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Psychosis and Cannabis Abuse in the Gambia

A Case-Control Study

Published online by Cambridge University Press:  02 January 2018

M. Rolfe*
Affiliation:
Armed Forces Hospital, PO Box 726, CPO Seeb, Area Code 111, Sultanate of Oman, and Royal Victoria Hospital, Banjul, The Gambia
C. M. Tang
Affiliation:
Royal Victoria Hospital, Banjul, The Gambia
S. Sabally
Affiliation:
Royal Victoria Hospital, Banjul, The Gambia
J. E. Todd
Affiliation:
Medical Research Council Laboratories, Fajara, The Gambia
E. B. Sam
Affiliation:
Medical Research Council Laboratories, Fajara, The Gambia
A. B. Hatib N'jie
Affiliation:
Medical & Health Department, Banjul, The Gambia
*
Correspondence

Abstract

Cannabis abuse is a major public health problem in The Gambia and other parts of West Africa, and the rise in the incidence of psychotic illness reflects the increased background use of cannabis by the local population. A case-control study was performed to determine the association between psychosis and cannabis abuse in The Gambia and the importance of other risk factors. Out of 234 patients admitted to Campama Psychiatric Unit over 12 months, 210 (90%) were enrolled in a case-control study. Urine was tested for cannabinoid substances and 38% were positive compared with 12% of matched non-psychotic control subjects. Analysis of the matched pairs showed that a positive urinary cannabinoid test, cigarette smoking, alcohol consumption, travel to Europe and family history of mental illness were all significant risk factors for psychotic illness; Koranic education reduced the risk. There was a positive correlation among the psychotic patients between a positive urinary cannabinoid test and the use of alcohol, ataya tea and cigarette smoking; a family history of mental illness showed a negative correlation.

Type
Research Article
Copyright
Copyright © The Royal College of Psychiatrists 

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