Use of Khat and Posttraumatic Stress Disorder as Risk Factors for Psychotic Symptoms : A Study of Somali Combatants

The chewing of the khat leaves, which contain the amphetamine-like cathinone, is a traditional habit in Somalia. Our objective was to explore the effects of khat use and Posttraumatic Stress Disorder (PTSD) on paranoid symptoms and to test a potential causal chain. We report on a cross-sectional stu...

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Main Authors:	Odenwald, M., Hinkel, H., Schauer, E., Schauer, M., Elbert, T., Neuner, F., Rockstroh, B.
Format:	Journal Article
Language:	EN
Published:	2012
Online Access:	http://hdl.handle.net/10986/5306

id	okr-10986-5306
recordtype	oai_dc
spelling	okr-10986-53062021-04-23T14:02:21Z Use of Khat and Posttraumatic Stress Disorder as Risk Factors for Psychotic Symptoms : A Study of Somali Combatants Odenwald, M. Hinkel, H. Schauer, E. Schauer, M. Elbert, T. Neuner, F. Rockstroh, B. The chewing of the khat leaves, which contain the amphetamine-like cathinone, is a traditional habit in Somalia. Our objective was to explore the effects of khat use and Posttraumatic Stress Disorder (PTSD) on paranoid symptoms and to test a potential causal chain. We report on a cross-sectional study in Somalia that was conducted in 2003. Trained local staff interviewed 8723 personnel of armed groups in seven regional convenience samples. Of them, 8124 were included in the analysis. We assessed current khat use, PTSD symptoms, functional drug use and paranoid ideation using items from the Composite International Diagnostic Interview (CIDI) and the Somali version of the Posttraumatic Stress Diagnostic Scale (PDS). Applying the causal steps approach, in a series of logistic regression models, we used PTSD as independent and paranoia as outcome variable; the quantity of khat use was defined as mediator variable and functional drug use as moderator. The results showed that respondents with PTSD used khat more frequently. Khat chewers with PTSD reported a higher intake compared to khat chewers without PTSD. Among excessive khat chewers with PTSD, paranoia was most frequent. The greatest amount of khat use was among respondents with PTSD who indicated that they found drugs help them to forget war experiences. The proposed mediated moderation model was supported by the data, i.e. besides the direct effects of PTSD and functional drug use on paranoia, the amount of khat use appeared to be a mechanism, by which paranoia is caused. We conclude that in our data we have uncovered a relationship between khat, PTSD and paranoia. Khat is functionally used by respondents with PTSD. Findings support a dose effect: the more khat consumption and when a respondent has PTSD, the higher the odds for paranoid ideation. However, the proposed causal chain needs to be confirmed in longitudinal studies. Demobilization and reintegration programs in Somalia need to be prepared to deal with complex psychological problems. (C) 2009 Elsevier Ltd. All rights reserved. 2012-03-30T07:32:13Z 2012-03-30T07:32:13Z 2009 Journal Article Social Science & Medicine 0277-9536 http://hdl.handle.net/10986/5306 EN http://creativecommons.org/licenses/by-nc-nd/3.0/igo World Bank Journal Article Somalia
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	EN
geographic_facet	Somalia
relation	http://creativecommons.org/licenses/by-nc-nd/3.0/igo
description	The chewing of the khat leaves, which contain the amphetamine-like cathinone, is a traditional habit in Somalia. Our objective was to explore the effects of khat use and Posttraumatic Stress Disorder (PTSD) on paranoid symptoms and to test a potential causal chain. We report on a cross-sectional study in Somalia that was conducted in 2003. Trained local staff interviewed 8723 personnel of armed groups in seven regional convenience samples. Of them, 8124 were included in the analysis. We assessed current khat use, PTSD symptoms, functional drug use and paranoid ideation using items from the Composite International Diagnostic Interview (CIDI) and the Somali version of the Posttraumatic Stress Diagnostic Scale (PDS). Applying the causal steps approach, in a series of logistic regression models, we used PTSD as independent and paranoia as outcome variable; the quantity of khat use was defined as mediator variable and functional drug use as moderator. The results showed that respondents with PTSD used khat more frequently. Khat chewers with PTSD reported a higher intake compared to khat chewers without PTSD. Among excessive khat chewers with PTSD, paranoia was most frequent. The greatest amount of khat use was among respondents with PTSD who indicated that they found drugs help them to forget war experiences. The proposed mediated moderation model was supported by the data, i.e. besides the direct effects of PTSD and functional drug use on paranoia, the amount of khat use appeared to be a mechanism, by which paranoia is caused. We conclude that in our data we have uncovered a relationship between khat, PTSD and paranoia. Khat is functionally used by respondents with PTSD. Findings support a dose effect: the more khat consumption and when a respondent has PTSD, the higher the odds for paranoid ideation. However, the proposed causal chain needs to be confirmed in longitudinal studies. Demobilization and reintegration programs in Somalia need to be prepared to deal with complex psychological problems. (C) 2009 Elsevier Ltd. All rights reserved.
format	Journal Article
author	Odenwald, M. Hinkel, H. Schauer, E. Schauer, M. Elbert, T. Neuner, F. Rockstroh, B.
spellingShingle	Odenwald, M. Hinkel, H. Schauer, E. Schauer, M. Elbert, T. Neuner, F. Rockstroh, B. Use of Khat and Posttraumatic Stress Disorder as Risk Factors for Psychotic Symptoms : A Study of Somali Combatants
author_facet	Odenwald, M. Hinkel, H. Schauer, E. Schauer, M. Elbert, T. Neuner, F. Rockstroh, B.
author_sort	Odenwald, M.
title	Use of Khat and Posttraumatic Stress Disorder as Risk Factors for Psychotic Symptoms : A Study of Somali Combatants
title_short	Use of Khat and Posttraumatic Stress Disorder as Risk Factors for Psychotic Symptoms : A Study of Somali Combatants
title_full	Use of Khat and Posttraumatic Stress Disorder as Risk Factors for Psychotic Symptoms : A Study of Somali Combatants
title_fullStr	Use of Khat and Posttraumatic Stress Disorder as Risk Factors for Psychotic Symptoms : A Study of Somali Combatants
title_full_unstemmed	Use of Khat and Posttraumatic Stress Disorder as Risk Factors for Psychotic Symptoms : A Study of Somali Combatants
title_sort	use of khat and posttraumatic stress disorder as risk factors for psychotic symptoms : a study of somali combatants
publishDate	2012
url	http://hdl.handle.net/10986/5306
_version_	1764394607672557568

Use of Khat and Posttraumatic Stress Disorder as Risk Factors for Psychotic Symptoms : A Study of Somali Combatants

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