Prevalence of Depression and Post Traumatic Stress Disorder Among Patients With Substance Use Disorders in Rehabilitation Centres in Nairobi and Its Environs

Abstract

Background: There is paucity of data whereby mental healthcare workers in rehabilitation centres diagnose co-occurring depression and post-traumatic stress disorder, which are common mental disorders among patients with Substance Use Disorders (SUDs). This failure to detect the dual diagnosis results in a more chronic course of the illnesses as there is increased rates of relapses. Study Objectives and Setting: This study sought to determine the prevalence, severity and relationship between depression and post-traumatic stress disorder among clients with substance use disorder admitted in rehabilitation centres in Nairobi and its environs. Methods: This was a cross-sectional study of 222 in-patients using Beck’s Depression Inventory (BDI-II), posttraumatic stress Disorder Checklist for DSM-5(PCL-5) and The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and researcher designed socio-demographic questionnaire. SPSS for windows version 24 was used for data analysis. Frequencies, proportions and Pearson’s correlation was used. Results: Prevalence of PTSD and depression was 27.5% and 34.2%, respectively. Females had higher scores of PTSD. Respondents who were divorced, separated or widowed had higher scores for both depression and PTSD. Respondents in business had higher scores for depression. There was a significant positive correlation between depression and PTSD scores and alcohol use disorder. Conclusions: The findings of this study add some clarity to the prevalence and severity of depression and PTSD in substance use disorder patients in rehabilitation centres. PTSD and depression co-morbidities form a critical sub-group of substance use disorder patients in rehabilitation centres. Thus, correct diagnosis is essential to managing SUD patients to prevent chronic course of illness and relapses. The clinicians in rehabilitation centres should routinely screen for depression and PTSD in individuals undergoing rehabilitation. Policy makers should design protocols for integrated management of comorbidities. More training on how to handle addiction plus co-morbidities. Recommendations: Future researchers need to set-up longitudinal studies to assess impact of co-morbidities of depression and PTSD on rehabilitation treatment outcome. Further studies can look at the causal relation between SUD, depression and PTSD. Researchers can do a longitudinal follow up of similar population and conduct more qualitative researches in Kenya.