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采用或不采用团体认知行为疗法逐渐减少长期苯二氮䓬类药物使用:三条件随机对照试验

Tapering off long-term benzodiazepine use with or without group cognitive-behavioural therapy: three-condition, randomised controlled trial.

作者信息

Voshaar R C Oude, Gorgels W J M J, Mol A J J, van Balkom A J L M, van de Lisdonk E H, Breteler M H M, van den Hoogen H J M, Zitman F G

机构信息

University Medical Centre, Nijmegen, The Netherlands.

出版信息

Br J Psychiatry. 2003 Jun;182:498-504. doi: 10.1192/bjp.182.6.498.

Abstract

BACKGROUND

Benzodiazepine withdrawal programmes have never been experimentally compared with a nonintervention control condition.

AIMS

To evaluate the efficacy and feasibility of tapering off long-term benzodiazepine use in general practice, and to evaluate the value of additional group cognitive-behavioural therapy (CBT).

METHOD

A 3-month randomised, 3-month controlled trial was conducted in which 180 people attempting to discontinue long-term benzodiazepine use were assigned to tapering off plus group CBT, tapering off alone or usual care.

RESULTS

Tapering off led to a significantly higher proportion of successful discontinuations than usual care (62% nu. 21%). Adding group CBT did not increase the success rate (58% v. 62%). Neither successful discontinuation nor intervention type affected psychological functioning. Both tapering strategies showed good feasibilityin general practice.

CONCLUSIONS

Tapering off is a feasible and effective way of discontinuing long-term benzodiazepine use in general practice. The addition of group CBT is of limited value.

摘要

背景

从未通过实验将苯二氮䓬类药物戒断方案与非干预对照条件进行比较。

目的

评估在全科医疗中逐渐减少长期苯二氮䓬类药物使用的疗效和可行性,并评估附加的团体认知行为疗法(CBT)的价值。

方法

进行了一项为期3个月的随机、3个月的对照试验,将180名试图停用长期苯二氮䓬类药物的人分配到逐渐减量加团体CBT组、单独逐渐减量组或常规护理组。

结果

与常规护理相比,逐渐减量导致成功停药的比例显著更高(62%对21%)。添加团体CBT并未提高成功率(58%对62%)。成功停药和干预类型均未影响心理功能。两种逐渐减量策略在全科医疗中均显示出良好的可行性。

结论

在全科医疗中,逐渐减量是停用长期苯二氮䓬类药物的一种可行且有效的方法。附加团体CBT的价值有限。

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