Cannabis and Tramadol are Prevalent among the First Episode Drug-Induced Psychosis in the Egyptian Population: Single Center Experience

Abstract

(1) Background: Cannabis and tramadol are featuring prominently in Egypt; however, their prevalence in first episode psychosis is still uncertain. We aimed at determining the prevalence of cannabis and tramadol among the first-psychotic episode in Egyptian inpatients and to compare the demographic and psychopathological profiles of substance abusers versus patients with the comorbid diagnosis. (2) Methods: Patients presented with psychotic episode and admitted to Mansoura Psychiatric Department were recruited. Diagnosis of psychiatric illness and drug/substance use was carried out using the Diagnostic and Statistical Manual- Fourth Edition (DSM-IV) criteria. Standard urine tests and thin layer chromatography were performed to detect cannabis and tramadol. (3) Results: Of the 100 subjects in the study, the majority (55.6%) of patients were cannabis-only positive. Overall, cannabis-alone showed the highest frequency of substance used among the currently diagnosed psychotic disorders. According to urine tests, cannabis demonstrates the higher frequency of intake in both studied groups. 66.7% of the studied population had 1–5 years self-reported histories of substance abuse predating the first psychotic episode. (4) Conclusions: The percentage of cannabis and tramadol among the first episode psychotic patients has been unexpectedly high and the standard urine testing should be considered in emergency and mental health facilities.

Frequency of Socio-Demographic Factors and Variety of Substances used by Drug Induced Psychotic Patients in Tertiary Care Hospital

“…In the present study, cannabinoids were the prevalent substance (46.3%) used followed by multiple drugs (36.6%) and opioids (9.6%). These findings were consistent with various studies conducted in the UK [17], Australia [18], and Canada [19] where cannabis besides alcohol was a commonly used substance. Compared to other substances, alcohol was less prevalent in psychotic disorder patients due to religious and cultural disapproval among ethnic groups.…”

“…Patterns of substance use appear to have a substantial part of individuals prior to the onset of psychotic disorders, possibly as early as first signs of illness [15]. There have only been a few large-scale studies of drug-induced psychosis where the incidence rates of alcohol and drug abuse ranged from 3% to 35% and 6% to 44%, respectively [16,17]. However, no study assessing the incidence of substance use in drug-induced chronic psychiatric patients has been conducted so far in our country.…”

Substance Abuse Patterns in Brick Industry Workers Detection and Evaluation

“…Taha and colleagues in 2019 held a study on patients who presented with psychotic episode and admitted to Mansoura Psychiatric Department, they found that 66.7% of the studied patients had between 1-5 years self-reported histories of substance abuse predating the first psychotic episode [6]. That's to say, drug abuse may share a common genetic predisposition along with psychotic disorders, in which an increased probability for an individual to abuse substances and concomitantly or eventually tend to develop psychosis.…”

“…In Egypt, drug abuse became an alarming problem in the last years that continue to cause national and societal concern [5]. In 2018, the Egyptian Ministry of Social Solidarity declared that substance abuse rates in Egypt surpassed 10% and doubled the global average and that tramadol was the commonest abused substance followed by cannabis and heroin [6].…”

Substance use and substance use disorders in Africa: An epidemiological approach to the review of existing literature

“…This has been attributed to a lack of capacity for data collection and analysis[ 64 ]. In Egypt, there are reports that substance abuse rates are as high as 10%-20% the global average, with cannabis and tramadol being the most abused substances[ 65 ]. In Tunisia, an increase in the trafficking and consumption of psychoactive substances have been observed since the political uprising that occurred in 2011[ 66 ].…”