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Psychiatric comorbidity in injecting drug users in Asia and Africa

Iskandar, Shellya,b; Kamal, Ramac; De Jong, Cor A.c

Current Opinion in Psychiatry: May 2012 - Volume 25 - Issue 3 - p 213–218
doi: 10.1097/YCO.0b013e3283523d66
ADDICTIVE DISORDERS: Edited by John B Saunders and Linda B Cottler

Purpose of review: The prevalence of psychiatric co-morbidity in injecting drug users (IDUs) in the Western countries is high and is associated with lower quality of life and reduces the effectiveness of treatment programs. The aim of this study is to provide a review about psychiatric comorbidity in IDUs in Asia and Africa, where HIV prevalence is high and still increasing.

Recent findings: Studies focusing on psychiatric comorbidity in Asia and Africa are scarce. The prevalence of psychiatric comorbidity is comparable with the prevalence in western countries. Psychiatric disorders can occur before or during drug abuse and are also associated with substance abuse and physical comorbidity and its treatments. Childhood trauma followed by post-traumatic disorders is a significant risk factor for substance abuse. Psychiatric co-occurring disorders influence the adherence to the physical and drug use treatment. Evidence-based treatment for psychiatric comorbidity in IDUs is still limited.

Summary: A better understanding of the prevalence of psychiatric disorders in IDUs and its impact on the overall treatments is growing. However, more studies focusing on the treatment for psychiatric comorbidity in IDUs in Asia and Africa are needed.

aDepartment of Psychiatry

bHealth Research Unit, Faculty of Medicine, Padjadjaran University/Hasan Sadikin Hospital, Bandung, Indonesia

cNijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Nijmegen, the Netherlands

Correspondence to Shelly Iskandar, Department of Psychiatry, Faculty of Medicine, Padjajaran University/Hasan Sadikin Hospital, Jl. Pasirkaliki no. 190, Bandung 40151, Indonesia. Tel: +622270720492; fax: +62222033915; e-mail: shelly_bdg@yahoo.com

© 2012 Lippincott Williams & Wilkins, Inc.