Document Detail


Benzodiazepine use and abuse among patients with severe mental illness and co-occurring substance use disorders.
MedLine Citation:
PMID:  14557527     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Because use of benzodiazepines may exacerbate existing substance use disorders or become abused substances, prescription of benzodiazepines for patients with severe mental illness (schizophrenia or bipolar disorder) and co-occurring substance use disorders (abuse or dependence) is controversial. The authors examined benzodiazepine use and associated psychiatric, substance abuse, and institutional outcomes in a six-year longitudinal study of patients with co-occurring disorders. METHODS: At baseline and yearly follow-up for six years, 203 patients with co-occurring severe mental illness and substance use disorder were prospectively assessed for medication use, substance use, psychiatric symptoms, use of hospitalization, and quality of life. RESULTS: Almost one-half of the patients (43 percent) reported taking prescribed benzodiazepines at the time of at least one assessment. Patients taking prescribed benzodiazepines were more likely to have high scores on measures of overall symptoms and affective symptoms (anxiety and depression) and low ratings for general quality of life throughout the study. Benzodiazepine use was unrelated to remission of substance use disorder or hospitalization, but a greater proportion of patients who were prescribed benzodiazepines developed benzodiazepine abuse, compared with those who were not prescribed benzodiazepines (15 percent compared with 6 percent). CONCLUSIONS: Prescription benzodiazepine use was common among patients with co-occurring severe mental illness and a substance use disorder and was not associated with any of the measured outcomes other than increasing the likelihood of benzodiazepine abuse. Physicians should consider other treatments for anxiety in this population.
Authors:
Mary F Brunette; Douglas L Noordsy; Haiyi Xie; Robert E Drake
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Psychiatric services (Washington, D.C.)     Volume:  54     ISSN:  1075-2730     ISO Abbreviation:  Psychiatr Serv     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-14     Completed Date:  2004-04-01     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9502838     Medline TA:  Psychiatr Serv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1395-401     Citation Subset:  IM    
Affiliation:
Department of Psychiatry, Dartmouth Medical School, Concord, New Hampshire 03301, USA. mary.f.brunette@dartmouth.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Alcoholism / diagnosis,  epidemiology*,  psychology,  rehabilitation
Ambulatory Care
Benzodiazepines* / adverse effects,  therapeutic use
Bipolar Disorder / diagnosis,  epidemiology*,  psychology,  rehabilitation
Cocaine-Related Disorders / diagnosis,  epidemiology,  psychology,  rehabilitation
Comorbidity
Cross-Sectional Studies
Diagnosis, Dual (Psychiatry)
Drug Prescriptions / statistics & numerical data
Female
Humans
Longitudinal Studies
Male
Marijuana Abuse / diagnosis,  epidemiology,  psychology,  rehabilitation
New Hampshire
Prospective Studies
Psychiatric Status Rating Scales
Psychotic Disorders / diagnosis,  epidemiology*,  psychology
Risk
Risk Factors
Schizophrenia / diagnosis,  epidemiology*,  rehabilitation
Schizophrenic Psychology*
Street Drugs*
Substance-Related Disorders / diagnosis,  epidemiology*,  psychology,  rehabilitation
Chemical
Reg. No./Substance:
0/Street Drugs; 12794-10-4/Benzodiazepines

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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