Duresso, SW and Matthews, AJ and Ferguson, SG and Bruno, R, Is khat use disorder a valid diagnostic entity?, Addiction, 111, (9) pp. 1666-76. ISSN 0965-2140 (2016) [Refereed Article]
Copyright 2016 Society for the Study of Addiction
Aims: This study aimed to validate the presence of a khat use disorder syndrome using DSM-5 criteria and to examine its relationship with increased experience of harms.
Design: Cross-sectional, purposive sample of current khat-chewers, recruited from khat markets and cafes.
Setting: Participants were recruited from the general community and from Adama Science and Technology University in Ethiopia.
Participants: A total of 400 current khat consumers aged 16 and above were recruited between September 2014 and January 2015.
Measures: Survey comprising current clinical symptoms (using a modified Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV), and validated measures of health, psychological distress, quality of life and academic functioning.
Findings: A third [35.5% 95% confidence interval (CI) = 31.0-40.3] of respondents reported daily khat use and a quarter (25.4% 95% CI = 21.4-30.0) using three times or more per week. Using DSM-5 criteria, 10.5% (95% CI = 7.9-13.9) were categorized as experiencing mild, 8.8% (95% CI = 6.4-12.0) moderate and 54.5% (95% CI = 49.6-59.3) severe khat use disorder. Confirmatory factor analysis demonstrated a good fit of symptoms to a single underlying construct, consistent with other substance use disorders. Individuals categorized as experiencing khat use disorder demonstrated significantly greater frequency [odds ratio (OR) = 45.29; 95% CI = 10.97-19.01) and quantity of khat use (OR = 2.35; 95% CI = 1.29-4.29). They also demonstrated increased financial problems associated with use, greater problems with academic functioning and higher rates of self-reported mental health problems, higher psychological distress and poorer quality of life. Treatment access was poor, with only one-third (32.9%) of individuals with khat use disorder reporting life-time access, near-exclusively related to help-seeking from friends and relatives.
Conclusion: The construct of a substance use disorder syndrome for khat using DSM-5 criteria appears valid and performs in a manner consistent with other substances of dependence. Individuals with khat use disorder experience substantial problems in association with khat use. Despite this, there are low levels of help-seeking for these problems.
|Item Type:||Refereed Article|
|Keywords:||Catha, central nervous system stimulants, DSM-5, DSM-IV, khat, khat dependence, khat use disorder, stimulant use disorder, substance-related disorders|
|Research Division:||Medical and Health Sciences|
|Research Group:||Public Health and Health Services|
|Research Field:||Preventive Medicine|
|Objective Group:||Public Health (excl. Specific Population Health)|
|Objective Field:||Substance Abuse|
|UTAS Author:||Duresso, SW (Mr Samson Duresso)|
|UTAS Author:||Matthews, AJ (Dr Allison Matthews)|
|UTAS Author:||Ferguson, SG (Associate Professor Stuart Ferguson)|
|UTAS Author:||Bruno, R (Associate Professor Raimondo Bruno)|
|Web of Science® Times Cited:||8|
Repository Staff Only: item control page