Correlates of benzodiazepine dependence in the Netherlands Study of Depression and Anxiety.
OBJECTIVE
Benzodiazepines (BZDs) are effective in the short term against anxiety and insomnia. However, some BZD users develop BZD dependence after a relatively short period of time. Therefore, we aimed to identify the risk factors of BZD dependence.


METHODS
An observational cohort study.


METHODS
The Netherlands.


METHODS
Four hundred and one BZD users of the 2981 participants of the Netherlands Study of Depression and Anxiety (NESDA) were included.


METHODS
Socio-demographic, physical, psychological, addiction-related and BZD use-related characteristics were investigated as possible correlates of BZD dependence severity. Dependence severity was measured by the three subscales of the Benzodiazepine Self-Report Questionnaire, comprising problematic use, preoccupation and lack of compliance.


RESULTS
In multivariate analyses, problematic use was associated with more GP contacts in the past 6 months (β = 0.170, P = 0.001) and severity of insomnia (β = 0.145, P = 0.004). Preoccupation was related to anxiety severity (β = 0.194, P = 0.001), antidepressant use (β = 0.197, P < 0.001), alcohol dependence (β = 0.185, P < 0.001) and a higher daily dosage of BZD (β = 0.160, P = 0.001). Lack of compliance was associated with higher age (β = 0.122, P = 0.03), unemployment (β = 0.105, P = 0.04), insomnia (β = 0.129, P = 0.01), antidepressant use (β = 0.148, P = 0.002) and alcohol dependence (β = 0.108, P = 0.02).


CONCLUSIONS
Insomnia, antidepressant use and alcohol dependence may increase the risk of benzodiazepine dependence among individuals who use benzodiazepines.
Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands. l.manthey@lumc.nl
Leonie
L
Manthey
Marijke
M
Lohbeck
Erik J
EJ
Giltay
Tineke
T
van Veena
Frans G
FG
Zitman
Brenda W J H
BW
Penninx
D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications; D000928:Antidepressive Agents / Q000009:adverse effects; D001008:Anxiety Disorders / Q000188:drug therapy*; D001569:Benzodiazepines / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications; D019966:Substance-Related Disorders / Q000209:etiology*; D055815:Young Adult; D016903:Drug Monitoring
D000928:Antidepressive Agents; D001569:Benzodiazepines