PSYCHOACTIVE SUBSTANCE USE AMONG PSYCHIATRIC OUTPATIENTS OF A TERTIARY HOSPITAL IN NIGERIA
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ABSTRACT
Psychoactive substances and mental illness is a common comorbidity with poor treatment outcome on patients in some parts of the world. In Nigeria, there is dearth of information on the use of psychoactive substance in mentally-ill patients and their effects. This study investigated the influence of socio-demographic factors, prevalence and types of psychoactive substance use and the effect of these substances on adherence to prescribed medication among psychiatric out-patients of the Ahmadu Bello University Teaching Hospital (ABUTH) Zaria, Nigeria. For this descriptive cross-sectional study, all adult patients (18 years and above) who had previously attended the clinic at least1 year prior to the data collection period of 4 months were used. A sample size of 207 obtained from an estimated population of 450 regular attendees expected to visit the clinic was calculated. From the routine clinic follow-up, each consecutive 4th patient eligible for the study was interviewed until the sample size was attained. The selected respondents were made to complete a socio-demographic and drug use questionnaires and were then administered the Schedule for Clinical Assessment in Neuropsychiatry (SCAN). The data generated from these instruments was analysed by means of descriptive statistics using the statistical package for social sciences (SPSS), version 16. Chi square and t-tests were used to test for differences in proportion for categorical and continuous variables respectively. A total of 208 respondents were interviewed (52.9% males and 47.1% females). Although respondents in the age bracket of 21 to 40 used the substances more, this difference was not statistically significant (p=0.83). The sex, marital status, highest level of education and occupation of the respondents were found to be significant predictors of substance use. From this study, males, those who were married, those with higher level of education and the unemployed were found to use psychoactive substances more. The prevalence for the use of at least one psychoactive substance was 29.3%, while that for the use of multiple substances was 17.7%. 8 The most commonly used substances were alcohol, cannabis and tobacco and they were also the ones used in combination with one or the other. Other substances used to a lesser extent included anxiolytics, solvents and opioids. The SCAN identified 10.1% of the respondents with psychoactive substance use disorder of one type or the other. No statistically significant relationship between substance use and adherence. This use of psychoactive substance is common among psychiatric outpatients of the ABUTH and adherence behaviour is influenced by substance use. Further studies using larger sample size are therefore needed to evaluate the relationship between substance use and medication adherence and other effects such as poor response to medication in mentally-ill patients.
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