Fløvig John C, Vaaler Arne E, Morken Gunnar
Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
BMC Res Notes. 2010 Oct 19;3:263. doi: 10.1186/1756-0500-3-263.
In the psychiatric acute and emergency services patients present in severe crisis often complicated by behavioral problems, substance use, and multiple axis 1 diagnoses. In these clinical settings both legal and illegal use of benzodiazepines are difficult to evaluate since benzodiazepines could in some patients be regarded as first line treatment and in other patients as the cause of the acute psychiatric condition. The aims of this study were to evaluate the frequency and clinical effects of both legal and illegal use of benzodiazepines at admittance to a psychiatric acute department.
All patients acutely admitted to a Norwegian acute psychiatric university department serving a catchment area were asked about use of benzodiazepines, other medications and substances before admission. Patients were asked to give urine samples for analyses of benzodiazepines and substances.
In 227 consecutive admissions there was legal use of benzodiazepines before admission in 39%, illegal use in 13% and no use in 48%. Patients with legal use of benzodiazepines were older, used more often antidepressants and a higher number of prescribed psychotropic medications. Illegal users of benzodiazepines more often used other illegal substances, were evaluated as clinically affected by a substance at admittance and were diagnosed with a substance use disorder. Patients with psychoses or major affective disorders treated with adequate medication (antidepressants, antipsychotics or mood-stabilizers) before admission more often received benzodiazepines than patients without adequate medication.
The patients using benzodiazepines at admittance to psychiatric acute departments could be divided in illegal and legal users. The illegal users were young, used illegal substances and were more often regarded clinically affected by substances at admittance. The legal users were older, did not use other substances and were not regarded as clinically affected by substances at admittance. Benzodiazepines were used as adjuvant therapy to specific pharmacological treatment with antidepressants, antipsychotics or mood stabilizers for major psychiatric disorders.
NCT 00184119/NCT 00184132.
在精神科急症服务中，患者常处于严重危机状态，常伴有行为问题、物质使用问题以及多种轴I诊断。在这些临床环境中，苯二氮䓬类药物的合法与非法使用情况都很难评估，因为在一些患者中，苯二氮䓬类药物可被视为一线治疗药物，而在另一些患者中，它又被认为是急性精神状况的病因。本研究的目的是评估在精神科急症科室入院时苯二氮䓬类药物合法与非法使用的频率及临床效果。
所有急性入住挪威一所服务特定区域的大学精神科急症科室的患者，均被询问入院前苯二氮䓬类药物、其他药物及物质的使用情况。患者被要求提供尿液样本以分析苯二氮䓬类药物及物质。
在连续227例入院患者中，39%在入院前合法使用苯二氮䓬类药物，13%非法使用，48%未使用。合法使用苯二氮䓬类药物的患者年龄较大，更常使用抗抑郁药及更多种类的处方精神药物。苯二氮䓬类药物非法使用者更常使用其他非法物质，入院时被评估为受物质临床影响，且被诊断为物质使用障碍。入院前接受适当药物（抗抑郁药、抗精神病药或心境稳定剂）治疗的精神病或重度情感障碍患者比未接受适当药物治疗的患者更常使用苯二氮䓬类药物。
入住精神科急症科室时使用苯二氮䓬类药物的患者可分为非法使用者和合法使用者。非法使用者较年轻，使用非法物质，入院时更常被认为受物质临床影响。合法使用者年龄较大，不使用其他物质，入院时不被认为受物质临床影响。苯二氮䓬类药物被用作主要精神障碍特定药物治疗（抗抑郁药、抗精神病药或心境稳定剂）的辅助治疗。
NCT 00184119/NCT 00184132。
