Drug dependence and psychotic symptoms: a retrospective study of adolescents who abuse drugs at Al-Amal Hospital in Jeddah, Saudi Arabia

Drug abuse is reported to be on the increase among young persons using illicit substances but little is known about the frequency with which they occur, the symptoms on presentation to health institutions, and the different substances abused. To establish this, we reviewed patient data collected at Al-Amal Hospital in Jeddah Kingdom of Saudi Arabia on young persons who are refered to the hospital for problems related to drug abuse. Data on 69 adolescent drug users were reviewed and analyzed using the Composite International Diagnostic Interview - Substance Abuse Model (CIDI-SAM) to assess dependence on substances including amphetamines, cannabis, cocaine, and opioids. Furthermore, we assessed the adolescents’ data on history of delusions and hallucinations in the context of use of, or withdrawal from, these specific substances. Our analysis shows that 10 to 79.6% of users of amphetamines, cannabis, cocaine, and opiates met DSM-III-R dependence criteria for each specific substance. The prevalence of psychotic symptoms associated with each specific substance ranged from users with no diagnosis to users with severe dependence as follows: amphetamines (3-100%), cannabis (7- 60.0%), cocaine (5-70.7%), and opiates (4- 88%). The risk of psychotic symptoms increased for respondents who abused (OR=7.2) or had mild (OR=8.1), moderate (OR=20.0), or severe dependence (OR=14.0) on cocaine when compared to those who were users with no diagnosis. A similar pattern was evident in cannabis, opiate, and amphetamine users. In conclusion, most adolescent drug users in Saudi Arabia who are dependent on illicit substances experience psychotic symptoms in the context of use of, or withdrawal from, these substances. Psychotic symptoms increased with the severity of the disorders associated with use of all four substances. These findings underscore the importance of developing services to target this population; a population at risk of developing psychotic symptoms.