Using the Severity of Dependence Scale to screen for DSM‐5 khat use disorder

Duresso, Samson W.; Matthews, Allison; Ferguson, Stuart G.; Bruno, Raimondo

doi:10.1002/hup.2653

Cited by 8 publications

(4 citation statements)

References 54 publications

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“…The remaining studies employed tools like the modified version of "Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDA-DIS-IV)" [32], a single Likert scale question with varying points (e.g., 2-point scale, 4-point scales) [33,34], or questions about the age of the onset of chewing [35], and the amount of chewing [36]. Only two studies employed a standardized and khat-specific multi-item module for measuring khat chewing [37,38].…”

Section: Measurement Of Khat Chewing Patternsmentioning

confidence: 99%

Is chewing khat associated with mental health disorders? A scoping review of the content and quality of the current evidence base

Olani

Gerbaba

Getnet

et al. 2023

Subst Abuse Treat Prev Policy

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Background Khat (Catha edulis) is a plant commonly found in the horn of Africa whose leaves are chewed for their psycho-stimulant effects. Several studies have demonstrated the association between khat use and mental health problems. Nevertheless, evidence is mixed and inconsistent, warranting further review of available studies. This scoping review is aimed at investigating the content and quality of evidence base on the associations between khat use and mental health disorders and suggesting avenues for further research. Methods We used a scoping review methodology to map the existing evidence using PubMed, SCOPUS, Embase, and CINAHL databases. Primary studies focusing on the association between any pattern of khat use and any form of mental health disorders are included. The review focused on all age groups, any study design, all geographical locations, and any publication year. The terms used for searching eligible studies include khat, mental disorders, and various alternative terminologies. Narrative review is employed to present findings. Results 7,121 articles were found, of which 108 were eligible, conducted across 12 different countries. The majority of the studies was done during the last ten years and the studies mostly employed cross-sectional design. About 10 different categories of mental health disorders have been identified as showing associations with khat use. Despite many contradictory findings between the studies, most of the evidence base suggests that khat use is associated with mental health disorders. Non-specific psychological distress is the most frequently mentioned mental health problem (reported in 26.9% of the studies). Khat use as a predictor variable is mostly assessed using a ‘yes/no’ category, and as a result, dose-dependent effects of khat use on mental health are not given much consideration. Conclusion Although most of the studies associate khat use with mental health disorders, the causal relationships are inconclusive given the cross-sectional design of the studies, and the presence of potential confounders and several forms of biases. Available studies also report contradictory findings. Further studies are recommended using prospective designs, standardized and valid measures of khat use, and focusing on specific types of mental health disorders.

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Section: Measurement Of Khat Chewing Patternsmentioning

confidence: 99%

Is chewing khat associated with mental health disorders? A scoping review of the content and quality of the current evidence base

Olani

Gerbaba

Getnet

et al. 2023

Subst Abuse Treat Prev Policy

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“…The severity of dependence scale [22] is currently the most widely used measure of problematic khat use, but it only measures a narrow concept of problematic khat use. Thus, taking previous theoretical and methodological lessons, we have developed the Problematic Khat Use Screening Test (PKUST-17) following standardized and rigorous procedures [17, 18].…”

