title: Benzodiazepine use associated with co-morbid post-traumatic stress syndrome and depression in older adults seeking services in general medical settings.
abstract: Benzodiazepines (BZD) should be limited in older adults. This study aimed to determine the association between BZD use and the presence of a probable post-traumatic stress syndrome (PTSS) and whether this association is dependent on gender and co-morbid physical and mental conditions.
  
  
  
  Data were retained from the Étude sur la Santé des Aînés (ESA) - Services study (2011-2013) and included 1,453 older adults (≥65 years) who completed a face to face at-home interview, who were covered under Quebec's public drug insurance plan, and had given permission to access their Régie de l'Assurance Maladie du Québec (RAMQ) medical and pharmaceutical services data. The presence of a PTSS was measured using the Impact of Event Scale-Revised (IES-R). The use of BZD and antidepressants in the year prior to interview was ascertained from data reported in the RAMQ drug registry. The presence of depression and an anxiety disorder was assessed with the ESA-Questionnaire which was based on DSM-5 criteria. The interaction between PTSS and gender, depression, anxiety, and multi-morbidity was also assessed.
  
  
  
  The prevalence of PTSS and BZD use reached 4.5% and 31.2%. Participants with PTSS were 1.9 (95% CI = 1.1-3.2) times more likely to use BZD. The presence of depression had a negative impact on the association between BZD use and PTSS (p = 0.04).
  
  
  
  The use of BZD in older adults with PTSS is still prevalent today. Differences in benzodiazepine prescribing practices for more complex co-morbid psychiatric cases needs to be further studied.
authors.affiliation: Department of Community Health Sciences,University of Sherbrooke;Longueuil,QC,Canada.
authors.forename: Helen-Maria
authors.initials: HM
authors.lastname: Vasiliadis
authors.affiliation: Université de Sherbrooke,Longueuil,QC,Canada.
authors.forename: Catherine
authors.initials: C
authors.lastname: Lamoureux-Lamarche
authors.affiliation: Department of Community Health Sciences,University of Sherbrooke;Longueuil,QC,Canada.
authors.forename: Michel
authors.initials: M
authors.lastname: Préville
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D001569:Benzodiazepines / Q000009:adverse effects* / Q000627:therapeutic use; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D011792:Quebec / Q000453:epidemiology; D012307:Risk Factors; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000139:chemically induced* / Q000453:epidemiology / Q000523:psychology
chemical_list: D000928:Antidepressive Agents; D001569:Benzodiazepines
keywords: benzodiazepine use; co-morbid depression; older adults; post-traumatic stress disorder