Knoop H, Kan C C, Mickers F C, Barnhoorn D
Nijmeegs Kenniscentrum Chronische Vermoeidheid van het Universitair Medisch Centrum St Radboud te Nijmegen.
Tijdschr Psychiatr. 2006;48(9):695-703.
After successful completion of a benzodiazepine withdrawal programme it nevertheless is hard to remain abstinent in the long term.
To determine to what extent the success of a benzodiazepine discontinuation programme for psychiatric patients with chronic benzodiazepine use (> or = 3 months) can be predicted from the severity of the anxiety, sleep disorders and depressive symptoms, and from the level of benzodiazepine dependence. The predictive values of coping style and personality characteristics were also studied.
A prognostic cohort study with patients of the Radboud University Nijmegen Medical Centre was conducted. Before entering the programme 92 patients were given a psychological assessment. Anxiety level, benzodiazepine dependence, coping style and personality traits were measured by means of psychological questionnaires. The DSM-IV axis I classification for each patient was known. Patients who had stopped their medication immediately after the discontinuation programme ended (n = 6o) were compared with patients who had not been successful in completing the programme (n = 32). Thereafter, patients who were still abstinent at the follow-up about 2 years later (n = 25) were compared with patients who at that time /used benzodiazepine (n = 43).
Of all the variables examined, it was only a specific coping style whereby patients expressed their (negative) emotions which was associated with the short- and long-term success of the discontinuation programme. The more patients expressed their negative emotions, the greater the chance of a successful outcome and permanent abstinence. Coping style, however, predicted for only a small proportion of the variance in the success of the discontinuation programme.
The psychological characteristics and the DSM-IV axis I classifications should not exert undue influence on the clinician's decision to advise the patient to stop or continue taking benzodiazepines.
尽管成功完成了苯二氮䓬类药物戒断计划，但长期保持戒断状态仍很困难。
确定对于长期（≥3个月）使用苯二氮䓬类药物的精神科患者，苯二氮䓬类药物停药计划的成功在多大程度上可以通过焦虑、睡眠障碍和抑郁症状的严重程度以及苯二氮䓬类药物依赖水平来预测。同时也研究应对方式和人格特征的预测价值。
对奈梅亨拉德堡大学医学中心的患者进行了一项预后队列研究。在进入该计划之前，对92名患者进行了心理评估。通过心理问卷测量焦虑水平、苯二氮䓬类药物依赖、应对方式和人格特质。每位患者的DSM-IV轴I分类是已知的。将停药计划结束后立即停药的患者（n = 60）与未成功完成该计划的患者（n = 32）进行比较。之后将约2年后随访时仍保持戒断状态的患者（n = 25）与当时仍使用苯二氮䓬类药物的患者（n = 43）进行比较。
在所有研究的变量中，只有一种特定的应对方式，即患者表达其（负面）情绪，与停药计划的短期和长期成功相关。患者表达负面情绪越多，成功停药和永久戒断的机会就越大。然而，应对方式仅能预测停药计划成功与否的一小部分差异。
心理特征和DSM-IV轴I分类不应过度影响临床医生关于建议患者停用或继续服用苯二氮䓬类药物的决定。
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