Mental Disorders and Consumption of Psychoactive Substances in Women: Epidemiological and Clinical Aspects in the Service of Psychiatry of the Donka National Hospital Guinea, Conakry

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J Psychiatry Psychiatric Disord 2018; 2 (2): 41-48 41
Journal of Psychiatry and Psychiatric Disorders doi: 10.26502/jppd.2572-519X0039
Research Article Volume 2, Issue 2
Mental Disorders and Consumption of Psychoactive Substances
in Women: Epidemiological and Clinical Aspects in the Service
of Psychiatry of the Donka National Hospital Guinea, Conakry
Keita MM1*, Doukouré M2, Condé S3, Soumaoro K4 and Souare M5
1Psychiatrist-addictologist, Psychiatric Department of Donka National Hospital, Conakry University Hospital
2Child Psychiatrist, Psychiatric Service of Donka National Hospital, CHU Conakry
3Psychiatrist, Department of Psychiatry at Donka National Hospital, CHU Conakry
4Psychiatrist, Department of Psychiatry at Donka National Hospital, CHU Conakry
5Psychiatric Department of Donka National Hospital, CHU Conakry
*Corresponding Author: Dr. Keita MM, Psychiatrist-addictologist, Psychiatric Department of Donka
National Hospital, Conakry University Hospital, Conakry, Guinea; Tel: 224 628779717 (or) 657408760; E-
mail: saramady1957@gmail.com (or) keitapsy@yahoo.fr
Received: 29 January 2018; Accepted: 26 February 2018; Published: 02 March 2018
Abstract
Introduction: The use of psychoactive substances (PPS) is a public health problem for vulnerable populations,
particularly women and those with mental disorders.
Objectives: In this work, our objectives were to determine the frequency of mental disorders and consumption of
psychoactive substances in women, to describe their socio-demographic profile, to identify the psychoactive
substances consumed, to identify the different types of mental disorders and to describe the clinical aspects of
mental disorders induced by the consumption of psychoactive substances in these women.
Methodology: This was a retrospective study, of a descriptive type with a duration of 5 years (from 1 January 2009
to 31 December 2013). Data collection lasted three months. Included in this study were all records of hospitalized or
outpatient patients in the Mental Disorders and Psychoactive Substance Use Service.
Results: The incidence of mental disorders and psychoactive substance use was 10.51%. The age groups 20-29, 30-
39 were the most represented are respectively 55.49%, 31.87% with an average age of 29.5 years and extremes of
10-49 years. Singles were the most affected with 91.76% of cases. The majority was in the informal sector and the
secondary level was the most affected with 40.11%, 56.04%, respectively. The most commonly used psychoactive

J Psychiatry Psychiatric Disord 2018; 2 (2): 41-48
substances were cigarettes (3.30%) and alcohol (2.20%). The alcohol and cigarette association was the most
frequent, 45.60%. Depression was the most prevalent type of disorder with 35.71%. Occasional consumption was
the most common mode of consumption with 84.62%, followed by 15.38% of regular consumption or dependence.
Conclusion: This retrospective study did not identify all aspects of women's psychoactive substance use, yet a
general population survey could better capture the magnitude of this phenomenon.
Keywords: Guinea (Conakry); Women; Psychoactive substances; Mental disorders; Epidemiology; Clinic
1. Introduction
Mental disorders are clinical conditions characterized by a change in thinking, mood and behavior [1]. According to
the WHO, "a psychoactive substance (PPS)" refers to a substance that is ingested or administered, which impairs
mental processes such as cognitive function or affect [1]. The links between mental disorders and psychoactive
substance use are not straightforward. In part, mental disorders may be risk factors for increased use of psychoactive
substances and, secondly, psychoactive substance abuse may be a risk factor for mental disorders [2]. With regard to
gender, it is clear that consumption data indicate a difference between men and women. Regardless of the product
and mode of consumption, women consume less than men. This gap in addictive behaviors between men and
women often tends to ignore feminine addiction as more and more people develop their own forms of addiction [3].
