Insomnia, depression and anxiety disorders and their association with benzodiazepine drug use among the community-dwelling elderly: implications for mental health nursing.

Benzodiazepine (BZD) drug use among seniors is an important public health issue because the benefit from their use is moderate and of short duration and numerous adverse events have been linked to their use. Furthermore, there is a significant discrepancy between the prevalence of mental health disorders and BZD drug use in the elderly population, which can be attributed to a measurement issue. The goal of this cross-sectional descriptive study was to determine the prevalence of mental health disorders among seniors using BZD and living in the community, basing this information on both a thorough face-to-face interview and a pair of self-reported validated instruments. Among the 216 seniors recruited in our study, nearly 20 % were users of BZD and over three quarters of them had been using this drug for more than a year. Thirteen subjects were recognized as depressed according to a self-report measure compared to 18 according to the interview. Likewise, 13 seniors were categorized as anxious, based on a self-report questionnaire compared to 39 based on the interview. Among self-reported measures of mental health variables, logistic regression indicated that insomnia increases by 7 the likelihood of using BZD (odds ratio: 7.2) and is the only statistically significant variable associated with BZD consumption. Based on thorough interviews, logistic regression showed that insomnia (odds ratio: 6.9) is still the dominant symptom associated with BZD drugs. In conclusion, our results clearly support the assertion that mental health status is influenced according to how it is measured. Finally, nurses should be aware that not all individuals are capable of expressing their mental health problems using either psychological or emotional terminologies. They may opt for expressing their psychological suffering as a physical symptom such as sleeping problems.