Lin Shih-Chi, Chen Cheng-Chung, Chen Yeng-Hung, Chung Kung-Shang, Lin Ching-Hua
Kai‐Suan Psychiatric Hospital, Kaohsiung, Taiwan.
Hum Psychopharmacol. 2011 Apr;26(3):201-7. doi: 10.1002/hup.1193.
Because benzodiazepines (BZDs) may be abused, prescribing them is debatable. The purpose of this study was to investigate the prescription of BZDs to explore the current status of BZD use at discharge and at 4 months after discharge.
From 1 January 2006 to 31 December 2006, prescribed doses for BZDs at discharge and at 4 months after discharge were recorded for all discharged inpatients with schizophrenia, bipolar I disorder, and major depressive disorder. Two‐way analysis of variance was used to analyze the effects of severe mental illness and co‐occurring alcohol abuse/dependence on BZD doses at discharge and at 4 months after discharge.
Patients with severe mental illness prescribed with significantly higher rates and higher doses of BZDs at discharge and at 4 months after discharge are more likely to have major depressive disorder and to have co‐occurring alcohol abuse/dependence problems. No significant interactions were found between severe mental illness and co‐occurring alcohol abuse/dependence.
These findings suggest that caution should be applied in prescribing BZDs to patients with severe mental illness, particularly those with major depressive disorder and co‐occurring alcohol abuse/dependence. Future studies require being conducted in many different mental health‐care systems in Taiwan to generalize the findings.
由于苯二氮䓬类药物（BZDs）可能被滥用，其处方开具存在争议。本研究的目的是调查BZDs的处方情况，以探究出院时及出院后4个月BZDs的使用现状。
2006年1月1日至2006年12月31日，记录所有出院的精神分裂症、双相I型障碍和重度抑郁症住院患者出院时及出院后4个月的BZDs处方剂量。采用双向方差分析来分析严重精神疾病和并发酒精滥用/依赖对出院时及出院后4个月BZDs剂量的影响。
出院时及出院后4个月，被开具BZDs比例和剂量显著更高的严重精神疾病患者更有可能患有重度抑郁症且存在并发酒精滥用/依赖问题。严重精神疾病和并发酒精滥用/依赖之间未发现显著交互作用。
这些发现表明，为严重精神疾病患者开具BZDs时应谨慎，尤其是那些患有重度抑郁症且并发酒精滥用/依赖的患者。未来需要在台湾许多不同的精神卫生保健系统中开展研究，以推广这些研究结果。
