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1.
Aging Ment Health ; : 1-9, 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38952209

RESUMO

OBJECTIVES: To examine how change in benzodiazepine (BZD) use is linked to changes in depressive symptoms intensity, worry intensity, and sleep quality over 16 months. METHOD: Data come from a larger randomised controlled trial (RCT) named the 'Programme d'Aide du Succès au SEvrage (PASSE-60+)' study (NCT02281175). Seventy-three participants age 60 years and older took part in a 4-month discontinuation programme and were assessed four times over 16 months. Change in BZD use was defined as the difference in reported mg/day between two assessments. Control variables were RCT discontinuation group; BZD use at T1; and either depressive symptoms, worry intensity, or sleep quality at T1. Hierarchical multiple regressions were used to analyse data. RESULTS: In the short term, right after the discontinuation programme, sleep quality worsened with lower BZD use. This link was no longer significant at the 3- and 12-month follow-up. In the long term, depressive symptoms lowered with lower BZD use. No change was found in worry intensity in relation to BZD use at all measurement times. CONCLUSION: Discontinuation may improve depressive symptoms. Our study also questions the long-term effectiveness of BZD use, since long-term discontinuation was not linked with change in worry intensity and sleep quality.

2.
Aging Ment Health ; 24(9): 1437-1443, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-30977682

RESUMO

Objective: Benzodiazepines (BZD) are often prescribed to address sleep difficulties but many BZD users report a poor quality of sleep. Although social support was found to be associated with quality of sleep in a recent meta-analysis, this relationship was never studied in older BZD users. This study thus aims to examine how social support is associated with quality of sleep in older BZD users.Method: Seventy-two older adults (age 60-85) using BZD were recruited. Data was collected during the pre-test of the ''PASSE-60+; Support program for a successful withdrawal, NCT02281175'' study. Quality of sleep was measured using the Pittsburgh Sleep Quality Index (PSQI), while social support was evaluated with the Social Support Questionnaire (SSQ-6).Results: When examining the various dimensions of self-reported sleep quality as a whole, we found no significant association with social support, while controlling for daily BZD dose, anxiety and depression. However, we found a significant association between self-reported diurnal dysfunctions (e.g., daytime sleepiness) and satisfaction with social support.Conclusion: Although the results of our study should be replicated with larger samples, they might indicate that social support is not a significant factor influencing sleep quality in older chronic BZD users. Our results could differ from those found in other populations because of the changes in sleep quality associated with long term BZD use. Longitudinal studies should analyse the relationship between diurnal dysfunctions and satisfaction with social support, to examine if social support could help older adults alleviate their diurnal dysfunctions and eventually facilitate BZD tapering.


Assuntos
Benzodiazepinas , Distúrbios do Início e da Manutenção do Sono , Idoso , Idoso de 80 Anos ou mais , Transtornos de Ansiedade , Humanos , Sono , Distúrbios do Início e da Manutenção do Sono/induzido quimicamente , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico , Apoio Social
3.
Addict Behav ; 102: 106195, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31838367

RESUMO

BACKGROUND: Long-term benzodiazepine (BZD) use among seniors is mostly inappropriate and associated with adverse health outcomes. To prevent these consequences, withdrawal is crucial, yet knowledge is limited about what predicts BZD discontinuation. Until now, most studies have focused on sociodemographic and BZD intake factors as predictors while neglecting psychological factors. This research addresses this issue by studying how the intensity of depressive symptoms, social support satisfaction, self-perceived competence in the ability to withdraw, and overall quality of sleep predict discontinuation in long-term older consumers. METHOD: Seventy-three participants aged 60 years and older were enrolled in this study. There were four time measures: before discontinuation (T1), after (T2), 3 months after (T3), and 12 months after (T4). Data were collected in the "Programme d'Aide du Succès au SEvrage" (PASSE-60+) study. RESULTS: Social support satisfaction predicted discontinuation at T2 and T4. Self-perceived competence in the ability to withdraw and depressive symptoms predicted discontinuation at T4. This later prediction was counterintuitive; higher depressive symptoms at T1 were linked with higher discontinuation success. BZD intake factors (length of use and dose) were good predictors for short term discontinuation. Psychological factors were moderate predictors for short term and good predictors for long term discontinuation. CONCLUSION: Psychological factors are good predictors of discontinuation and are better predictors than BZD intake factors of long-term discontinuation. Discontinuation programs should focus on social support and self-perceived competence to improve their efficacy. Further studies are needed to acquire a more complete picture of the psychological predictors of discontinuation success. ClinicalTrials.gov Identifier: NCT02281175.


Assuntos
Benzodiazepinas/uso terapêutico , Terapia Cognitivo-Comportamental/métodos , Desprescrições , Depressão , Redução da Medicação/métodos , Autoeficácia , Apoio Social , Idoso , Idoso de 80 Anos ou mais , Ansiedade , Benzodiazepinas/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autogestão , Distúrbios do Início e da Manutenção do Sono , Síndrome de Abstinência a Substâncias/psicologia
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