|LETTER TO EDITOR
|Year : 2022 | Volume
| Issue : 1 | Page : 177-180
Demographic and clinical profile of women receiving inpatient treatment at a deaddiction unit of a psychiatric hospital in India: Five years' observation
Sourav Khanra, Ujjwal Singh, Sanjay Kumar Munda, Basudeb Das
Centre for Addiction Psychiatry, Central Institute of Psychiatry, Ranchi, Jharkhand, India
|Date of Submission||15-Apr-2021|
|Date of Acceptance||26-Jun-2021|
|Date of Web Publication||17-Feb-2022|
Dr. Sourav Khanra
Central Institute of Psychiatry, Ranchi - 834 006, Jharkhand
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Khanra S, Singh U, Munda SK, Das B. Demographic and clinical profile of women receiving inpatient treatment at a deaddiction unit of a psychiatric hospital in India: Five years' observation. Ind Psychiatry J 2022;31:177-80
|How to cite this URL:|
Khanra S, Singh U, Munda SK, Das B. Demographic and clinical profile of women receiving inpatient treatment at a deaddiction unit of a psychiatric hospital in India: Five years' observation. Ind Psychiatry J [serial online] 2022 [cited 2022 Nov 29];31:177-80. Available from: https://www.industrialpsychiatry.org/text.asp?2022/31/1/177/337845
The recent national survey found a varying proportion of women use alcohol, cannabis, opioid, inhalants, and other substances. It has also reported that a small proportion of persons with substance use disorder (SUD) receive inpatient treatment. Studies examining gender differences found that women experience a unique set of barriers to seeking treatment as compared to men, such as more opposition and less support from family and friends, more unemployment, greater economic barriers, family responsibilities, and increased stigma and social disapproval., An earlier review has found women with substance abuse were less likely to enter treatment than males. Research on characteristics and profiles of women with substance use seeking treatment at a psychiatric center in India is limited. To our best of knowledge, only two of these studies included all women seeking treatment at a deaddiction unit., Hence, our study aimed to examine sociodemographic and clinical profiles of women in patients who received inpatient treatment at deaddiction unit of a psychiatric hospital in India during a period of 5 years from July 2015 to June 2020.
The study was conducted at the addiction psychiatry unit of a psychiatric hospital in India. Before collecting data, approval was obtained from the Institute Ethics Committee. Case record files of all women in patients who were admitted at deaddiction unit of our institute during the specified period were accessed. Case record files were reviewed to collect sociodemographic information and clinical details in a predesigned semi-structured pro forma. Data were analyzed using SPSS version 25 (IBM Corp., Armonk, NY, USA) for Windows.
[Table 1] shows sociodemographic and clinical profile of female in patients who were admitted during the past 5 years in our institute. A total of 26 women had received inpatient treatment at our deaddiction unit during a specified period of 5 years. The majority (69.20%) of them were Hindu which might be due to the fact that Hinduism is most commonly followed in the general population in India. Near 70% of them were educated only up to or below the 10th class. Lower level of education has been a high-risk factor for substance abuse among women., Lower education has been also found to be a predictor of treatment entry and retention.,, Most of them are unemployed (69.20%). This agrees with earlier research where unemployment has been found to be a consequence and risk factor and to predict treatment retention among women.,, Around 60% of them hailed from urban areas and 88.5% were living in a nuclear family. Although the location of our hospital in a city might contribute urban predominance among inpatients, few research has discussed urban-rural differences in accessing treatment for SUD and utilization of SUD treatment due to rural specific challenges and barriers.,, Majority had a family history of substance abuse (53.80%). Genetic predisposition for SUD among the general population could explain this. Demographic profiles found in our study are consistent with earlier studies., While 58% of them had anxious affect (P < 0.001), around 40% of them had depressive cognitions at the time of admission.
|Table 1: Demographic and clinical characteristics of inpatient women with substance use at an addiction psychiatry unit of a psychiatric hospital over five years period (n=26)|
Click here to view
Alcohol was the most abused substance in our study following a trend found in a recent national survey in India. An earlier hospital-based study among inpatient women attending deaddiction center found opioid to be the most abused substance, whereas a recent study found tobacco to be the most abused one. This reflects the heterogeneous pattern and raises the possibility of changing trends of substance abuse among women across several regions in the country. Which would have a bearing in policymaking on demand reduction. A recent national household survey on the nature and extent of substance use in India, which did not focus on tobacco, found alcohol to be the most commonly (1.7%) used substance among women. Considering the fact that the recent Global Adult Tobacco Survey in India, another recent survey exclusively for tobacco use found 14.2% of women in India use tobacco, it might be concluded that tobacco is the most commonly used substance among women in India. Furthermore, the inpatient population of a hospital-based study does not represent the general population thereby differing from other hospital-based and epidemiological studies. The majority of them did not visit the hospital for follow-up consultation. Research found higher motivation among women,, and comparable motivation with men. While poor motivation might be one reason behind this, other factors should also be examined for poor retention among them. As mentioned earlier several gender-specific barriers exist which play a role for poor retention in SUD treatment among women. A recent qualitative study has reaffirmed a few barriers such as fear of losing custody of a child, social stigma. Lack of childcare facilities in SUD treatment centers is often reported by participants. Although Greenfield et al. found women were less likely to enter treatment, gender was not a significant predictor for treatment retention. Mean follow-up period of about 1 year could not be compared as research on this using standardized constructs of treatment retention is limited.
