Prevalence of Post-Traumatic Stress Disorder and Associated Trauma Exposure Among Inpatients with Substance Use Disorders in Nairobi Rehabilitation Centers

Abstract

Objective(s): To determine the prevalence of post-traumatic stress disorder (PTSD), describe patterns of trauma exposure, and identify associated factors among inpatients with substance use disorders (SUDs) in Nairobi.
Design: Cross-sectional analytical study.
Setting: Thirteen inpatient rehabilitation centers within a 50-kilometre radius of Nairobi, Kenya.
Subjects or Participants: A total of 222 adult inpatients aged 18–65 years with diagnosed SUDs, stabilized on treatment for at least two weeks.
Interventions: None.
Main Outcome Measures: PTSD prevalence and severity assessed using the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), trauma exposure patterns, and substance involvement measured using ASSIST.
Results: Participants were predominantly male (91.0%) with a mean age of 34.1 years (SD 9.0). Trauma exposure was reported by 59.9%, including significant life events (37.4%), physical injury (19.4%), and sexual assault (3.2%). The prevalence of PTSD was 27.5% (95% CI: 22.1–33.3). Independent predictors of higher PTSD severity included divorced/separated/widowed marital status (β = -11.10, p=0.001), physical injury (β = 8.00, p=0.028), and significant life events (β = 9.69, p=0.001). PTSD severity was strongly correlated with depression severity (r=0.545, p<0.001).
Conclusion: PTSD is a common comorbidity among SUD inpatients in Nairobi and is strongly associated with trauma exposure and marital disruption. Routine trauma screening and integration of trauma-informed care into substance use treatment programs are recommended.