Consumption and Dependence on Benzodiazepines in Elderly Outpatients in Psychiatry

Results

Seventy-three patients were included (male/female ratio = 1.08). Psychoactive substance use was reported by 81% of patients, and polysubstance use by 41%. BZD consumption was found in 69% of cases (n = 51), with a mean duration of use of 23.3 years (range: 2–40 years). The most frequently used molecule was lorazepam, reported in 61% of cases. During the six months preceding the study, BZD use was daily in 92% of cases. Among the 51 BZD users, 31 patients (61%) had attempted withdrawal; among them, 27 (87%) reported failure. The main reasons for withdrawal failure were withdrawal syndrome (48%) and reappearance of initial symptoms (44%).

Among the 51 patients who used BZD, 41 (80%) met the criteria for dependence. A significant association was observed between BZD dependence and living in urban or semi-urban areas (p = 0.04). Clinically, dependence was significantly linked to the presence of personal somatic history (p = 0.021), depressive and bipolar disorders (p = 0.024), younger age at onset of psychiatric illness (p = 0.05), and longer illness duration (p = 0.035).

Regarding substance use, BZD dependence correlated with caffeine use (p = 0.021), stimulant use (p = 0.024), and polysubstance use (p = 0.038). Strong associations were also found with the duration (p < 0.001) and frequency (p = 0.021) of BZD use, as well as with failed withdrawal attempts (p < 0.001). On psychometric assessment, dependent patients showed significantly higher HADS-D (p = 0.001) and HADS-A (p = 0.005) scores, indicating more severe depressive and anxious symptomatology. Regarding cognitive performance, a negative correlation was observed between age (in years) and MMSE score among dependent patients (p = 0.001), while this association was less pronounced in non-dependent patients (p = 0.016).