Maravillas-Estrada Angélica, Roy-García Ivonne Analí, Rivas-Ruiz Rodolfo, Vilchis-Chaparro Eduardo
Instituto Mexicano del Seguro Social, Hospital General de Zona con Medicina Familiar No. 8 "Dr Gilberto Flores Izquierdo", Departamento de Enseñanza. Ciudad de México, México.
Instituto Politécnico Nacional, Escuela Superior de Medicina. Ciudad de México, México.
Rev Med Inst Mex Seguro Soc. 2023 Oct 2;61(Suppl 3):S387-S394. doi: 10.5281/zenodo.8319759.
The use of benzodiazepines as a treatment for insomnia can have side effects such as impaired coordination causing falls in adults and even dependence.
To assess the factors associated with dependence on benzodiazepines in patients with insomnia.
Observational, cross-sectional, prospective, and analytical study, at the first level of care. Patients older than 18 years with a diagnosis of insomnia and a benzodiazepine prescription were selected. The dependency was measured with the International Neuropsychiatric Interview.
107 patients were included. Median age 67 years, predominantly female (72%), 74% attended secondary school or more, 71% had more than 3 years of diagnosis, 84% used clonazepam. The 54% presented dependency. In the bivariate analysis, schooling RM 0.392 (95%CI: 0.15-0.96) p = 0.038, moderate and severe clinical insomnia RM 3.618 (95%CI: 1.44-9.08) p = 0.005 and more than 3 years of diagnosis RM 2.428 (95%CI: 1.03-5.71) p = 0.040. In the multivariate model, schooling (p = 0.084), years of diagnosis (p = 0.062) and frequency of consumption (p = 0.065) obtained an R2 of 0.13.
Primary schooling showed a lower risk of presenting dependence on benzodiazepines. The risk was increased in those with more than 3 years of diagnosis, and in those with moderate and severe insomnia.
使用苯二氮䓬类药物治疗失眠可能会产生副作用，如协调性受损导致成年人跌倒，甚至产生依赖性。
评估失眠患者对苯二氮䓬类药物产生依赖性的相关因素。
在一级护理机构进行观察性、横断面、前瞻性分析研究。选取年龄大于18岁、诊断为失眠且有苯二氮䓬类药物处方的患者。使用国际神经精神访谈量表测量依赖性。
纳入107例患者。中位年龄67岁，以女性为主（72%），74%接受过中学及以上教育，71%诊断时间超过3年，84%使用氯硝西泮。54%存在依赖性。在双变量分析中，受教育程度比值比为0.392（95%置信区间：0.15 - 0.96），p = 0.038；中度和重度临床失眠比值比为3.618（95%置信区间：1.44 - 9.08），p = 0.005；诊断时间超过3年比值比为2.428（95%置信区间：1.03 - 5.71），p = 0.040。在多变量模型中，受教育程度（p = 0.084）、诊断年限（p = 0.062）和用药频率（p = 0.065）的R2为0.13。
小学教育程度者对苯二氮䓬类药物产生依赖性的风险较低。诊断时间超过3年者以及中度和重度失眠患者的风险增加。
