title: Dependence, misuse, and beliefs regarding use of hypnotics by elderly psychiatric patients taking zolpidem, estazolam, or flunitrazepam.
abstract: BACKGROUND
  To examine the prevalence rates and correlates of dependence on, misuse of, and beliefs regarding use of hypnotics in elderly psychiatric patients with long-term use of zolpidem, estazolam, or flunitrazepam.
  
  
  METHODS
  A total of 139 psychiatric outpatients 65 or more years of age who used zolpidem, estazolam, or flunitrazepam for at least 3 months were studied. The levels of hypnotic dependence and beliefs regarding hypnotic use (necessity and concern) were assessed. Three patterns of hypnotic misuse in the past 1 month were also explored. The correlates of high dependence, misuse, and unfavorable attitude and high concern toward hypnotic use were examined using logistic regression analyses.
  
  
  RESULTS
  A total of 28.8%, 7.9%, 12.2%, and 22.3% of participants reported high dependence on, misuse of, unfavorable attitude toward, and high concern toward hypnotic use, respectively. Males were more likely to report unfavorable attitude toward hypnotic use than females. Elders with significant depression were more likely to report high concern toward hypnotic use than those without significant depression. Elders with high concern toward hypnotic use were more likely to report high dependence on hypnotics than those with low concern. Elders with significant depression and taking zolpidem were more likely to misuse hypnotics than those without significant depression and taking estazolam or flunitrazepam, respectively.
  
  
  CONCLUSIONS
  Clinicians should monitor the possibility of dependence on and misuse of hypnotics among elderly psychiatric patients who had the correlates identified in this study.
authors.affiliation: Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.|Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Cheng-Fang
authors.initials: CF
authors.lastname: Yen
authors.affiliation: Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.|Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Psychiatry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan.
authors.forename: Chih-Hung
authors.initials: CH
authors.lastname: Ko
authors.affiliation: School of Nursing, The State University of New York, Buffalo, NY, USA.
authors.forename: Yu-Ping
authors.initials: YP
authors.lastname: Chang
authors.affiliation: Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Cheng-Ying
authors.initials: CY
authors.lastname: Yu
authors.affiliation: Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.|Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Mei-Feng
authors.initials: MF
authors.lastname: Huang
authors.affiliation: Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.|Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Yeh
authors.affiliation: Department of Psychiatry, Chi-Mei Medical Center, Tainan, Taiwan.|Department of Psychiatry, Chi-Mei Hospital, Liuying Campus, Tainan, Taiwan.|Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Jin-Jia
authors.initials: JJ
authors.lastname: Lin
authors.affiliation: Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.|Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Cheng-Sheng
authors.initials: CS
authors.lastname: Chen
mesh_terms: D000368:Aged; D001294:Attitude to Health; D004949:Estazolam / Q000627:therapeutic use; D005260:Female; D005445:Flunitrazepam / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D011569:Psychiatric Status Rating Scales; D011725:Pyridines / Q000627:therapeutic use; D012737:Sex Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy* / Q000523:psychology; D019966:Substance-Related Disorders / Q000523:psychology*; D000077334:Zolpidem
chemical_list: D006993:Hypnotics and Sedatives; D011725:Pyridines; D004949:Estazolam; D005445:Flunitrazepam; D000077334:Zolpidem
keywords: benzodiazepine; dependence; elderly; misuse behavior; zolpidem