Section: Introductionmentioning

confidence: 99%

Validation of the Problematic Khat Use Screening Test: A Cross-Sectional Study

et al. 2022

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Aim: The study aimed to evaluate the psychometric properties of the Problematic Khat Use Screening Test (PKUST-17) in Ethiopia. Methods: A validation study of PKUST-17 was carried out among 510 khat users, using a house-to-house survey. Confirmatory factor analysis and 2-parametric item response theory (IRT) were used to evaluate the construct validity of PKUST-17. We also used Spearman’s rank-order correlation coefficient and other test statistics to assess the convergent validity of PKUST-17 with depression symptoms, functional impairment, and other characteristics of participants. We generated latent classes of problematic khat use using latent profile analysis (LPA) and validated the classes using multinomial logistic regression. Results: The data confirm the unidimensional model of the PKUST-17. The internal consistency of PKUST-17 was excellent (Cronbach’s alpha = 0.93). IRT discrimination parameters indicated that each item had a strong ability to distinguish participants across the spectrum of problematic khat use (α thresholds range from 1.02 to 2.9). The items were fairly or moderately severe to be endorsed by participants (β thresholds vary from 1.43 to 5.57). The LPA identified three latent classes which have severity differences: mild (34%), moderate (34%), and severe (32%) problematic khat use. Depression symptoms, functional impairment, and other khat use patterns were also associated with moderate and severe problematic khat use class membership compared to mild problematic khat use class. Conclusion: We found that the PKUST-17 is a culturally appropriate, brief, easy to use, and psychometrically sound screening test. PKUST-17 can be used to screen khat users with different levels of risk for providing stepped care at different healthcare levels, including integration of services in primary care. Future studies need to test the predictive capacity of the PKUST-17 for khat-related harms.

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“…One study [55] suggested gender by age interaction for problematic khat use. Many of the studies reported that the construct psychological dependence is valid and applicable for problematic khat use [17,21,55,56]. Few studies applied constructs-khat use disorder [16] and harmful khat use [19] to denote problematic khat use.…”

Section: Psychometric Studiesmentioning

confidence: 99%

“…There was a discrepancy in the psychometric properties of SDS. Two studies [17,56] suggested SDS is a unidimensional scale, but another study [55] found 2 factors where items 3 and 4 could be collapsed into one domain desire to stop. Kassim et al [17] recommended ≥6 points cutoff, whereas Duresso et al [56] established ≥3 using DSM-5 stimulant use disorder as a gold standard and ≥5 cutoff for another study [55].…”

Section: Psychometric Studiesmentioning

confidence: 99%

Definition and Validity of the Construct “Problematic Khat Use”: A Systematic Review

et al. 2019

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Background: Problematic khat use, not khat use per se, is a public health and social concern for the public, researchers, and policy makers. However, the construct problematic khat use is not well-established and not fully recognized in the modern definition of substance use disorders including Diagnostic Statistic Manual (DSM-5) and international classification of diseases (ICD-10), although DSM-5 included it in the “stimulant use disorder” category. Existing scoping reviews have focused on khat use, which could not allow the differentiation of khat use from problematic khat use. Thus, the aim of this systematic review was to define and validate the construct problematic khat use. Methods: This systematic review was reported following the PRISMA guidelines. We searched all English language studies without publication date restriction from 5 databases; PubMed, EMBASE, psychINFO, SocINDEX, and Google scholar. All studies that defined, explored, evaluated, or measured the construct problematic khat use were included. Adapted data extraction tool and criteria for quality evaluation were employed. We presented the results in tables and thematic synthesis of the major findings. Result: Overall, 30 qualitative and cross-sectional design studies were included. Associated harms with khat use, an increased amount used, increased frequency of use, and withdrawal experiences were indicators of problematic khat use. Using khat on an average of 3 or more times per week and using other psychoactive substances during and after khat use were frequently used to define problematic khat use. The most frequently reported withdrawal symptoms were depressed mood, irritability, fatigue, lack of motivation, increased sleep, and appetite. The existing measures (severity of dependence scale and DSM-5) of problematic khat use had psychometrically acceptable properties in terms of construct, criterion, and convergent validity, but they are poor in terms of other domains of validity including content, conceptual, and semantic validity. Conclusion: Problematic khat use constitutes, but is not limited to, harms, increased use over time, and frequent engagement in other psychoactive substances misuse. Khat use is different from problematic khat use since it is occasional and used for prayer, social, and functional reasons. Strong empirical studies that could establish thresholds for patterns of problematic khat use and a culturally suitable problematic khat use measures that follows a bottom-up approach of scale development are warranted.

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Using the Severity of Dependence Scale to screen for DSM‐5 khat use disorder

Cited by 8 publications

References 54 publications

Is chewing khat associated with mental health disorders? A scoping review of the content and quality of the current evidence base

Is chewing khat associated with mental health disorders? A scoping review of the content and quality of the current evidence base

Validation of the Problematic Khat Use Screening Test: A Cross-Sectional Study

Definition and Validity of the Construct “Problematic Khat Use”: A Systematic Review

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