD = 7.8). Of the total, 42% had high psychological distress – 50% in women and 37% in men. The adjusted odds of having high psychological distress were significantly higher among participants who were 25–34 years old and 35 years and above, had been to a drug rehabilitation center, had been insulted by family members, and had been sexually harassed/abused by someone when they were growing up. The odds of having high psychological distress were significantly lower among participants who were male, lived in their own dwelling, reported injecting as the mode of the first drug use, and had someone taking care of them when they got sick.ConclusionsThis study documents a high prevalence of psychological distress among people who use drugs in Cambodia. Intervention programs that attempt to address mental health problems among people who use drugs in resource-limited settings should be gender- and age-sensitive and target more marginalized subpopulations. Mental health services can be integrated into HIV and harm-reduction programs for people who use drugs.

Highlights

People who use drugs are at a disproportionately higher risk of mental disorders due to prolonged exposure to psychosocial challenges
The participants included in the analyses had an average age of 28.6 years (SD = 7.8), average years of formal schooling completed of 6.0 years (SD = 3.9), and a median monthly income in the past 6 months of US$100.0
Around one-third of the participants resided in Phnom Penh, while 16% lived in Banteay Meanchey and 11% in Battambang province, which border Thailand

Summary

Introduction

People who use drugs are at a disproportionately higher risk of mental disorders due to prolonged exposure to psychosocial challenges. Studies on mental health among people who use drugs in resourceconstrained countries are scarce. The availability of and access to treatment services among people with drug use disorders remain limited globally. One in seven people who use drugs receive the treatment each year [1]. Existing studies show that the comorbidity between drug-use disorders and mental health problems is common among people who use drugs. People who use drugs without drug-use disorders are at increased risk of mental health problems [3,4,5,6,7,8,9,10]. Substance use disorders have been found to occur in tandem with anxiety disorders including generalized anxiety disorder, panic disorder, and post-traumatic stress disorder [11,12,13,14]; mental disorders including depression and bipolar disorder [8, 11,12,13]; attention deficit hyperactivity disorder [12, 14]; and antisocial personality disorder [15]

Methods

Results

Discussion

Conclusion