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 (2009)
Soc Sci Med 69(7): 1040-1048.

Zeitschriftenaufsatz | Veröffentlicht | Englisch
 
Download
Es wurden keine Dateien hochgeladen. Nur Publikationsnachweis!
DOI
Autor*in
Odenwald, Michael; Hinkel, Harald; Schauer, Elisabeth; Schauer, Margarete; Elbert, Thomas; Neuner, FrankUniBi; Rockstroh, Brigitte
Einrichtung
Fakultät für Psychologie und Sportwissenschaft > Abteilung für Psychologie > Arbeitseinheit 11 - Klinische Psychologie und Psychotherapie
Abstract / Bemerkung
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.
Erscheinungsjahr
2009
Zeitschriftentitel
Soc Sci Med
Band
69
Ausgabe
7
Seite(n)
1040-1048
ISSN
0277-9536
Page URI
https://pub.uni-bielefeld.de/record/1913960

Zitieren

Odenwald M, Hinkel H, Schauer E, et al. Use of khat and posttraumatic stress disorder as risk factors for psychotic symptoms: a study of Somali combatants. Soc Sci Med. 2009;69(7):1040-1048.
Odenwald, M., Hinkel, H., Schauer, E., Schauer, M., Elbert, T., Neuner, F., & Rockstroh, B. (2009). Use of khat and posttraumatic stress disorder as risk factors for psychotic symptoms: a study of Somali combatants. Soc Sci Med, 69(7), 1040-1048. https://doi.org/10.1016/j.socscimed.2009.07.020
Odenwald, Michael, Hinkel, Harald, Schauer, Elisabeth, Schauer, Margarete, Elbert, Thomas, Neuner, Frank, and Rockstroh, Brigitte. 2009. “Use of khat and posttraumatic stress disorder as risk factors for psychotic symptoms: a study of Somali combatants”. Soc Sci Med 69 (7): 1040-1048.
Odenwald, M., Hinkel, H., Schauer, E., Schauer, M., Elbert, T., Neuner, F., and Rockstroh, B. (2009). Use of khat and posttraumatic stress disorder as risk factors for psychotic symptoms: a study of Somali combatants. Soc Sci Med 69, 1040-1048.
Odenwald, M., et al., 2009. Use of khat and posttraumatic stress disorder as risk factors for psychotic symptoms: a study of Somali combatants. Soc Sci Med, 69(7), p 1040-1048.
M. Odenwald, et al., “Use of khat and posttraumatic stress disorder as risk factors for psychotic symptoms: a study of Somali combatants”, Soc Sci Med, vol. 69, 2009, pp. 1040-1048.
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. Soc Sci Med. 69, 1040-1048 (2009).
Odenwald, Michael, Hinkel, Harald, Schauer, Elisabeth, Schauer, Margarete, Elbert, Thomas, Neuner, Frank, and Rockstroh, Brigitte. “Use of khat and posttraumatic stress disorder as risk factors for psychotic symptoms: a study of Somali combatants”. Soc Sci Med 69.7 (2009): 1040-1048.

20 Zitationen in Europe PMC

Daten bereitgestellt von Europe PubMed Central.

