Prevalence of cognitive impairment and associated factors among patients with substance use disorder at SPHMMC, AA, Ethiopia Institutional Based Cross-Sectional Study

Abstract

Abstract Background: - Cognitive impairment is a significant concern in the field of mental health, particularly among individuals with substance use disorder. The relationship between cognitive functioning and substance use disorders is complex and it can affect the quality of life, treatment retention and risk of relapse. Prevalence of cognitive impairments in patients with substance use disorders has been estimated to be between 30% and 80% in previous studies conducted in diverse settings, including the Netherlands and China. However, there still remains a gap in knowledge regarding specific prevalence rates and associated factors among patients with Substance Use Disorder (SUD) in Ethiopia which is crucial for tailoring interventions, making this research of a great need. Objective: - To assess the prevalence of cognitive impairment and associated factors among patients with substance use disorder at SPHMMC, AA, Ethiopia. Methods: - Cross-sectional study was conducted in SPHMMC among total of 418 patients with substance use disorder, receiving treatment at the psychiatric OPD and inpatient settings. Data were collected by pretested interviewer administered structured questionnaire and using convenience sampling technique. The returned questionnaire was analyzed using STATA version 17. The association between cognitive impairment and independent variable was done using logistic regression using both bivariate and multivariate analysis. Statistical significance were assured at a p-value <0.05. Results: A total of 418 patients participated in the study, with 99.05% response rate. The prevalence of cognitive impairment was 58.61% with a 95% confidence interval of (53.81, 63.25). Factors that were found to be significantly associated with cognitive impairment include: older age [AOR = 3.62; 95% CI: (1.76 5.43)], severe alcohol, khat and tobacco use disorder [AOR= 2.43; 95% CI: (1.39-4.62)], use of two substances [AOR = 2.25; 95% CI: (1.56-4.75)], use of three or more substances [AOR = 3.89; 95% CI: (1.23 5.49)], concurrent use of more than one substance [AOR = 3.04; 95% CI: (2.01-5.97)], and presence of co morbid medical or psychiatric illness [AOR =1.96; 95% CI: (1.12-3.74)]. Conclusion: More than half of the study participants had cognitive impairment. Older age, severe and multiple substance use, particularly concurrent poly substance use, and the presence of co-morbid medical or psychiatric illnesses were key factors associated with cognitive impairment. Strengthening early screening, substance-use prevention, and integrated management of co-morbid conditions may help reduce the burden of cognitive impairment. Keywords: - Cognitive impairment, Substance use disorder, Ethiopia, SPHMMC