title: Severity of khat dependence among adult khat chewers: the moderating influence of gender and age.
abstract: BACKGROUND
  The escalating use of khat (Catha edulis) in East Africa and Arabia is a major concern for public health. Yet little is known about the impact of khat on behavior. There has been no study in the region to assess the extent to which dependence syndrome is associated with khat use in this population.
  
  
  OBJECTIVE
  To examine psychometric properties of the Severity of Dependence Scale-Khat (SDS-khat), gender differences in patterns of khat use and dependence, and the extent to which age moderated the link between gender and khat dependence.
  
  
  METHODS
  Two-hundred and seventy khat chewers recruited in two Yemeni cities completed face-to-face interviews asking about demographics and patterns of khat use. Validity of SDS-khat was examined by the principle component analysis and reliability of the scale was tested by Cronbach׳s alpha. A series of chi-square tests and analysis of variances (ANOVAs) were conducted to examine gender differences in khat use variables.
  
  
  RESULTS
  The results indicated that the mean age of khat chewers was 30.52 years (95% CI: 29.34, 31.70) and 52% of them were males. The SDS-khat was found to have two factors with moderate reliability. This pattern was consistent when the analysis was conducted in the entire sample and in each gender. Male khat chewers reported more symptoms related to khat dependence than female chewers. A significant gender by age interaction in SDS-khat levels (p=0.013) revealed a positive association between age and khat dependence in women only.
  
  
  CONCLUSIONS
  These results provide initial support for the use of SDS-khat in the assessment of khat dependence in Yemen. Gender differences in khat use patterns and dependence observed in this study call the need for more studies carefully examining the role of gender in khat research.
authors: University of Minnesota Medical School, 1035 University Drive, Duluth, Minnesota 55812, USA. Electronic address: mnakajim@umn.edu.
authors: Motohiro
authors: M
authors: Nakajima
authors: Taiz university, Taiz, Yemen. Electronic address: anisa_dokm@yahoo.com.
authors: Anisa
authors: A
authors: Dokam
authors: Taiz university, Taiz, Yemen. Electronic address: abednaji123@gmail.com.
authors: Abed
authors: A
authors: Alsameai
authors: Taiz university, Taiz, Yemen. Electronic address: m_alsoofi@yahoo.com.
authors: Mohammed
authors: M
authors: AlSoofi
authors: Sana׳a university, Sana׳a, Yemen. Electronic address: najatsayem@gmail.com.
authors: Najat
authors: N
authors: Khalil
authors: University of Minnesota Medical School, 1035 University Drive, Duluth, Minnesota 55812, USA. Electronic address: malabsi@umn.edu.
authors: Mustafa
authors: M
authors: al'Absi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D029754:Catha; D002947:Cities / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology; D015006:Yemen / Q000453:epidemiology; D055815:Young Adult
keywords: Gender; Khat dependence; Psychometric properties; SDS-khat; Yemen