Department of Psychiatry, Yale University School of Medicine, 300 George St. Suite 901, New Haven, CT 06511, USA,
Psychiatr Q. 2012 Dec;83(4):521-9. doi: 10.1007/s11126-012-9220-8.
Psychiatrists' decision making about prescribing benzodiazepines (BZD) was evaluated in a community mental health center. An anonymous survey of outpatient psychiatrists in an academic-affiliated public mental health center was conducted using a 45-item questionnaire developed based on the results of a previous study. Sixty-six percent of responses indicate that, at times, psychiatrists experienced requests for behaviors suspicious for abuse, including 'lost/missing prescriptions' and 'use of BZD by others'. Patient characteristics such as 'history of abuse', 'unknown patient', and 'patient use of illicit substances' were occasional or common reasons for NOT prescribing BZDs (75%). The most common contexts in which the majority of our sample was uncomfortable prescribing BZDs involved a patient history of substance abuse, fear of initiation of dependence, diversion, and feeling manipulated by the patient. Time limitations were a dilemma for 20%. Psychiatrist self-reported dilemma and behavior in prescribing BZDs largely reflected concerns with substance abuse and less frequently workload or time issues.
在社区心理健康中心评估了精神科医生开苯二氮䓬类药物 (BZD) 的决策。对一家学术附属公立心理健康中心的门诊精神科医生进行了一项匿名调查，使用了根据先前研究结果制定的 45 项问卷。66%的回复表明，有时精神科医生会遇到疑似滥用行为的请求，包括“丢失/失踪的处方”和“他人使用 BZD”。患者特征，如“滥用史”、“未知患者”和“患者使用非法物质”，偶尔或经常成为不开具 BZD 的原因 (75%)。我们的样本中大多数人在开 BZD 时感到不舒服的常见情况涉及患者的药物滥用史、对依赖、转移的恐惧以及感到被患者操纵。20%的人因时间限制而陷入困境。精神科医生自我报告的开 BZD 的困境和行为主要反映了对药物滥用的担忧，而较少反映工作量或时间问题。