The consumption of this product is not a problem of society, not only because of the misuse of this product, but also
because of the negative consequences that the traffic and the use of these substances induce in economic terms,
sanitary, social and mental. The studies conducted by (SERGE and GUILLAUME) [4], note a coexistence between
mental problems and substance abuse, particularly among women who have suffered violence during childhood.
In France, BECK's work indicates that women in high socioeconomic positions tend to drink more than women in
less advantaged positions [5]. If women remain a minority among cannabis smokers (5% of women against 23% of
men), they catch up with men in terms of tobacco (27% for them against 33% for them), and ahead of them in
consumption psychotropic drugs (23% versus 13%) [3]. In GUINEA, Doukouré M et al. [6] in their study of
psychoactive substances and mental disorders reported a 5% frequency of psychoactive substance use among
women. The use of PPS and drug addiction among women are constantly increasing in Guinea, they have become a
real public health problem, they are the worst scourge of our time, because it affects young people at an older age.
earlier and destroys the vital force of our country. It is a terrible threat to the future of our society. Yet despite this
critical situation, women as such are of little interest to investigators. The absence of a previous study on mental
disorders and psychoactive substance use among women in Guinea motivated the choice of this theme.
Our objectives for this study were to determine the frequency of mental disorders among women who use
psychoactive substances and to describe their socio-demographic profile, to identify the psychoactive substances
they use, to identify the different types of mental disorders and to describe the clinical aspects. Mental disorders
induced by the consumption of psychoactive substances.
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2. Methodology
The psychiatric service of Donka National Hospital served as the framework for the realization of our study. It is the
only reference center in the country for the management of mental disorders, behavior and addictions to
psychoactive substances. The study looked at the records of patients in hospital or outpatients in the department who
had mental health disorders with substance use during the study period. We used as support for data collection,
consultation and hospitalization records, patients' individual files and an investigation form developed for this
purpose. This was a retrospective, descriptive study lasting five years (from January 1, 2009 to December 31, 2013).
Data collection lasted three months. Our study population consisted of patient records received in the department,
hospitalized or followed as outpatients for mental disorders and PPS consumption during the study period. Included
in our study were all records of patients hospitalized or followed as outpatients in the department during the study
period in which the diagnosis of mental disorders and consumption of one or more psychoactive substances was
retained and whose records included the parameters of our study; however, incomplete patient records received in
the department during the study period and for other diagnoses than mental disorders and ASA were excluded from
this study. We grouped our variables into quantitative and qualitative variables to allow an analysis of our data. The
anonymity was preserved and the survey cards were destroyed after the study. As with any scientific study, we have
been faced with certain difficulties, including the incomplete filling of some medical files and the lack of similar
studies carried out on this subject in the Service.
3. Results
The frequency of mental disorders and substance use was 10.51%. The age groups 20-29, 30-39 were the most
represented being respectively 55.49%, 31.87% with an average age of 29.5 years and extremes of 10-49 years.
Singles were the most affected with 91.76% of cases. The majority was in the informal sector and the secondary
level was the most affected, with 40.11% and 56.04% respectively. The most used psychoactive substances were
cigarettes (3.30%) and alcohol (2.20%). The association alcohol and cigarette was the most frequent is 45,60%.
Depression was the most predominant type of disorder with 35.71%. Occasional consumption was the most popular
mode of consumption with 84.62%, followed by 15.38% of regular consumption or dependence (Table 1).
Consumed substances
Number of cases
Percentage
Cigarette only
6
3.30
Palm wine alone
2
1.10
Alcohol alone
4
2.20
Alcohol + Cigarette
83
45.60
Cannabis + Alcohol + Cigarette
76
41.76
Cannabis + Alcohol + Alcohol + Cigarette
2
1.10
Cannabis + Alcohol
8
4.40
Tea + Benzodiazepine
1
0.55
Total
182
100
Table 1: Distribution of patients by substances consumed.
