Ribeiro Carmen Sylvia, Azevedo Renata Cruz Soares, Silva Viviane Franco da, Botega Neury José
Department of Medical Psychiatry and Psychology, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
Sao Paulo Med J. 2007 Sep 6;125(5):270-4. doi: 10.1590/s1516-31802007000500004.
Chronic use of benzodiazepines is frequent in general practice. The aim of this study was to describe the usage pattern and profile of chronic users of diazepam who had been consuming this drug for a minimum of thirty-six months continuously.
This was a descriptive study (survey and clinical assessment) at five primary healthcare centers in Campinas, Brazil.
Psychotropic drug control books revealed 48 eligible patients. Among these, 41 were assessed by means of the Schedule for Clinical Assessment in Neuropsychiatry (SCAN), the Hospital Anxiety and Depression scale (HAD) and a questionnaire on usage pattern.
Most patients were women (85.4%). The patients' mean age was 57.6 years, and they were from the social strata C (39%), D (54%) and E (7%). The mean length of diazepam consumption was 10 years. The patients presented a lack of prescription compliance and had made frustrated attempts to stop using the drug. 55.5% said their doctor had never given any guidance on the effects of the drug. According to SCAN, 25 patients (61%) suffered from depressive disorders; only 12 cases of benzodiazepine dependence were detected by this instrument.
There is a need to improve the detection and treatment of mental disorders, as well as to prevent inappropriate prescription and use of benzodiazepines. Diazepam dependence has distinctive characteristics that make it undetected by SCAN.
在普通医疗实践中，长期使用苯二氮䓬类药物的情况很常见。本研究的目的是描述连续服用地西泮至少36个月的慢性使用者的用药模式和特征。
这是一项在巴西坎皮纳斯的五个初级医疗保健中心进行的描述性研究（调查和临床评估）。
精神药物控制记录显示有48名符合条件的患者。其中，41名患者通过神经精神病学临床评估量表（SCAN）、医院焦虑抑郁量表（HAD）和一份用药模式问卷进行评估。
大多数患者为女性（85.4%）。患者的平均年龄为57.6岁，来自社会阶层C（39%）、D（54%）和E（7%）。地西泮的平均服用时长为10年。患者存在用药依从性差的问题，且尝试停药均以失败告终。55.5%的患者表示他们的医生从未就药物的作用给予任何指导。根据SCAN，25名患者（61%）患有抑郁症；该工具仅检测出12例苯二氮䓬类药物依赖病例。
有必要改善精神障碍的检测和治疗，以及防止苯二氮䓬类药物的不适当处方和使用。地西泮依赖具有独特的特征，使得SCAN无法检测到。