Although our study had few limitations such as having a small sample size, being retrospective, and our study adds to the sparse literature of inpatient women with substance use at a psychiatric hospital. As India is a large country with diverse demographics with heterogeneous patterns of SUD among women, knowledge on this area would help us to develop more suitable and user-oriented SUD treatment programs which would serve the needs of women with SUD in the future. Future multicentric studies with larger samples with comparison group of men with SUD and prospective design would reduce the knowledge gap in this area.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Ambekar A, Agrawal A, Rao R, Mishra AK, Khandelwal SK, Chadda RK, et al
. Magnitude of Substance Use in India. New Delhi: Ministry of Social Justice and Empowerment, Government of India; 2019.
Small J, Curran GM, Booth B. Barriers and facilitators for alcohol treatment for women: Are there more or less for rural women? J Subst Abuse Treat 2010;39:1-13.
Brady KT, Ashley OS, editors. Women in Substance Abuse Treatment: Results from the Alcohol and Drug Services Study (ADSS) (DHHS Publication No. SMA 04-3968, Analytic Series A-26). Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies; 2005.
Lal R, Deb KS, Kedia S. Substance use in women: Current status and future directions. Indian J Psychiatry 2015;57:S275-85.
Greenfield SF, Brooks AJ, Gordon SM, Green CA, Kropp F, McHugh RK, et al
. Substance abuse treatment entry, retention, and outcome in women: A review of the literature. Drug Alcohol Depend 2007;86:1-21.
Grover S, Irpati AS, Saluja BS, Mattoo SK, Basu D. Substance-dependent women attending a de-addiction center in North India: Sociodemographic and clinical profile. Indian J Med Sci 2005;59:283-91.
] [Full text]
Nebhinani N, Sarkar S, Gupta S, Mattoo SK, Basu D. Demographic and clinical profile of substance abusing women seeking treatment at a de-addiction center in north India. Ind Psychiatry J 2013;22:12-6.
] [Full text]
Murthy P, editor. Women and Drug Use in India. New Delhi: Substance, Women and High Risk Assessment Study: United Nations Office on Drugs and Crime, Ministry of Social Justice and Empowerment, Government of India and United Nations Development Fund for Women; 2008.
Vigna-Taglianti FD, Burroni P, Mathis F, Versino E, Beccaria F, Rotelli M, et al
. Gender differences in heroin addiction and treatment: Results from the VEdeTTE cohort. Subst Use Misuse 2016;51:295-309.
Choi S, Adams SM, Morse SA, MacMaster S. Gender differences in treatment retention among individuals with co-occurring substance abuse and mental health disorders. Subst Use Misuse 2015;50:653-63.
Dayal P, Sarkar S, Balhara YP. Predictors of inpatient treatment completion among females with opioid use disorder: Findings from a tertiary care drug dependence treatment Centre of India. Indian J Psychol Med 2017;39:464-8.
] [Full text]
Hutchison L, Blakely C. Substance abuse – trends in rural areas: A literature review. In: Gamm L, Hutchison L, Dabney B, Dorsey A. editors. Rural Healthy People 2010. Volume 2. College Station, TX: The Texas A&M University System Health Science Center, School of Rural Public Health, Southwest Rural Health Research Center; 2003. p. 145-54.
Oser CB, Leukefeld CG, Tindall MS, Garrity TF, Carlson RG, Falck R, et al
. Rural drug users: Factors associated with substance abuse treatment utilization. Int J Offender Ther Comp Criminol 2011;55:567-86.
Lister JJ, Weaver A, Ellis JD, Himle JA, Ledgerwood DM. A systematic review of rural-specific barriers to medication treatment for opioid use disorder in the United States. Am J Drug Alcohol Abuse 2020;46:273-88.
Dayal P, Balhara YP. Profile of female patients seeking in-patient treatment for prescription opioid abuse from a tertiary care drug dependence treatment centre from India. Indian J Med Res 2016;143:95-100.
] [Full text]
Grosso JA, Epstein EE, McCrady BS, Gaba A, Cook S, Backer-Fulghum LM, et al
. Women's motivators for seeking treatment for alcohol use disorders. Addict Behav 2013;38:2236-45.
Drapalski A, Bennett M, Bellack A. Gender differences in substance use, consequences, motivation to change, and treatment seeking in people with serious mental illness. Subst Use Misuse 2011;46:808-18.
Taylor LR, Caudy M, Blasko BL, Taxman FS. Differences by gender in predictors of motivation among substance abuse treatment participants. Subst Use Misuse 2017;52:468-76.
Schamp J, Simonis S, Roets G, Van Havere T, Gremeaux L, Vanderplasschen W. Women's views on barriers and facilitators for seeking alcohol and drug treatment in Belgium. Nord Stud Alcohol Drugs 2021;38:175-89.