Prevalence of substance use disorders among forensic psychiatry inpatients at Windhoek Central Hospital Forensic Unit, Namibia

Abstract

The prevalence and incidence of substance related disorders is on the increase worldwide. Substance abuse and mental disorders are important cause of disease burden accounting for 8.8% and 16.6% of the total burden of disease in low income and lower middle – income countries, respectively. The prevalence is even higher among forensic patients, however 50 to 80% of patients in forensic settings with co-morbid substance related disorders remain unrecognized and/or are misdiagnosed. The study Aim: To establish the prevalence of substance abuse among the forensic psychiatric inpatients at Windhoek Central Hospital, Namibia. The study method - descriptive cross-sectional. A convenient sample of 75 forensic inpatients were interviewed. Socio-demographic data questionnaire and structured clinical interview - ASSIST screening questionnaire were used. Descriptive and inferential analysis was done using the statistical package for social science (SPSS) version 17. Results: Prevalence of substance use disorder was found to be 82.7% among 75 forensic in patients. The patients with substance use problems were on average younger. The study participants’ age ranged from 19 to 65 years. Mean age was 38.5 years. Males were 90.7% as compared to 9.3%. Sixty two (82.7%) had been previously admitted for psychiatric illness with duration of stay raging from a day to 8 years. Previous admission for psychiatric illness was significantly related with level of formal education (p =0.02). Fifty (67%) of the patients had a diagnose of schizophrenia and only 7% had a diagnose of substance abuse as per records. While (53.3%) violence offences including murder were the common index offences. Alcoholic beverages, tobacco and cannabis were the leading substance of abuse in that order. While alcoholic beverages were reportedly being the most frequently used prior to admission, tobacco 52 (72%) is the most substance used. Cannabis use and its substance involvement score was statistically significant associated with gender (p = 0.016). There was a statistically significant association between cannabis use and the index offence (p = 0.019) and patient age showed a statistically significant with substance abuse (p= 0.03). Prevalence of substance abuse was found to be 82.7% among 75 forensic in patients. Conclusion: There is high prevalence of substance use disorder among inpatients admitted in forensic psychiatric unit Windhoek Central Hospital, Namibia.