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Mental disorders associated with benzodiazepine use among older primary care attenders--a regional survey.
- Source :
-
Social psychiatry and psychiatric epidemiology [Soc Psychiatry Psychiatr Epidemiol] 2005 Apr; Vol. 40 (4), pp. 308-15. - Publication Year :
- 2005
-
Abstract
- Background: Benzodiazepines (BDZs) are among the most commonly prescribed drugs in the elderly and their use is often too prolonged according to current international guidelines.<br />Methods: We investigated the pattern of use of BDZs among 65- to 84-year-old attenders at 40 Italian primary care practices who answered positively in a questionnaire on the use of anxiolytic/hypnotic drugs and successfully completed the PRIME-MD questionnaire. The survey lasted 6 months, from February to July 2001.<br />Results: Of the 1,156 subjects who completed the PRIME-MD, 748 subjects were positive for at least one psychiatric diagnosis. A depressive disorder was present in 36.5% of all PRIME-MD completers and in about one-third of cases represented by major depression, whereas anxiety disorders, somatoform disorders and alcohol abuse accounted for 18.2%, 8.1% and 1.7% of all PRIME-MD completers, respectively. Most patients were first prescribed BDZs by their General Practitioners (GPs) for each diagnostic group. However, patients with pure anxiety started BDZ treatment during hospitalisation more often (19.7%) than patients with depressive disorders (13.7 %). Moreover, patients with comorbid anxiety and depressive disorders (CADD) were most likely to receive their first BDZ prescription from a psychiatrist (15.7 %). Sleep disturbances were present in at least 50% of cases (and up to 86 %) in each diagnostic group. About 75% of prescriptions concerned anxiolytic BDZ or medium/long-acting BDZ. Most patients with anxiety, CADD and depression used night-time BDZ (65.2%, 56.9 % and 60.5%, respectively). The prevalence of chronic use of BDZs was equally high in all categories of psychiatric disorder (about 90 % for each), showing that the vast majority of patients, irrespective of the diagnosis, had been using BDZs for years.<br />Conclusions: BDZs are widely prescribed for elderly people by their GPs, often for a considerable length of time. The evidence that many BDZ consumers suffer from a depressive or an anxiety disorder, or both, could be a starting point for encouraging a rational prescription in accordance with international guidelines.
- Subjects :
- Adult
Aged
Aged, 80 and over
Female
Humans
Italy epidemiology
Male
Mental Disorders diagnosis
Middle Aged
Benzodiazepines adverse effects
Mental Disorders chemically induced
Mental Disorders epidemiology
Primary Health Care statistics & numerical data
Substance-Related Disorders epidemiology
Substance-Related Disorders rehabilitation
Surveys and Questionnaires
Subjects
Details
- Language :
- English
- ISSN :
- 0933-7954
- Volume :
- 40
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Social psychiatry and psychiatric epidemiology
- Publication Type :
- Academic Journal
- Accession number :
- 15834782
- Full Text :
- https://doi.org/10.1007/s00127-005-0899-9