Frontiers in Public Health
Volume 2, Issue JUN, 2014

Khat use, PTSD and psychotic symptoms among somali refugees in Nairobi - a pilot study (Article) (Open Access)

Widmann M.* , Warsame A.H. , Mikulica J. , von Beust J. , Isse M.M. , Ndetei D. , al'Absi M. , Odenwald M.G.
  • a Department of Clinical Psychology, University of Konstanz, Konstanz, Germany
  • b Africa Mental Health Foundation, Nairobi, Kenya
  • c Department of Clinical Psychology, University of Konstanz, Konstanz, Germany
  • d Department of Clinical Psychology, University of Konstanz, Konstanz, Germany
  • e Africa Mental Health Foundation, Nairobi, Kenya
  • f Africa Mental Health Foundation, Nairobi, Kenya, Department of Psychiatry, University of Nairobi, Nairobi, Kenya
  • g Department of Family Medicine, University of Minnesota Medical School, Duluth, MN, United States, Department of Physiology and Pharmacology, University of Minnesota Medical School, Duluth, MN, United States
  • h Department of Clinical Psychology, University of Konstanz, Konstanz, Germany, Vivo International, Allensbach, Germany

Abstract

In East-African and Arab countries, khat leaves are traditionally chewed in social settings. They contain the amphetamine-like alkaloid cathinone. Especially among Somali refugees, khat use has been associated with psychiatric symptoms. We assessed khat-use patterns and psychiatric symptoms among male Somali refugees living in a disadvantaged urban settlement area in Kenya, a large group that has not yet received scientific attention. We wanted to explore consume patterns and study the associations between khat use, traumatic experiences, and psychotic symptoms. Using privileged access sampling, we recruited 33 healthy male khat chewers and 15 comparable non-chewers. Based on extensive preparatory work, we assessed khat use, khat dependence according to DSM-IV, traumatic experiences, posttraumatic stress disorder (PTSD), and psychotic symptoms using standardized diagnostic instruments that had been adapted to the Somali language and culture. Hazardous use patterns like chewing for more than 24 h without interruption were frequently reported. All khat users fulfilled the DSM-IV-criteria for dependence and 85% reported functional khat use, i.e., that khat helps them to forget painful experiences. We found that the studied group was heavily burdened by traumatic events and post-traumatic symptoms. Khat users had experienced more traumatic events and had more often PTSD than non-users. Most khat users experience khat-related psychotic symptoms and in a quarter of them we found true psychotic symptoms. In contrast, among control group members nopsychotic symptoms could be detected.We found first evidence for the existence and high prevalence of severely hazardous use patterns, comorbid psychiatric symptoms, and khat use as aself-medicationof trauma-consequences among male Somali refugees in urban Kenyan refugee settlements.There is a high burden by psychopathology and adequate community-based interventions urgently need to be developed. © 2014 Widmann, Warsame, Mikulica, von Beust, Isse, Ndetei, al'Absi and Odenwald.

Author Keywords

Somali refugees in Kenya Khat-related psychosis Psychotic symptoms Khat PTSD

Index Keywords

[No Keywords available]
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84931272318&doi=10.3389%2ffpubh.2014.00071&partnerID=40&md5=b2353da50cd910cbe776fc0ca5684fba
DOI: 10.3389/fpubh.2014.00071
ISSN: 22962565
Cited by: 18
Original Language: English