Albrecht Bonnie, Staiger Petra K, Hall Kate, Miller Peter, Best David, Lubman Dan I
School of Psychology, Deakin University, Melbourne, Australia.
School of Psychology, Deakin University, Melbourne, Australia
Aust N Z J Psychiatry. 2014 Dec;48(12):1096-114. doi: 10.1177/0004867414548902. Epub 2014 Sep 2.
The relationship between benzodiazepine consumption and subsequent increases in aggressive behaviour in humans is not well understood.
The current study aimed to identify, via a systematic review, whether there is an association between benzodiazepine consumption and aggressive responding in adults.
A systematic review was conducted and reported in line with the PRISMA statement. English articles within MEDLINE, PsycARTICLES, PsycINFO, Academic Search Complete, and Psychology and Behavioural Sciences Collection databases were searched. Additional studies were identified by searching reference lists of reviewed articles. Only articles that explicitly investigated the relationship between benzodiazepine consumption and subsequent aggressive behaviour, or a lack thereof, in human adults were included.
Forty-six studies met the inclusion criteria. It was not possible to conduct a meta-analysis due to the heterogeneity of study design and benzodiazepine type and dose. An association between benzodiazepine use and subsequent aggressive behaviour was found in the majority of the more rigorous studies, although there is a paucity of high-quality research with clinical or forensic populations. Diazepam and alprazolam have received the most attention. Dose-related findings are inconsistent: therapeutic doses may be more likely to be associated with aggressive responding when administered as a once-off, whereas higher doses may be more risky following repeated administration. Trait levels of anxiety and hostility may indicate a vulnerability to the experience of benzodiazepine-related aggression.
There appears to be a moderate association between some benzodiazepines and subsequent aggressive behaviour in humans. The circumstances under which aggressive responding may be more likely to follow benzodiazepine use remain unclear, although some evidence suggests dose and/or personality factors may influence this effect.
苯二氮䓬类药物的使用与人类随后攻击性行为增加之间的关系尚未得到充分理解。
本研究旨在通过系统评价确定成人苯二氮䓬类药物的使用与攻击反应之间是否存在关联。
按照PRISMA声明进行并报告了一项系统评价。检索了MEDLINE、PsycARTICLES、PsycINFO、Academic Search Complete以及Psychology and Behavioural Sciences Collection数据库中的英文文章。通过检索已审阅文章的参考文献列表确定了其他研究。仅纳入明确调查成人苯二氮䓬类药物使用与随后攻击性行为之间关系或不存在这种关系的文章。
46项研究符合纳入标准。由于研究设计、苯二氮䓬类药物类型和剂量的异质性，无法进行荟萃分析。在大多数更严格的研究中发现了苯二氮䓬类药物使用与随后攻击性行为之间的关联，尽管针对临床或法医人群的高质量研究较少。地西泮和阿普唑仑受到的关注最多。剂量相关的研究结果不一致：一次性给药时治疗剂量可能更有可能与攻击反应相关，而重复给药后高剂量可能风险更大。焦虑和敌意的特质水平可能表明易发生苯二氮䓬类药物相关攻击行为。
某些苯二氮䓬类药物与人类随后的攻击性行为之间似乎存在中度关联。尽管一些证据表明剂量和/或人格因素可能影响这种效应，但苯二氮䓬类药物使用后更有可能出现攻击反应的情况仍不清楚。
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