TRAMADOL ABUSE: SOCIODEMOGRAPHIC AND CLINICAL CORRELATES

Abstract

An increasingly alarming phenomenon of tramadol abuse has been heavily demonstrated in the Egyptian community in the last four years.
Aim of the work: To assess the sociodemographic characteristics, the severity of tramadol abuse, presence of commorbid psychiatric and personality disorders and evaluation of the cognitive functions among treatment seeking patients with tramadol use disorders. Patient and Methods: The study included 100 patients recruited from psychiatric outpatient clinic and inpatient unit of Zagazig university hospital and 100 control persons selected from patients' relatives. The patients had to fulfill the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, criteria for tramadol use disorder. The control subjects were matched for age, sex, education, and lack a history of substance abuse (except smoking). The participants were subjected to all of the following: semistructured clinical interview for DSM-IV (SCID-I & II), Montreal Cognitive Assessment (MoCA), Addiction Severity Index scale (only for patients), and urine screening for substance abuse. Results: The mean age of tramadol use disorder patients was 30.18 ± 7.84. The majority of them were males (93%), about 54% were rural residents, 56% were married and 76% of patients abuse other substances. 49% and 64% of patients had comorbid axis I and axis II disorders respectively compared to 24% and 31% in control participants. The most common psychiatric disorders were mood disorders while the most common personality disorders were borderline and antisocial. Cognitive impairment is present in 81% in Patients compared to 28% in control participants. Conclusions: Most of tramadol abuse patients were using other substances (polysubstance). Almost half of the patients had at least one comorbid psychiatric disorder especially mood disorders and about two-thirds of the patients had personality disorders especially cluster B. Tramadol abuse patients were nearly three times more likely to have cognitive impairment than control subjects.
Keywords: Tramadol abuse, correlates, Comorbidity, cognitive impairment