title: Adjunctive benzodiazepine treatment of hospitalized schizophrenia patients in Asia from 2001 to 2008.
abstract: Benzodiazepines are commonly prescribed to patients with schizophrenia in many countries, but as little is known about such treatment in Asia, we evaluated their adjunctive use for 6761 in-patients diagnosed with schizophrenia in nine Asian countries using a cross-sectional study design in 2001, 2004 and 2008. Multivariate logistic regression and multivariate linear regression analyses were performed to assess predictors of benzodiazepine use and dose, respectively. Overall, 54% of the patients received adjunctive benzodiazepines at an average daily dose equivalent to 30.3 mg diazepam, with minor changes over the years sampled. Benzodiazepine use was highest in Taiwan and Japan, lowest in Thailand and China, and was associated with fewer years ill, presence of delusions (OR 1.24), hallucinations (OR 1.22), disorganized speech (OR 1.17), social or occupational dysfunction (OR 1.16), and use of mood stabilizers (OR 3.15), antiparkinsonian (OR 1.79) or antidepressant drugs (OR 1.33), and lower doses of antipsychotics (all p=0.016 to <0.001). Benzodiazepine doses were highest in Taiwan and China, lowest in Korea and Singapore; higher doses were associated with being young, male, physically aggressive, receiving mood stabilizers, and having electroconvulsive treatment (all p=0.019 to <0.001). Benzodiazepine use was associated with neurological and systemic adverse effects. In conclusion, benzodiazepine use was common in Asian patients with schizophrenia. Predictors of benzodiazepine use and dose differed in this population. Critical clinical guidelines should be developed specifically for Asian countries to address sound practices in regard to use of benzodiazepines for psychotic disorders.
authors.affiliation: National University Hospital, Singapore. torphernchern@gmail.com
authors.forename: Phern-Chern
authors.initials: PC
authors.lastname: Tor
authors.forename: Tze Pin
authors.initials: TP
authors.lastname: Ng
authors.forename: Kian-Hui
authors.initials: KH
authors.lastname: Yong
authors.forename: Kang
authors.initials: K
authors.lastname: Sim
authors.forename: Yu-Tao
authors.initials: YT
authors.lastname: Xiang
authors.forename: Chuan-Yue
authors.initials: CY
authors.lastname: Wang
authors.forename: Edwin Ho Ming
authors.initials: EH
authors.lastname: Lee
authors.forename: Senta
authors.initials: S
authors.lastname: Fujii
authors.forename: Shu-Yu
authors.initials: SY
authors.lastname: Yang
authors.forename: Mian-Yoon
authors.initials: MY
authors.lastname: Chong
authors.forename: Gabor S
authors.initials: GS
authors.lastname: Ungvari
authors.forename: Tianmei
authors.initials: T
authors.lastname: Si
authors.forename: Yan Ling
authors.initials: YL
authors.lastname: He
authors.forename: Eun Kee
authors.initials: EK
authors.lastname: Chung
authors.forename: Kok-Yoon
authors.initials: KY
authors.lastname: Chee
authors.forename: Jintendra
authors.initials: J
authors.lastname: Trivedi
authors.forename: Pichet
authors.initials: P
authors.lastname: Udomratn
authors.forename: Naotaka
authors.initials: N
authors.lastname: Shinfuku
authors.forename: Ee Heok
authors.initials: EH
authors.lastname: Kua
authors.forename: Chay Hoon
authors.initials: CH
authors.lastname: Tan
authors.forename: Norman
authors.initials: N
authors.lastname: Sartorius
authors.forename: Ross J
authors.initials: RJ
authors.lastname: Baldessarini
mesh_terms: D000328:Adult; D000368:Aged; D001208:Asia; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004359:Drug Therapy, Combination / Q000009:adverse effects; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011619:Psychotropic Drugs / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012559:Schizophrenia / Q000188:drug therapy* / Q000503:physiopathology; D013223:Statistics as Topic; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs; D001569:Benzodiazepines