Mental Health Problems Associated with the Use and Abuse of Khat (Catha edulis)

Abstract

During the past decades khat use has become a frequent and frenetic, but unnoticed, phenomenon in a number of very poor countries in the world where its use is not controlled and where its economic importance grows. Khat research is still in its beginnings and lags behind the increasingly uninhibited pattern of khat use. In this chapter, potential khat-induced hazards are reviewed and discussed. The currently held view on khat dependence as rare phenomenon contrasts with newer empirical data that demonstrate the existence of a growing binge user group. More research is urgently needed on this topic. Khat can be related to psychosis in several ways, among which evidence is strongest for khat-induced brief psychotic states. Khat can also exacerbate pre-existing psychotic states. The question whether khat constitutes a risk factor for schizophrenia requires urgently further studies. Numerous somatic disorders have also been associated with khat use, among which evidence is strongest for coronary heart diseases. Research has failed so far to prove risks and causal associations based on strong research designs. However, there is enough evidence to state that khat may represent an important but neglected threat for the public health of countries around the Horn of Africa, especially related to substance dependence and psychosis.