title: Correlates of dependence and beliefs about the use of hypnotics among zolpidem and zopiclone users.
abstract: BACKGROUND
  Zolpidem and zopiclone are the two most commonly prescribed Z-drugs approved to treat insomnia.
  
  
  OBJECTIVE
  To examine the demographic and clinical correlates of dependence and beliefs about hypnotic use among long-term zolpidem and zopiclone users in psychiatric treatment for insomnia.
  
  
  METHODS
  A total of 392 psychiatric outpatients who received zolpidem or zopiclone treatment for at least 3 months for insomnia were studied. Participants' severity of hypnotic dependence and beliefs about the use of hypnotics to treat sleep problems were assessed. The correlation of dependence and beliefs about zolpidem and zopiclone treatment with demographic characteristics, hypnotic-using behaviors, co-use of addictive substances, and depressive symptoms were analyzed using multiple regression analysis models.
  
  
  RESULTS
  Zolpidem users reported more severe dependence and a lower level of necessity regarding the use of hypnotics than zopiclone users did. High equivalent doses of hypnotics and long duration of use were significantly associated with severe dependence and a low level of necessity. Severe depressive symptoms were signiciantly associated with severe dependence, a low level of necessity, and a low level of concern. Educational level was also associated with the levels of concern and necessity. Conclusions/Importance: There were differences in the level of dependence and belief about hypnotic use between zolpidem and zopiclone users. The correlates of dependence and belief identified in this study can serve as the basis for prevention and intervention programs.
authors.affiliation: 1Department of Psychiatry, Kaohsiung Medical University Hospital, and School 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.forename: Chia-Nan
authors.initials: CN
authors.lastname: Yen
authors.forename: Chih-Hung
authors.initials: CH
authors.lastname: Ko
authors.forename: Tzung-Jeng
authors.initials: TJ
authors.lastname: Hwang
authors.forename: Cheng-Sheng
authors.initials: CS
authors.lastname: Chen
authors.forename: Tzu-Ting
authors.initials: TT
authors.lastname: Chen
authors.forename: Po-Wen
authors.initials: PW
authors.lastname: Su
authors.forename: Shao-Tsu
authors.initials: ST
authors.lastname: Chen
authors.forename: Jin-Jia
authors.initials: JJ
authors.lastname: Lin
mesh_terms: D000328:Adult; D053961:Azabicyclo Compounds / Q000009:adverse effects* / Q000627:therapeutic use; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006761:Hospitals; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010879:Piperazines / Q000009:adverse effects* / Q000627:therapeutic use; D063487:Prescription Drug Misuse / Q000523:psychology; D055553:Prescription Drugs; D011569:Psychiatric Status Rating Scales; D011725:Pyridines / Q000009:adverse effects* / Q000627:therapeutic use; D012044:Regression Analysis; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology*; D013624:Taiwan / Q000453:epidemiology; D000077334:Zolpidem
chemical_list: D053961:Azabicyclo Compounds; D006993:Hypnotics and Sedatives; D010879:Piperazines; D055553:Prescription Drugs; D011725:Pyridines; C515050:zopiclone; D000077334:Zolpidem
keywords: Belief; Z-drugs; dependence; zolpidem; zopiclone