Toxic effect of khat (Catha edulis) on memory: Systematic review and meta-analysis.
Berihu BA, Asfeha GG, Welderufael AL, Debeb YG, Zelelow YB, Beyene HA., J Neurosci Rural Pract 8(1), 2017
PMID: 28149078
Comorbid psychopathology and everyday functioning in a brief intervention study to reduce khat use among Somalis living in Kenya: description of baseline multimorbidity, its effects of intervention and its moderation effects on substance use.
Widmann M, Apondi B, Musau A, Warsame AH, Isse M, Mutiso V, Veltrup C, Ndetei D, Odenwald M., Soc Psychiatry Psychiatr Epidemiol 52(11), 2017
PMID: 28321455
Catha edulis Forsk. (Khat): Evaluation of its Antidepressant-like Activity.
Alfaifi H, Abdelwahab SI, Mohan S, Elhassan Taha MM, Syame SM, Shaala LA, Alsanosy R., Pharmacogn Mag 13(suppl 2), 2017
PMID: 28808405
Memory deficits associated with khat (Catha edulis) use in rodents.
Kimani ST, Patel NB, Kioy PG., Metab Brain Dis 31(1), 2016
PMID: 26423676
Projection neurons in the cortex and hippocampus: differential effects of chronic khat and ethanol exposure in adult male rats.
Alele PE, Matovu D, Imanirampa L, Ajayi AM, Kasule GT., J Exp Pharmacol 8(), 2016
PMID: 27785113
Khat Use: What Is the Problem and What Can Be Done?
Omar YS, Jenkins A, Altena Mv, Tuck H, Hynan C, Tohow A, Chopra P, Castle D., Biomed Res Int 2015(), 2015
PMID: 26064915
Use of a bibliometric literature review to assess medical research capacity in post-conflict and developing countries: Somaliland 1991-2013.
Boyce R, Rosch R, Finlayson A, Handuleh D, Walhad SA, Whitwell S, Leather A., Trop Med Int Health 20(11), 2015
PMID: 26293701
Global mental health and trauma exposure: the current evidence for the relationship between traumatic experiences and spirit possession.
Hecker T, Braitmayer L, van Duijl M., Eur J Psychotraumatol 6(), 2015
PMID: 26589259
Combat high or traumatic stress: violent offending is associated with appetitive aggression but not with symptoms of traumatic stress.
Köbach A, Schaal S, Elbert T., Front Psychol 5(), 2014
PMID: 25709586
Khat Use, PTSD and Psychotic Symptoms among Somali Refugees in Nairobi - A Pilot Study.
Widmann M, Warsame AH, Mikulica J, von Beust J, Isse MM, Ndetei D, al'Absi M, Odenwald MG., Front Public Health 2(), 2014
PMID: 25072043
Lower intake of vegetables and legumes associated with cognitive decline among illiterate elderly Chinese: a 3-year cohort study.
Chen X, Huang Y, Cheng HG., J Nutr Health Aging 16(6), 2012
PMID: 22659995
Khat use among Somali mental health service users in South London.
Tulloch AD, Frayn E, Craig TK, Nicholson TR., Soc Psychiatry Psychiatr Epidemiol 47(10), 2012
PMID: 22249804
A pilot study on community-based outpatient treatment for patients with chronic psychotic disorders in Somalia: Change in symptoms, functioning and co-morbid khat use.
Odenwald M, Lingenfelder B, Peschel W, Haibe FA, Warsame AM, Omer A, Stöckel J, Maedl A, Elbert T., Int J Ment Health Syst 6(1), 2012
PMID: 22747911
Trauma exposure, PTSD and psychotic-like symptoms in post-conflict Timor Leste: an epidemiological survey.
Soosay I, Silove D, Bateman-Steel C, Steel Z, Bebbington P, Jones PB, Chey T, Ivancic L, Marnane C., BMC Psychiatry 12(), 2012
PMID: 23249370
Psychoses, PTSD, and depression in Somali refugees in Minnesota.
Kroll J, Yusuf AI, Fujiwara K., Soc Psychiatry Psychiatr Epidemiol 46(6), 2011
PMID: 20354676
Mephedrone (4-methylmethcathinone; 'meow meow'): chemical, pharmacological and clinical issues.
Schifano F, Albanese A, Fergus S, Stair JL, Deluca P, Corazza O, Davey Z, Corkery J, Siemann H, Scherbaum N, Farre' M, Torrens M, Demetrovics Z, Ghodse AH, Psychonaut Web Mapping, ReDNet Research Groups., Psychopharmacology (Berl) 214(3), 2011
PMID: 21072502
Khat use and trait anger: effects on affect regulation during an acute stressful challenge.
Bongard S, al'Absi M, Khalil NS, Al Habori M., Eur Addict Res 17(6), 2011
PMID: 21860244
Correlates of nicotine dependence in U.K. resident Yemeni khat chewers: a cross-sectional study.
Kassim S, Islam S, Croucher RE., Nicotine Tob Res 13(12), 2011
PMID: 21937753
The stimulant khat--another door in the wall? A call for overcoming the barriers.
Odenwald M, Warfa N, Bhui K, Elbert T., J Ethnopharmacol 132(3), 2010
PMID: 19913607
Khat use and neurobehavioral functions: suggestions for future studies.
Hoffman R, Al'Absi M., J Ethnopharmacol 132(3), 2010
PMID: 20553832

52 References

Daten bereitgestellt von Europe PubMed Central.

