The Effect of Personality on Withdrawal Severity and Taper Outcome in Benzodiazepine Dependent Patients
Abstract
BACKGROUND: Personality psychopathology exerts a significant and independent effect on the course of benzodiazepine (BZ) discontinuation, worsening the subjective severity of withdrawal symptoms and significantly increasing the occurrence of early taper failures. METHOD: One hundred and seventy-one patients participating in a BZ discontinuation programme were administered several personality measures prior to taper. Patients were stabilized for 3 weeks at their baseline BZ dosage and then tapered off 25% per week over 4 weeks, with the option to extend up to 6 weeks if necessary. RESULTS: High levels of passivity and dependency as assessed by the MMPI Dependence subcluster, and at a trend level high Eysenck Neuroticism and high TPQ Harm Avoidance contributed significantly to the prediction of benzodiazepine withdrawal severity. Though there was a high correlation between personality measures, psychopathology and adjusted BZ dose, the effects of personality on withdrawal severity was significant, particularly in the initial phases of BZ taper, when taper severity was still relatively mild. CONCLUSIONS: These findings indicate that clinical decisions on how to manage BZ tapering should be guided by personality assessments, in addition to the usual considerations of BZ dosage, residual psychopathology, duration of treatment, etc. The potential for difficulty with discontinuation related to personality traits should be one of the factors weighted in the risk-benefit assessment made in the planning of benzodiazepine treatment for patients with anxious symptomatology.
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Psychopathological variables, such as psychological suffering, anxiety or insomnia, best predict relapse rates in benzodiazepine withdrawal programs.
“but it is the psychopathological variables [86,87,88,89,90,91] (e.g., psychological suffering, anxiety or insomnia) which best predict relapse rates in withdrawal programs.”
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 [86]
CBT's goal-oriented approach increases compliance with the withdrawal program and reduces the risk of early relapse.
“By encouraging the patient to take an active role, this goal-oriented approach increases compliance with the withdrawal program and reduces the risk of early relapse [38,44,86,87,91,116].”
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 [86]
The development of emotional regulation abilities and cognitive and behavioral work enables patients to better manage their withdrawal symptoms.
“In addition, the development of emotional regulation abilities and cognitive and behavioral work enables them to better manage their withdrawal symptoms, the intensity of which also increases the risk of relapse [86].”
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 [86]
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- Authors
- SCHWEIZER, E., RICKELS, K., De MARTINIS, N., CASE, G., & GARCÍA-ESPAÑA, F.
- Affiliations
- University of Pennsylvania (US)
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 1998-05
- Volume
- 28
- Issue
- 3
- Pages
- 713-720
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W1994085939
- Cited by
- 60
- References
- 14
- Citations by year
- 2025: 2 · 2024: 4 · 2023: 4 · 2022: 2 · 2021: 2 · 2020: 1 · 2018: 2 · 2017: 3 · 2015: 1 · 2014: 2 · 2013: 4 · 2012: 4
- FWCI
- 0.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (MHO-8957)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- benzodiazepine withdrawal, benzodiazepine tapering, personality traits, harm avoidance, withdrawal severity, benzodiazepine dependence, anxiety disorders, personality assessment
- MeSH terms
- Adolescent, Adult, Aged, Benzodiazepines, Dose-Response Relationship, Drug, Female, Humans, Male, Middle Aged, Neurologic Examination, Personality Disorders, Personality Inventory, Substance Withdrawal Syndrome, Anti-Anxiety Agents, Treatment Outcome, Substance-Related Disorders
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