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4. Discussion
The main difficulty of our study was the lack of specific documentation concerning mental disorders and
consumption of PPS in women elsewhere and in Guinea, nevertheless we reached the following results:
During the study period, 1732 patients were received in consultation, of which 182 patients presented with mental
disorders and psychoactive substance use, with a hospital frequency of 10.51% (Figure 1).
In 2007 Doukouré et al. [6] found a 5% incidence of mental disorders related to substance use among women.
In Quebec Serge Brochir et al. Found in their study of substance use among female prisoners a frequency of 94.7%
[7].
This low incidence of women with mental disorders and psychoactive substance use in our study may be due to the
fear of being judged, they have a much harder time getting through the door of a health center. especially psychiatric
that men and on the other hand, they are victims of double punishment, shame and guilt, because our society still
very severely judges these women. Feeling ashamed, delay their consultation and necessarily their treatment and
prefer a self-therapy.
Figure 1: Frequency of mental disorders and psychoactive substance use among women.
The age of the patients varies between 10 to 49 years with an average of 29.5 years. The most affected age groups
were 20-29 years old, 30-39 years old respectively 55.49% and 31.87%. This predominance of young adults could
be explained by the fact that these periods constitute the transition between childhood and adulthood and are periods
of high psychological vulnerability, instability of the personality in women as well, the consumption of some
psychoactive substances can trigger mental disorders, and the older women become, the more it turns out that
substance use is shifting to so-called hard drugs (such as hallucinogens, cocaine and heroin). Subsequently, the
experimentation of new products is more rare and one observes a certain stability inside the drugs already
experimented. However, the feminization of the consumption phenomenon remains a current concern. These results
confirm those reported by Biron and Savard [8]. In the vast majority of cases, the association alcohol and cigarettes
(45.60%), cannabis, alcohol and cigarette (41.76%), was the most observed. This high frequency of psychoactive
10.51%
89.49%
Mental disorders
and substance
abuse
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J Psychiatry Psychiatric Disord 2018; 2 (2): 41-48
substance use could be explained on the one hand by their easy accessibility and at a lower cost and on the other
hand, the consumption of these psychoactive substances could reduce social inhibitions, occupational stress and
increases sensations, desire, excitement as well as sexual pleasure, the notion of climbing and the search for
sensation [9] (Figure 2).
Figure 2: Distribution of patients by age. Average age: 29.5 years. Extreme ages: 10-49 years.
The vast majority (91.76%) are single people versus (2.75%) brides. Unlike our study, Verdoux H and al. reported
47.5% of brides [10] who had mood disorders associated with substance use. This high frequency of singles could
be explained by the fact that they are young people in whom the mental disorders and behavior engendered or
aggravated by the consumption of psychoactive substances compromise any marriage project, but also disrupts the
socio-occupational functioning and family of these subjects. The vast majority of the study population (56.04%) has
a secondary level followed by a primary level (32.97%). This high level of secondary education can be explained by
the fact that these are teenage girls, who for the most part make their first experiences of using psychoactive
substances, either out of curiosity, during festivities or through their friends; which, in the long run, decreases school
performance and then leads to a cessation of schooling. This rate of 32.97% for the primary level draws attention to
the precocity of the phenomenon in preadolescent women. Weiss and Michel G reported in their study that most
patients with mood disorders associated with substance use had a low academic level [11, 12].
In our study the informal sector was the most affected with 40.11% of cases followed by formal training 28.57%.
