Hellerstein D J, Flansaas D M, Zweben-Howland L D, Samstag L W
Mount Sinai School of Medicine, New York, NY.
Hosp Community Psychiatry. 1994 Apr;45(4):362-5. doi: 10.1176/ps.45.4.362.
In 1989 New York State extended regulation of controlled substances to benzodiazepines. To study the effects on patients, the authors examined characteristics of patients who came to a psychiatric outpatient clinic seeking benzodiazepines during the year after the regulation took effect.
Demographic and clinical characteristics of 44 patients who sought benzodiazepines were compared with those of 297 other patients evaluated at the clinic during the same period. Compliance with clinic treatment recommendations by patients who sought benzodiazepines was assessed at six-month follow-up.
Patients seeking benzodiazepines were predominantly impoverished minority women with a diagnosis of a mood disorder or anxiety disorder. Most were not drug or alcohol abusers. After evaluation at the clinic, nearly half received prescriptions for antidepressant medications instead of benzodiazepines. Although the patients seeking benzodiazepines had many psychosocial problems, they had poor compliance with clinic psychotherapy interventions.
Regulation of benzodiazepine prescriptions appeared to significantly disrupt the treatment of some patients and to encourage them to seek treatment in a psychiatric setting. The high frequency of mood disorders among these patients suggests that some patients may have been misdiagnosed earlier as having anxiety disorder and raises questions about the appropriateness of their previous use of benzodiazepines.
1989年,纽约州将管制物质的管理范围扩大至苯二氮䓬类药物。为研究其对患者的影响,作者调查了该管理规定生效后一年内到一家精神科门诊寻求开具苯二氮䓬类药物的患者的特征。
将44名寻求开具苯二氮䓬类药物的患者的人口统计学和临床特征与同期在该门诊接受评估的297名其他患者的特征进行比较。在六个月的随访中评估寻求开具苯二氮䓬类药物的患者对门诊治疗建议的依从性。
寻求开具苯二氮䓬类药物的患者主要是贫困的少数族裔女性,诊断为情绪障碍或焦虑障碍。大多数人并非药物或酒精滥用者。在门诊评估后,近一半患者收到的是抗抑郁药物处方而非苯二氮䓬类药物处方。尽管寻求开具苯二氮䓬类药物的患者存在许多心理社会问题,但他们对门诊心理治疗干预的依从性较差。
苯二氮䓬类药物处方管理规定似乎严重扰乱了部分患者的治疗,并促使他们到精神科就诊。这些患者中情绪障碍的高发生率表明,一些患者此前可能被误诊为焦虑障碍,这也引发了对他们此前使用苯二氮䓬类药物是否恰当的质疑。