Psychological Predictors of Benzodiazepine Discontinuation among Older Adults: Results from the PASSE 60+
Abstract
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.
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Successful withdrawal depends on the individual's level of confidence in their ability to manage their psychological states without the use of substances.
“Successful withdrawal also depends on the individual’s level of confidence in their ability to manage their psychological states without the use of substances [113,114,115].”
From Cognitive behavioral therapy and acceptance and commitment therapy for the discontinuation of long-term benzodiazepine use in insomnia and anxiety disorders (2021) · cites this paper as [115]
During maintenance of abstinence, orienting behaviors towards life-values, ACT improves quality of life, which along with social support is a factor in successful withdrawal and protection against relapse.
“During the phase of maintaining abstinence, by orientating behaviors towards life-values, ACT improves quality of life which, along with social support, is a factor involved in successful withdrawal and protection against relapse [113,115,152,153,154].”
From Cognitive behavioral therapy and acceptance and commitment therapy for the discontinuation of long-term benzodiazepine use in insomnia and anxiety disorders (2021) · cites this paper as [115]
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- Authors
- Allary, A., Proulx-Tremblay, V., Bélanger, C., Hudon, C., Marchand, A., O'Connor, K., Pérodeau, G., Roberge, P., Tannenbaum, C., Vasiliadis, H.-M., Desrosiers, C., Cruz-Santiago, D., & Grenier, S.
- Affiliations
- Université du Québec à Montréal (CA)
- Institut Universitaire de Gériatrie de Montréal (CA)
- Université Laval (CA)
- Université du Québec en Outaouais (CA)
- Université de Sherbrooke (CA)
- Corresponding author
- Grenier, Sébastien
- ORCID
- Venue
- Addictive Behaviors
- Publisher
- Elsevier BV
- Published
- 2020-03
- Volume
- 102
- Pages
- 106195
- ISSN
- 0306-4603 (ISSN-L)
- OpenAlex
- W2987654369
- Cited by
- 17
- References
- 69
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 3 · 2023: 4 · 2022: 3 · 2021: 1
- FWCI
- 0.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Addictive Behaviors (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Fonds de Recherche du Québec - Santé
- Canadian Institutes of Health Research (309810)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- benzodiazepine withdrawal, benzodiazepine discontinuation, older adults, long-term benzodiazepine use, depressive symptoms, social support satisfaction, perceived competence, sleep quality
- MeSH terms
- Deprescriptions, Self-Management, Drug Tapering, Aged, Aged, 80 and over, Anxiety, Benzodiazepines, Depression, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Social Support, Substance Withdrawal Syndrome, Cognitive Behavioral Therapy, Self Efficacy
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