Swartz M, Landerman R, George L K, Melville M L, Blazer D, Smith K
Department of Psychiatry, Duke University Medical Center, Durham, NC 27710.
Am J Public Health. 1991 May;81(5):592-6. doi: 10.2105/ajph.81.5.592.
Benzodiazepine anti-anxiety agents are the most widely prescribed psychotherapeutic drugs in the United States today. Recent evidence, however, suggests that their use may be decreasing.
We examine the population prevalence and correlates of use of benzodiazepine anxiolytics at the Duke site of the NIMH-sponsored Epidemiologic Catchment Area project.
Bivariate analysis of use patterns for the drugs revealed demographic predictors similar to those reported in previous studies: increased likelihood of use by the elderly, Whites, women, the less educated, and the separated or divorced. Use is also associated with symptoms of psychic distress, negative life events, use of health care services, and diagnoses of affective disorder, agoraphobia with panic, and panic disorder. Age, sex, race, education, and marital status remain associated with non-hypnotic benzodiazepine use in a logistic regression analysis.
Multivariate analyses of these data indicate that when potential confounding factors are controlled, age, sex, race, education, and marital status are significantly related to benzodiazepine anxiolytic use but the effects of sex and education are mediated by intervening variables. Implications of these findings are discussed particularly in relation to high levels of use in the elderly.
苯二氮䓬类抗焦虑药物是当今美国处方量最大的心理治疗药物。然而,最近的证据表明其使用量可能正在下降。
我们在国立精神卫生研究所资助的流行病学集水区项目的杜克站点,研究了苯二氮䓬类抗焦虑药的人群患病率及其使用的相关因素。
对这些药物使用模式的双变量分析揭示了与先前研究报告相似的人口统计学预测因素:老年人、白人、女性、受教育程度较低者以及分居或离婚者使用的可能性增加。使用还与精神痛苦症状、负面生活事件、医疗服务的使用以及情感障碍、伴有惊恐发作的广场恐惧症和惊恐障碍的诊断相关。在逻辑回归分析中,年龄、性别、种族、教育程度和婚姻状况仍与非催眠性苯二氮䓬类药物的使用有关。
对这些数据的多变量分析表明,当潜在的混杂因素得到控制时,年龄、性别、种族、教育程度和婚姻状况与苯二氮䓬类抗焦虑药的使用显著相关,但性别和教育程度的影响由中介变量介导。特别针对老年人的高使用水平,讨论了这些发现的意义。