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      Current state of hypnotic use disorders: Results of a survey using the Japanese version of Benzodiazepine Dependence Self‐Report Questionnaire

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          Abstract

          Aims

          Benzodiazepine receptor agonists (BZ‐RAs) are frequently prescribed to treat insomnia; however, their long‐term use is not recommended. To introduce an appropriate pharmaco‐therapy, the current state and background factors of BZ‐RAs' dependence must be elucidated. In this study, we developed a Japanese version of the Benzodiazepine Dependence Self‐Report Questionnaire (Bendep‐SRQ‐J) and conducted a study of BZ‐RAs' use disorder.

          Methods

          The Bendep‐SRQ‐J was created with permission from the original developer. Subjects were inpatients and outpatients receiving BZ‐RAs between 2012 and 2013. Clinical data collected were Bendep‐SRQ‐J scores, sleep disorders for which BZ‐RAs were prescribed, physical comorbidities, psychotropic drugs, and lifestyle factors. Logistic analysis was performed to extract factors associated with severe symptoms.

          Results

          Of the 707 patients prescribed BZ‐RAs, 324 had voluntarily tapered or discontinued their drugs. Logistic analysis showed that the total number of drugs administered in the last 6 months correlated with both worsening of symptoms or conditions. This was more notable among younger patients, and the proportion of patients with severe symptoms or conditions increased with the increasing number of drugs.

          Conclusion

          Using the Bendep‐SRQ‐J, we elucidated the current state of BZ‐RA dependence. Nearly half of the patients were non‐compliant. The proportion of patients with severe symptoms or disease conditions increased with the increase in the number of drugs administered. These findings highlight the need for clinicians to be aware of the likelihood of benzodiazepine dependence, especially in young patients and patients prescribed multiple hypnotics.

          Abstract

          Using the Bendep‐SRQ‐J, we elucidated the current state of BZ‐RA dependence. Nearly half of the patients were non‐compliant.

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          Most cited references50

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          SCAN. Schedules for Clinical Assessment in Neuropsychiatry.

          After more than 12 years of development, the ninth edition of the Present State Examination (PSE-9) was published, together with associated instruments and computer algorithm, in 1974. The system has now been expanded, in the framework of the World Health Organization/Alcohol, Drug Abuse, and Mental Health Administration Joint Project on Standardization of Diagnosis and Classification, and is being tested with the aim of developing a comprehensive procedure for clinical examination that is also capable of generating many of the categories of the International Classification of Diseases, 10th edition, and the Diagnostic and Statistical Manual of Mental Disorders, revised third edition. The new system is known as SCAN (Schedules for Clinical Assessment in Neuropsychiatry). It includes the 10th edition of the PSE as one of its core schedules, preliminary tests of which have suggested that reliability is similar to that of PSE-9. SCAN is being field tested in 20 centers in 11 countries. A final version is expected to be available in January 1990.
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            Epidemiology of insomnia: prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors.

            To estimate the prevalence of insomnia symptoms and syndrome in the general population, describe the types of self-help treatments and consultations initiated for insomnia, and examine help-seeking determinants. A randomly selected sample of 2001 French-speaking adults from the province of Quebec (Canada) responded to a telephone survey about sleep, insomnia, and its treatments. Of the total sample, 25.3% were dissatisfied with their sleep, 29.9% reported insomnia symptoms, and 9.5% met criteria for an insomnia syndrome. Thirteen percent of the respondents had consulted a healthcare provider specifically for insomnia in their lifetime, with general practitioners being the most frequently consulted. Daytime fatigue (48%), psychological distress (40%), and physical discomfort (22%) were the main determinants prompting individuals with insomnia to seek treatment. Of the total sample, 15% had used at least once herbal/dietary products to facilitate sleep and 11% had used prescribed sleep medications in the year preceding the survey. Other self-help strategies employed to facilitate sleep included reading, listening to music, and relaxation. These findings confirm the high prevalence of insomnia in the general population. While few insomnia sufferers seek professional consultations, many individuals initiate self-help treatments, particularly when daytime impairments such as fatigue become more noticeable. Improved knowledge of the determinants of help-seeking behaviors could guide the development of effective public health prevention and intervention programs to promote healthy sleep.
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              Meta-analysis of the impact of 9 medication classes on falls in elderly persons.