Khat (Qat): assessment of risk to individual and communities in the UK
Advisory, 2005
Khat: pharmacological and medical aspects and its social use in Yemen.
Al-Motarreb A, Baker K, Broadley KJ., Phytother Res 16(5), 2002
PMID: 12203257

Anderson, 2007
Differential effects of amphetamine and neuroleptics on negative vs. positive symptoms in schizophrenia.
Angrist B, Rotrosen J, Gershon S., Psychopharmacology (Berl.) 72(1), 1980
PMID: 6110217
Corticolimbic dysregulation and chronic methamphetamine abuse.
Baicy K, London ED., Addiction 102 Suppl 1(), 2007
PMID: 17493049
The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations.
Baron RM, Kenny DA., J Pers Soc Psychol 51(6), 1986
PMID: 3806354
The experimental reproduction of amphetamine psychosis.
Bell DS., Arch. Gen. Psychiatry 29(1), 1973
PMID: 4711131
Traumatic events, migration characteristics and psychiatric symptoms among Somali refugees--preliminary communication.
Bhui K, Abdi A, Abdi M, Pereira S, Dualeh M, Robertson D, Sathyamoorthy G, Ismail H., Soc Psychiatry Psychiatr Epidemiol 38(1), 2003
PMID: 12563557
Mental disorders among Somali refugees: developing culturally appropriate measures and assessing socio-cultural risk factors.
Bhui K, Craig T, Mohamud S, Warfa N, Stansfeld SA, Thornicroft G, Curtis S, McCrone P., Soc Psychiatry Psychiatr Epidemiol 41(5), 2006
PMID: 16520881
Substance abuse and the risk of readmission of people with schizophrenia at Amanuel Psychiatric Hospital, Ethiopia.
Bimerew MS, Sonn FC, Kortenbout WP., Curationis 30(2), 2007
PMID: 17703825
Perceived functions predict intensity of use and problems in young polysubstance users.
Boys A, Marsden J., Addiction 98(7), 2003
PMID: 12814501
Validity of 'post-traumatic stress disorder with secondary psychotic features': a review of the evidence.
Braakman MH, Kortmann FA, van den Brink W., Acta Psychiatr Scand 119(1), 2008
PMID: 18764840
Posttraumatic stress disorder and cocaine dependence. Order of onset.
Brady KT, Dansky BS, Sonne SC, Saladin ME., Am J Addict 7(2), 1998
PMID: 9598216
Trauma and substance cue reactivity in individuals with comorbid posttraumatic stress disorder and cocaine or alcohol dependence.
Coffey SF, Saladin ME, Drobes DJ, Brady KT, Dansky BS, Kilpatrick DG., Drug Alcohol Depend 65(2), 2002
PMID: 11772473
Changes in PTSD symptomatology during acute and protracted alcohol and cocaine abstinence.
Coffey SF, Schumacher JA, Brady KT, Cotton BD., Drug Alcohol Depend 87(2-3), 2006
PMID: 17008029
The use of stimulants in the treatment of post traumatic stress disorder: case report.
Daly OE., Hum Psychopharmacol 15(4), 2000
PMID: 12404325
Psychiatric morbidity among khat chewers.
Dhadphale M, Omolo OE., East Afr Med J 65(6), 1988
PMID: 3181055
Humiliation experienced by Somali refugees in Norway
Fangen, Journal of Refugee Studies 19(1), 2006
The validation of a self-report measure of posttraumatic stress disorder: the posttraumatic diagnostic scale
Foa, Psychological Assessment 9(4), 1997

Hinkel, 2004
Substance use disorders in patients with posttraumatic stress disorder: a review of the literature.
Jacobsen LK, Southwick SM, Kosten TR., Am J Psychiatry 158(8), 2001
PMID: 11481147
Dopamine transmission in the initiation and expression of drug- and stress-induced sensitization of motor activity.
Kalivas PW, Stewart J., Brain Res. Brain Res. Rev. 16(3), 1991
PMID: 1665095
Catha edulis, a plant that has amphetamine effects.
Kalix P., Pharm World Sci 18(2), 1996
PMID: 8739260
Khat chewing amongst UK resident male Yemeni adults: an exploratory study.
Kassim S, Croucher R., Int Dent J 56(2), 2006
PMID: 16620038
Debating war-trauma and post-traumatic stress disorder (PTSD) in an interdisciplinary arena.
Kienzler H., Soc Sci Med 67(2), 2008
PMID: 18450348

