Multidimensional and population-based genetico-epidemiological research in Africa

Adorjan, Kristina (2020): Multidimensional and population-based genetico-epidemiological research in Africa. Habilitationsschrift, LMU München: Medizinische Fakultät

Abstract

Objective: Evidence supports that environmental factors contribute to the presentation of psychotic symptoms. Khat leaves contain amphetamine-like alkaloids, and heavy use is frequently associated with psychotic symptoms. We studied how khat use and exposure to traumatic events affect khat-induced psychotic experiences. Methods: At Gilgel Gibe Field Research Center of Jimma University, Ethiopia, we randomly selected a representative cohort of 1,100 men aged 18 to 40 years; 853 (77.5%) agreed to participate. We interviewed participants during the dry season, when khat availability is restricted, and nine months later, just after the rainy season (n = 695; 81.5% of initial sample). We assessed self-reported khat use, khat-induced psychotic experiences, and exposure to potentially traumatic experiences. Khat alkaloids were determined in urine by immunoassay. Significant outcomes: (1) In a large of males from the general population in rural Ethiopia, khat use varies according to seasonal availability and is associated with psychotic experiences. (2) The interaction of several environmental risk factors contributes to explain the prevalence of psychotic experiences, i.e. severe khat use that is more prevalent during rainy season is related to a higher level of khat-induced psychotic experiences among respondents with a severe exposure to traumatic events. (3) Not just lifetime but also recent exposure to traumatic events seems to be a factor that increases the psychotomimetic effects of severe khat use. Conclusions: Our findings support that the interaction of environmental factors might be related to the development of psychotic experiences; this needs to be replicated in larger, longer studies that assess psychotic experiences and symptoms more comprehensively. Systematic studies on long-lasting effects of khat use on mental health in the general population are needed.

Abstract

Abstract

• Dokumententyp: Habilitationsschriften
• Keywords: Ethiopia, khat, traumatic experiences, psychosis, sensitization, dopamine
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften ; 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Fakultäten: Medizinische Fakultät
• Sprache der Hochschulschrift: Englisch
• Datum der mündlichen Prüfung: 2020