              There is increasing recognition that the use of certain medications contributes to falls in seniors. Our objective was to update a previously completed meta-analysis looking at the association of medication use and falling to include relevant drug classes and new studies that have been completed since a previous meta-analysis. Studies were identified through a systematic search of English-language articles published from 1996 to 2007. We identified studies that were completed on patients older than 60 years, looking at the association between medication use and falling. Bayesian methods allowed us to combine the results of a previous meta-analysis with new information to estimate updated Bayesian odds ratios (ORs) and 95% credible intervals (95% CrIs) Of 11 118 identified articles, 22 met our inclusion criteria. Meta-analyses were completed on 9 unique drug classes, including 79 081 participants, with the following Bayesian unadjusted OR estimates: antihypertensive agents, OR, 1.24 (95% CrI, 1.01-1.50); diuretics, OR, 1.07 (95% CrI, 1.01-1.14); beta-blockers, OR, 1.01 (95% CrI, 0.86-1.17); sedatives and hypnotics, OR, 1.47 (95% CrI, 1.35-1.62); neuroleptics and antipsychotics, OR, 1.59 (95% CrI, 1.37-1.83); antidepressants, OR, 1.68 (95% CrI, 1.47-1.91); benzodiazepines, OR, 1.57 (95% CrI, 1.43-1.72); narcotics, OR, 0.96 (95% CrI, 0.78-1.18); and nonsteroidal anti-inflammatory drugs, OR, 1.21 (95% CrI, 1.01-1.44). The updated Bayesian adjusted OR estimates for diuretics, neuroleptics and antipsychotics, antidepressants, and benzodiazepines were 0.99 (95% CrI, 0.78-1.25), 1.39 (95% CrI, 0.94-2.00), 1.36 (95% CrI, 1.13-1.76), and 1.41 (95% CrI, 1.20-1.71), respectively. Stratification of studies had little effect on Bayesian OR estimates, with only small differences in the stratified ORs observed across population (for beta-blockers and neuroleptics and antipsychotics) and study type (for sedatives and hypnotics, benzodiazepines, and narcotics). An increased likelihood of falling was estimated for the use of sedatives and hypnotics, neuroleptics and antipsychotics, antidepressants, benzodiazepines, and nonsteroidal anti-inflammatory drugs in studies considered to have "good" medication and falls ascertainment. The use of sedatives and hypnotics, antidepressants, and benzodiazepines demonstrated a significant association with falls in elderly individuals.
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                Author and article information

                Contributors
                mishima@med.akita-u.ac.jp
                Journal
                Neuropsychopharmacol Rep
                Neuropsychopharmacol Rep
                10.1002/(ISSN)2574-173X
                NPR2
                Neuropsychopharmacology Reports
                John Wiley and Sons Inc. (Hoboken )
                2574-173X
                01 December 2020
                March 2021
                : 41
                : 1 ( doiID: 10.1111/npr2.v41.1 )
                : 14-25
                Affiliations
                [ 1 ] Department of Psychiatry Tokyo Women's Medical University School of Medicine Shinjuku‐ku Japan
                [ 2 ] Department of Sleep‐wake disorders NIMH National Center of Neurology and Psychiatry Tokyo Japan
                [ 3 ] Department of Medical Technology School of Health Science Tokyo University of Technology Tokyo Japan
                [ 4 ] Department of Neuropsychiatry School of Medicine Kurume University Kurume Japan
                [ 5 ] Division of Diabetes, Metabolism and Endocrinology Department of Medicine Toho University School of Medicine Tokyo Japan
                [ 6 ] Yoyogi Sleep Disorder Center Tokyo Japan
                [ 7 ] Center for Sleep Disorders National Center of Neurology and Psychiatry Tokyo Japan
                [ 8 ] Department of Psychiatry Fujita Health University School of Medicine Shimotsuga‐gun Japan
                [ 9 ] Department of Neurology Dokkyo Medical University Mibu Japan
                [ 10 ] Department of Neuropsychiatry Faculty of Medicine Kagawa University Kagawa Japan
                [ 11 ] Department of Psychiatry Jikei University Tokyo Japan
                [ 12 ] Department of Neuropsychiatry Akita University Graduate School of Medicine Akita Japan
                [ 13 ] Department of Cardiology Tokyo Women's Medical University School of Medicine Shinjuku‐ku Japan
                [ 14 ] Department of Psychiatry and Neurosciences Hiroshima University Hiroshima Japan
                Author notes
                [*] [* ] Correspondence

                Kazuo Mishima, Department of Neuropsychiatry, Akita University Graduate School of Medicine, 44‐2 Hasunuma, Hiroomote, Akita City, Akita 010‐8543, Japan.

                Email: mishima@ 123456med.akita-u.ac.jp

                Author information
                https://orcid.org/0000-0002-3073-4588
                https://orcid.org/0000-0001-7414-9017
                https://orcid.org/0000-0003-1182-1181
                Article
                NPR212149
                10.1002/npr2.12149
                8182966
                33259705
                5ebde5f4-43ea-4f92-b948-c36110cb4ee0
                © 2020 The Authors. Neuropsychopharmacology Reports published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Society of NeuropsychoPharmacology.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 31 October 2020
                : 24 October 2020
                : 03 November 2020
                Page count
                Figures: 1, Tables: 6, Pages: 12, Words: 8205
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                March 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.2 mode:remove_FC converted:07.06.2021

                benzodiazepine,hypnotics,insomnia,japanese version of benzodiazepine dependence self‐report questionnaire,non‐compliance

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