Prevalence and correlates of psychological distress symptoms among patients with substance use disorders in drug rehabilitation centers in urban Nepal: a cross-sectional study.
The burden of substance misuse in developing countries is large and increasing, with negative consequences for physical and psychological health. Substance use disorders and psychological distress commonly co-exist, however few studies have examined this relationship in developing countries, including Nepal. Our aim was to investigate the prevalence of psychological distress symptoms and associated factors among patients with substance use disorders attending drug rehabilitation centers in Nepal.



We conducted a cross-sectional study including 180 patients attending drug rehabilitation centers in the Kathmandu Valley region of Nepal. We used the 6-item Kessler scale (K6) to measure symptoms of psychological distress, and data on socio-demographics, behavioral and psychosocial factors. Multivariable analyses were used to identify factors associated with distress.



The prevalence of high psychological distress symptoms among patients with substance use disorder was 51.1 %. The mean score found on the K6 was 12.22 (SD = 5.87). Outcomes of multivariable analyses demonstrated various factors associated with symptoms of psychological distress, including age (β = -0.122, 95 % CI = -0.218; -0.026), education (β =2.694, 95 % CI = 0.274; 5.115), severity of drug abuse (Drug Abuse Screening Test-10-DAST10)(β = 0.262, 95 % CI = 0.022;0.502), and family functioning (Adaptability, Partnership, Growth, Affection and Resolve-APGAR) (β = -0.525, 95 % CI = -0.787; -0.264).



High psychological distress symptoms are common in patients with substance use disorder in Nepal. Demographics (age, education), behavioral (drug abuse severity), and psychosocial factors (family functionality) were associated with psychological distress symptoms. If confirmed by future longitudinal studies such characteristics may assist in identifying groups at risk for co-morbid psychological distress symptoms among patients with substance use disorders. Future treatment approaches for substance use disorders should address co-existing mental illness in Nepal.
Center for Global Health, Department of Public Health, Aarhus University, Bartholins Allé 2, Building 1261, 2:15, DK-8000, Aarhus C, Denmark. bishalforu@hotmail.com.|Nepal Development Society (NEDS), Bharatpur, Nepal. bishalforu@hotmail.com.
Bishal
B
Gyawali
Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Maharajgunj, Kathmandu, Nepal.
Bishnu P
BP
Choulagai
Department of Public Health, School of Health and Allied Sciences, Pokhara University, Pokhara, Nepal.
Damaru Prasad
DP
Paneru
Department of Community Medicine, Manipal College of Medical Sciences, Pokhara, Nepal.
Meraj
M
Ahmad
Unit for Health Promotion Research, University of Southern Denmark, Niels Bohrs Vej 9, DK-6700, Esbjerg, Denmark.
Anja
A
Leppin
Center for Global Health, Department of Public Health, Aarhus University, Bartholins Allé 2, Building 1261, 2:15, DK-8000, Aarhus C, Denmark.
Per
P
Kallestrup
D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D009390:Nepal / Q000453:epidemiology; D015995:Prevalence; D013315:Stress, Psychological / Q000453:epidemiology*; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000453:epidemiology*; D055815:Young Adult
Distress; Kessler-6-item scale; Nepal; Rehabilitation; Substance use disorders