The relevance of psychiatric and somatic comorbidity in depressed chronic benzodiazepine users.
BACKGROUND
Comorbid conditions may add to the burden of depressed patients and hamper their treatment. We therefore investigated the impact of anxiety disorders and somatic comorbidity in a group of depressed chronic benzodiazepine users on disease status, treatment, benzodiazepine history and discontinuation outcome.


METHODS
At screening for a discontinuation programme, full psychiatric status was determined using the MINI-interview and psychopathology was assessed using several rating scales. Relevant medical history, including surgeries, was recorded as well.


RESULTS
Patients with comorbid anxiety disorders were 8 years younger (p < 0.001), more anxious (p = 0.004) and reported more benzodiazepine withdrawal symptoms (p = 0.011) than depressed patients without comorbid anxiety disorders. They also had been using more long-acting benzodiazepines (p = 0.003), in higher dosages (p = 0.019). However, this did not result in more difficulty in tapering off benzodiazepines, either at post-test, or at follow-up 2.3 years later. Somatic comorbidity was not associated with the level of psychopathology and not related to the outcome of the discontinuation programme.


CONCLUSIONS
Comorbid anxiety disorders are associated with a more severe disease status in depressed chronic benzodiazepine users, but have no influence on the benzodiazepine discontinuation. Somatic comorbidity has no impact on the severity of the psychopathology, or on benzodiazepine discontinuation.
Medical Department, GlaxoSmithKline, Zeist, The Netherlands. jaap.e.couvee@gsk.com
Jaap E
JE
Couvée
Abraham
A
Bakker
Frans G
FG
Zitman
D000328:Adult; D000368:Aged; D014151:Anti-Anxiety Agents; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000534:rehabilitation; D002908:Chronic Disease; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000534:rehabilitation; D003975:Diazepam / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017374:Paroxetine / Q000008:administration & dosage; D011569:Psychiatric Status Rating Scales; D013001:Somatoform Disorders / Q000453:epidemiology* / Q000534:rehabilitation; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000534:rehabilitation; D016896:Treatment Outcome
D014151:Anti-Anxiety Agents; D017374:Paroxetine; D003975:Diazepam