Article de Périodique
Dependence on prescription benzodiazepines and z-drugs among young to middle-aged patients in France (2015)
Auteur(s) :
GUERLAIS, M. ;
GRALL-BRONNEC, M. ;
FEUILLET, F. ;
GÉRARDIN, M. ;
JOLLIET, P. ;
VICTORRI-VIGNEAU, C.
Année :
2015
Page(s) :
320-327
Langue(s) :
Anglais
Domaine :
Autres substances / Other substances
Discipline :
EPI (Epidémiologie / Epidemiology)
Thésaurus géographique
FRANCE
Thésaurus mots-clés
MEDICAMENTS
;
BENZODIAZEPINES
;
PSYCHOTROPES
;
DEPENDANCE
;
ETUDE TRANSVERSALE
;
HYPNOTIQUES
;
ETUDE CLINIQUE
;
PHARMACIE
Résumé :
Background: Benzodiazepines (BZD) and nonbenzodiazepines hypnotics (z-drugs) are recognized as one of the most widely prescribed medications in the world.
Objectives: The purpose of the study was to assess the BZD and z-drugs dependence in young to middle-aged outpatients who were taking BZD/z-drugs on a chronic basis, and to characterize their profile.
Methods: This is a forward-looking cross-sectional epidemiological study. Data were collected through a semi-structured interview within a network of partner pharmacies from the Nantes area, in France. All data were obtained exclusively through patients' declarations. 212 patients (19-64 years old) were included: they were considered dependent when they answered positively to at least three items of the DSM IV. A multivariate logistic regression and a principal component analysis (PCA) were carried out to determine their profile.
Results: Almost half of the patients met criteria for BZD/z-drugs dependence. The risk to develop BZD/z-drugs dependence is significantly associated with psychiatric history and with the quantity of BZD/z-drugs that is taken. A two factor concept of dependence could be identified according to the PCA: one axis with items of "tolerance" and "long term administration or higher doses", and a second axis with "concerned by treatment" and "somatic consequences".
Conclusions/Importance: Among this BZD/z-drug dependent population, the two axes identified in the PCA represent two profiles of dependence: being in positive conditioning or suffering from negative consequences. Clinicians need to know them: these two clinical profiles may have an influence in terms of decision-making, especially to manage discontinuation.
Objectives: The purpose of the study was to assess the BZD and z-drugs dependence in young to middle-aged outpatients who were taking BZD/z-drugs on a chronic basis, and to characterize their profile.
Methods: This is a forward-looking cross-sectional epidemiological study. Data were collected through a semi-structured interview within a network of partner pharmacies from the Nantes area, in France. All data were obtained exclusively through patients' declarations. 212 patients (19-64 years old) were included: they were considered dependent when they answered positively to at least three items of the DSM IV. A multivariate logistic regression and a principal component analysis (PCA) were carried out to determine their profile.
Results: Almost half of the patients met criteria for BZD/z-drugs dependence. The risk to develop BZD/z-drugs dependence is significantly associated with psychiatric history and with the quantity of BZD/z-drugs that is taken. A two factor concept of dependence could be identified according to the PCA: one axis with items of "tolerance" and "long term administration or higher doses", and a second axis with "concerned by treatment" and "somatic consequences".
Conclusions/Importance: Among this BZD/z-drug dependent population, the two axes identified in the PCA represent two profiles of dependence: being in positive conditioning or suffering from negative consequences. Clinicians need to know them: these two clinical profiles may have an influence in terms of decision-making, especially to manage discontinuation.
Affiliation :
CHU de Nantes, Centre d'Evaluation et d'Information sur la Pharmacodépendance-Addictovigilance, Service de Pharmacologie Clinique, Institut de Biologie, Nantes, France