Yen Cheng-Fang, Ko Chih-Hung, Chang Yu-Ping, Yu Cheng-Ying, Huang Mei-Feng, Yeh Yi-Chun, Lin Jin-Jia, Chen Cheng-Sheng
Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Asia Pac Psychiatry. 2015 Sep;7(3):298-305. doi: 10.1111/appy.12147. Epub 2014 Oct 8.
To examine the prevalence rates and correlates of dependence on, misuse of, and beliefs regarding use of hypnotics in elderly psychiatric patients with long-term use of zolpidem, estazolam, or flunitrazepam.
A total of 139 psychiatric outpatients 65 or more years of age who used zolpidem, estazolam, or flunitrazepam for at least 3 months were studied. The levels of hypnotic dependence and beliefs regarding hypnotic use (necessity and concern) were assessed. Three patterns of hypnotic misuse in the past 1 month were also explored. The correlates of high dependence, misuse, and unfavorable attitude and high concern toward hypnotic use were examined using logistic regression analyses.
A total of 28.8%, 7.9%, 12.2%, and 22.3% of participants reported high dependence on, misuse of, unfavorable attitude toward, and high concern toward hypnotic use, respectively. Males were more likely to report unfavorable attitude toward hypnotic use than females. Elders with significant depression were more likely to report high concern toward hypnotic use than those without significant depression. Elders with high concern toward hypnotic use were more likely to report high dependence on hypnotics than those with low concern. Elders with significant depression and taking zolpidem were more likely to misuse hypnotics than those without significant depression and taking estazolam or flunitrazepam, respectively.
Clinicians should monitor the possibility of dependence on and misuse of hypnotics among elderly psychiatric patients who had the correlates identified in this study.
研究长期使用唑吡坦、艾司唑仑或氟硝西泮的老年精神病患者对催眠药的依赖率、误用情况及相关信念。
对139名65岁及以上使用唑吡坦、艾司唑仑或氟硝西泮至少3个月的精神科门诊患者进行研究。评估催眠药依赖水平及对催眠药使用的信念（必要性和担忧）。还探讨了过去1个月内三种催眠药误用模式。使用逻辑回归分析检查高度依赖、误用、对催眠药使用的不利态度和高度担忧的相关因素。
分别有28.8%、7.9%、12.2%和22.3%的参与者报告对催眠药高度依赖、误用、持不利态度和高度担忧。男性比女性更有可能报告对催眠药使用持不利态度。有明显抑郁症状的老年人比没有明显抑郁症状的老年人更有可能报告对催眠药使用高度担忧。对催眠药使用高度担忧的老年人比担忧程度低的老年人更有可能报告对催眠药高度依赖。有明显抑郁症状且服用唑吡坦的老年人比没有明显抑郁症状且分别服用艾司唑仑或氟硝西泮的老年人更有可能误用催眠药。
临床医生应监测本研究中确定了相关因素的老年精神病患者对催眠药的依赖和误用可能性。
