精神专科医院门诊患者中苯二氮类药物应用情况调查

A cross sectional study of the utilization of benzodiazepine in a psychiatric outpatient department

目的了解精神专科门诊患者中苯二氮 类(benzodiazepines,简称BZ类)药物的使用情况及药物依赖状况。方法采用自行设计的一般问卷与BZ自评量表,对调查时间内(1个月)在天津市安定医院门诊复诊的使用BZ类药物4周以上的符合研究要求的患者进行调查评估。结果(1)符合入组条件并接受调查者1040例,其中符合药物依赖诊断者654例,药物依赖率为62.9%。(2)BZ类药物依赖者在入组的各种精神疾病患者中所占的比例:精神分裂症55.2%,心境障碍72.8%,神经症74.7%。(3)随着年龄的增大、服药时间的延长、用药剂量越高发生药物依赖的危险性增加(趋势χ2检验,P<0.001),而且常规剂量依赖的较多。(4)患者知道BZ类药物会成瘾,仍然持续服用BZ类药物有72.5%～82.6%。(5)医生告知使用BZ类药物患者BZ类药物成瘾性有39.6%～62.2%。结论BZ类药物依赖问题严重,BZ类药物依赖发生与疾病种类有关,年龄大、服药剂量大、服药时间长是BZ类药物依赖的危险因素。

Objective To investigate the utilization and dependence of benzodiazepine in（BZ} a psychiatric outpatient department. Methods Use self-designed questionnaire and Benzodiazepine Dependence Self-report questionnaire to investigate prevalence of benzodiazepine dependence in Tianjin Anding hospital outpatients, limited to 1-month duration of investigation. The outpatients that fulfilled for the criteria of at least 4-week history of using benzodiazepines were selected for the study. Results （1） There were 1040 outpatients that fulfilled the criteria, 654 （62.9） of them had benzodiazepine dependence. （2） The psychiatric disorder spectrum in each group was about 55.2 % in schizophrenia group, 72.8 % in affective disorder group, and 74.7 % in neu- rosis group. （3）The elder age, the longer duration of medication, the large dosage,the more benzodiazepine dependence（the trend Х^2 test：P〈0. 001） ,there had more patients dependence in normal dosage. （4） Although knowing BZ have the dependence, the proportion of continuing use of BZ was about 72.5%-82.6%. （5）The proportion of patients that the doctor told about the dependence of benzodiazepines was about 39.6 %-62.2%. Conclusion The dependence of benzodiazepine was serious in outpatient department. The risk factors were the kind of primary psychiatric disorder, the elder age , the larger dosage, and the longer duration of medication.