Factors associated with anxiety disorders among adolescents and young adults with substance use disorders at a tertiary hospital in Zambia: a retrospective chart review

Abstract

Anxiety disorders are highly prevalent among individuals with substance use disorders (SUDs), yet factors associated with anxiety in this population remain poorly understood. This study aimed to identify demographic, clinical, and substance-related factors associated with anxiety in a cohort of individuals with SUDs. A retrospective chart review analysis was conducted among 427 participants with SUDs. Data on age, sex, residence, employment, marital status, developmental milestones, criminal history, insight into mental illness, substance type (alcohol, cannabis, opioids), comorbidities (depression, psychosis), and clinical variables (blood pressure, substance abuse duration) were collected. Anxiety was assessed as a binary outcome. Chi-square tests, Mann-Whitney U tests, and logistic regression (unadjusted and adjusted) were used to evaluate associations. The cohort had a median age of 21 years (IQR: 18–23), with 77.5% males. Anxiety prevalence was 3.04% ( n = 13). Univariate analyses showed non-significant trends between anxiety and urban residence (4.13% vs. 1.84%, p = 0.248), depression (6.56% vs. 2.46%, p = 0.099), and longer substance abuse duration (median 96 vs. 36 months, p = 0.152). Adjusted logistic regression identified depression as the sole significant factor associated with anxiety (AOR = 4.08, 95% CI: 1.15–14.45, p = 0.029). No associations were found with age, sex, substance type, or other variables. Depression was the only variable that reached statistical significance in the adjusted model (AOR = 4.08, 95% CI: 1.15–14.45, p = 0.029), suggesting an association with anxiety in this population. However, given the small number of anxiety cases ( n = 13) and the high rate of missing data (71.5% exclusion), these findings should be considered exploratory and hypothesis-generating. Further longitudinal research with larger, prospectively collected samples is necessary to validate these associations and explore potential causal mechanisms.