BACKGROUND:

Substance use disorder (SUD) is an increasing mental health challenge in Nigeria, with significant implications for public health, productivity, and social stability (National Bureau of Statistics & United Nations Office on Drugs and Crime [NBS & UNODC], 2019). Studies worldwide have demonstrated that gender significantly influences the patterns, progression, and outcomes of SUD (Miller et al., 2023; McKee & McRae-Clark, 2022) However, little is known about these disparities within Nigerian psychiatric inpatient settings. This research aimed to examine gender differences in the prevalence, clinical characteristics, and treatment outcomes of patients diagnosed with SUD at the psychiatric ward of the Federal Medical Centre (FMC), Umuahia, Abia State, Nigeria.

Methods:

A retrospective descriptive and analytical review was conducted on patient records from January 2018 to December 2024. All patients aged 18 years and above admitted with a primary diagnosis of SUD during this period were included. Prior to data extraction, patients were contacted via telephone and verbal consent was obtained for the use of their clinical information in the study. Data were extracted from case files using a structured proforma. This included sociodemographic information, types of substances used, duration of use, comorbid conditions, treatment modalities, and clinical outcomes such as length of hospital stay, relapse, and discharge status. Statistical analysis was performed using SPSS version 26. Chi-square tests were used to explore associations between gender and categorical variables, while independent t-tests assessed differences in continuous variables. Logistic regression was employed to evaluate gender as an independent predictor of poor treatment outcomes.

Results:

Of the 286 eligible cases reviewed, 198 (69.2%) were males and 88 (30.8%) were females, indicating a male-to-female ratio of approximately 2.3:1. Males were more likely to use multiple substances (p < 0.01), especially cannabis and alcohol, while females more often reported non-medical use of prescription drugs such as opioids and sedatives (p < 0.05). Females also had a higher prevalence of psychiatric comorbidities, notably depression and anxiety (p = 0.02). Although both genders benefited from inpatient treatment, males had a significantly higher rate of discharge against medical advice and relapse within six months (p = 0.03). Gender remained a significant predictor of poor treatment adherence in multivariate analysis.

Conclusion:

Significant gender differences were observed in the patterns and outcomes of SUD among psychiatric inpatients at FMC Umuahia. Male patients were more likely to present with severe substance-related complications and lower adherence to treatment, whereas female patients showed higher rates of psychiatric comorbidity. These findings underscore the need for gender-responsive interventions, policies, and rehabilitation strategies tailored to the unique needs of each group.

Dr. Kazeem Abimbola Uthman is a Consultant Psychiatrist specializing in addiction psychiatry. He is a Fellow of the National Postgraduate Medical College of Nigeria. Dr. Uthman has worked in both private and public sectors in the field of addiction psychiatry. He is currently the Head of Department of Psychiatry, Federal Medical Center, Umuahia, Abia State, Nigeria.