Psychiatric and Mental Health Nursing, St. Luke's International University, Tokyo 104-0044, Japan.
Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo 181-8611, Japan.
Int J Environ Res Public Health. 2023 Apr 3;20(7):5373. doi: 10.3390/ijerph20075373.
Although long-term use of benzodiazepines and z-drugs (BZDs) is not recommended, little is known about the stakeholders' perceptions. This study aimed to assess and compare the perceptions of BZD use and decision making regarding its discontinuation between psychiatric outpatients and psychiatrists.
A cross-sectional survey was conducted.
Of 104 outpatients, 92% were taking hypnotics and 96% were taking anxiolytics for ≥a year, while 49% were willing to taper hypnotic/anxiolytics within a year of starting. Most psychiatrists felt that "patient and psychiatrist make the decision together on an equal basis" compared to patients ( < 0.001), while more patients felt that "the decision is (was) made considering the psychiatrists' opinion" compared to psychiatrists ( < 0.001). Of 543 psychiatrists, 79% reported "patients were not willing to discontinue hypnotic/anxiolytic" whereas a certain number of patients conveyed "psychiatrists did not explain in enough detail about hypnotic/anxiolytic discontinuation such as procedure (18.3%), timing (19.2%), and appropriate condition (14.4%)".
The results suggest that the majority of psychiatric outpatients were taking hypnotic/anxiolytics for a long time against their will. There might be a difference in perceptions toward hypnotic/anxiolytic use and decision making for its discontinuation between psychiatric outpatients and psychiatrists. Further research is necessary to fill this gap.
尽管不建议长期使用苯二氮䓬类药物和 Z 类药物（BZDs），但对于利益相关者的看法却知之甚少。本研究旨在评估和比较精神科门诊患者和精神科医生对 BZD 使用的看法以及关于其停药的决策。
采用横断面调查。
在 104 名门诊患者中，92%的患者服用催眠药，96%的患者服用抗焦虑药≥1 年，而 49%的患者愿意在开始服用催眠药/抗焦虑药的 1 年内逐渐减少剂量。与患者相比，大多数精神科医生认为“患者和精神科医生在平等的基础上共同做出决定”（<0.001），而与精神科医生相比，更多的患者认为“考虑到精神科医生的意见做出决定”（<0.001）。在 543 名精神科医生中，79%的医生报告称“患者不愿意停止使用催眠药/抗焦虑药”，而一些患者表示“精神科医生没有详细说明催眠药/抗焦虑药停药的程序（18.3%）、时间（19.2%）和适当的情况（14.4%）”。
结果表明，大多数精神科门诊患者长期服用催眠药/抗焦虑药并非出于自愿。精神科门诊患者和精神科医生对催眠药/抗焦虑药的使用和停药决策可能存在看法上的差异。需要进一步的研究来填补这一空白。
