Abstract
BACKGROUND: Hazardous alcohol use frequently occurs among individuals with psychiatric disorders and may complicate clinical outcomes. However, there is limited evidence on its prevalence and associated factors in Sub-Saharan African psychiatric outpatient settings. This study aimed to estimate the prevalence of hazardous alcohol use and identify associated sociodemographic and clinical factors among patients receiving psychiatric care in Kinshasa, Democratic Republic of the Congo. METHODS: A cross-sectional analytical study was conducted at the Neuro-Psycho-Pathological Centre of Kinshasa over a period of 3 months (November 2023 to January 2024). Adults (≥ 18 years) with a documented psychiatric diagnosis attending outpatient follow-up were consecutively recruited. Data were collected via a structured questionnaire including the French version of the Alcohol Use Disorders Identification Test (AUDIT). Hazardous alcohol use was defined as an AUDIT score ≥ 10. Univariate logistic regression was used to screen variables; those with p-value < 0.20 entered a multivariate logistic regression model (forward stepwise). Multicollinearity was assessed (VIF < 2). Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) and p-values were reported. RESULTS: Of 204 participants, 190 (94.1%) reported regular alcohol consumption, and 121 (59.3%) met the threshold for hazardous alcohol use. In multivariate analysis, three variables were independently associated with hazardous alcohol use: increased alcohol consumption during the acute phase of psychiatric illness (aOR 5.21; 95% CI 2.40-11.34; p < 0.001), being in paid employment (aOR 2.28; 95% CI 1.01-5.14; p = 0.048), and having experienced a change or cessation of professional activity due to illness (aOR 2.15; 95% CI 1.02-4.52; p = 0.043). CONCLUSIONS: More than half of psychiatric outpatients in Kinshasa exhibited hazardous alcohol use. Elevated consumption during symptomatic episodes, employment status, and occupational disruption were key correlates. These findings underscore the need for routine alcohol use screening and integrated psychosocial interventions in psychiatric services in low-resource settings.