AUTHOR UNKNOWN, 0

Kulka, 1990
Estimating mediated effects in prevention studies
MacKinnon, Evaluation Review 17(2), 1993
Symptom profiles of psychiatric disorders based on graded disease classes: an illustration using data from the WHO International Pilot Study of Schizophrenia.
Manton KG, Korten A, Woodbury MA, Anker M, Jablensky A., Psychol Med 24(1), 1994
PMID: 8208878
Epidemiologic study of qat use in the National Army of Djibouti
Mion, Médecine Tropicale 58(2), 1998
Reintegration of soldiers: the missing piece
Mogapi, Intervention 2(3), 2004
When moderation is mediated and mediation is moderated.
Muller D, Judd CM, Yzerbyt VY., J Pers Soc Psychol 89(6), 2005
PMID: 16393020
Use and perception of khat among young Somalis in a UK city
Nabuzoka, Addiction Research 8(1), 2000
Psychiatric phenomenology across countries: constitutional, cultural, or environmental?
Ndetei DM., Acta Psychiatr Scand Suppl 344(), 1988
PMID: 3227985
Chronic khat use and psychotic disorders: a review of the literature and future prospects
Odenwald, Sucht 53(1), 2007
The consumption of khat and other drugs in Somali combatants: a cross-sectional study.
Odenwald M, Hinkel H, Schauer E, Neuner F, Schauer M, Elbert TR, Rockstroh B., PLoS Med. 4(12), 2007
PMID: 18076280
Screening for posttraumatic stress disorder among Somali ex-combatants: a validation study
Odenwald, Conflict and Health 1(10), 2007
Khat use as risk factor for psychotic disorders: a cross-sectional and case-control study in Somalia.
Odenwald M, Neuner F, Schauer M, Elbert T, Catani C, Lingenfelder B, Hinkel H, Hafner H, Rockstroh B., BMC Med 3(), 2005
PMID: 15707502
Psychosis as an extreme of continuous variation in dimensions of psychopathology
van, 1999

Patel, 2005
Risk assessment of khat use in the Netherlands: a review based on adverse health effects, prevalence, criminal involvement and public order.
Pennings EJ, Opperhuizen A, van Amsterdam JG., Regul. Toxicol. Pharmacol. 52(3), 2008
PMID: 18783727
Between myth and madness: the premigration dream of leaving among young Somali refugees.
Rousseau C, Said TM, Gagne MJ, Bibeau G., Cult Med Psychiatry 22(4), 1998
PMID: 10063465
The civilian labor market experiences of Vietnam-era veterans: the influence of psychiatric disorders.
Savoca E, Rosenheck R., J Ment Health Policy Econ 3(4), 2000
PMID: 11967456
Linking posttraumatic stress disorder and psychosis: a look at epidemiology, phenomenology, and treatment.
Seedat S, Stein MB, Oosthuizen PP, Emsley RA, Stein DJ., J. Nerv. Ment. Dis. 191(10), 2003
PMID: 14555870

Smith, 2002
The chemistry of khat.
Szendrei K., Bull Narc 32(3), 1980
PMID: 6911031
Khat use and mental illness: a critical review.
Warfa N, Klein A, Bhui K, Leavey G, Craig T, Alfred Stansfeld S., Soc Sci Med 65(2), 2007
PMID: 17544193

WHO, 2008

World, 1997
Susceptibility to subsequent episodes of spontaneous recurrence of methamphetamine psychosis.
Yui K, Goto K, Ikemoto S, Nishijima K, Yoshino T, Ishiguro T., Drug Alcohol Depend 64(2), 2001
PMID: 11543983
Trauma stories: violence, emotion and politics in Somali Ethiopia
Zarowsky, Transcultural Psychiatry 37(3), 2000
Rethinking trauma in a transnational world
Zarowsky, Transcultural Psychiatry 37(3), 2000
Export

Markieren/ Markierung löschen
Markierte Publikationen

Open Data PUB

Web of Science

Dieser Datensatz im Web of Science®
Quellen

PMID: 19666207
PubMed | Europe PMC

Suchen in

Google Scholar