This high frequency of patients in the informal sector could be explained by the fact that hard work in this sector
most often requires the use of psychoactive substances to fight or resist fatigue. Formal training, usually involving
adolescent girls and young adults, is a source of stress and frustration. Generally, young students consume these
psychoactive substances to fight against stress, but also try the drug out of curiosity, fashion, the pressure of the
group, the fascination of the taboo, just as to flee suffering and loneliness. Okitundu and al. found that most patients
in their series were from the informal sector [13]. The vast majority of the study population (84.62%) had a simple
use against 15.38% of cases of dependence. This high frequency of simple use could be explained by the fact that
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
10 - 19 ans 20 - 29 ans 30 - 39 ans 40 - 49 ans
8.79%
55.49%
31.87%
3.85%
F
r
é
q
u
e
n
c
e
s
Ages
Tranches d'age
N = 7
N = 182
N = 101
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J Psychiatry Psychiatric Disord 2018; 2 (2): 41-48
most women consume during the holidays, a dance party for the search for a new sensation. There is, however, the
speed of installation of dependence on certain psychoactive substances in women such as alcohol, tobacco, cannabis,
etc. The most commonly observed mental disorders were mood disorders (depression, bipolar disorder, mania),
respectively (35.71%, 27.47%, 22.53%) (Table 2 and 3).
Terms of use
Number of cases
Percentage
Outbuilding
28
15.38
Simple use
154
84.62
Total
182
100
Table 2: Distribution of patients according to consumption patterns.
Mental disorders and substance use
Number of cases
Percentage
Delirious puff
20
10.99
Dépression
65
35.71
Schizophrenia
2
1.10
Manic access
41
22.53
Pathological intoxication
3
1.65
Bipolar disorders
50
27.47
Chronic Hallucinatory Psychosis
1
0.55
Total
182
100
Table 3: Distribution of Patients by Mental Disorders and Consumption of psychoactive substances.
This could be explained by the fact that mood disorders are providers of psychoactive substance use. Our result is
clearly superior to the result of Bastin P et al. who found that 70% of the maniacs used psychoactive substances
[14]. The majority of our patients were hospitalized 56.04% against 43.96% of ambulatory follow-up. This high
frequency of cases of hospitalization is explained by the fact that the behavioral disorders caused by different
psychoactive substances disturb not only the socio-professional functioning of the patient, her family balance, but
also the socio-cultural intolerance of consumption. psychoactive substances in women, which indicates their
management in hospitalization. The most predominant reasons for consultation were insomnia (100%), psychomotor
retardation (89.01%), moodiness (60.44%) followed by headache (52.75%), logorrhea (48.35%), ambulation
(43.41%), psychomotor agitation (45.05%). Our data are consistent with those in the literature [14, 15] regarding the
prevalence of these different symptoms in mental disorders and substance use. The explanation that could be given
for these psychiatric manifestations is the acute or chronic effect of drugs, which have a common characteristic on
the central nervous system.
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J Psychiatry Psychiatric Disord 2018; 2 (2): 41-48
5. Conclusion
Mental disorders and psychoactive substance use among women occupy an important place among psychiatric
pathologies. Their epidemiological and clinical study is complex, it involves several factors including age,
occupation, associations of toxic, lifestyle, symptoms. We found in our study that adolescent girls and young adult
women were the most affected with a clear predominance of single people. The majority evolved in the informal
sector. Many of our patients had a level of study. The secondary level was the most affected, but the 32.97% of the
primary level should draw attention to the early and rejuvenated use of psychoactive substances.
This study also shows a predominance of the association of psychoactive substances. Alcohol and cigarettes were
the most abused substances, followed by cannabis, alcohol and cigarettes. The most common mental disorders were
bipolar disorder, manic access, depression and delirium. Occasional consumption was the most predominant type of
consumption. The primary reasons for consultation were insomnia, mood exaltation, logorrhea, ambulation,
psychomotor agitation, inconsistent speech, and moodiness. An extended study to the Guinean population on this
question would be necessary to appreciate the extent of this phenomenon.
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This article is an open access article distributed under the terms and conditions of the
Creative Commons Attribution (CC-BY) license 4.0
Citation: Keita MM, Doukouré M, Condé S, Soumaoro K, Souare M. Mental Disorders and Consumption
of Psychoactive Substances in Women: Epidemiological and Clinical Aspects in the Service of Psychiatry
of the Donka National Hospital Guinea, Conakry. Journal of Psychiatry and Psychiatric Disorders 2 (2018):
41-48.
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