Dependence, misuse, and beliefs regarding use of hypnotics by elderly psychiatric patients taking zolpidem, estazolam, or flunitrazepam: Hypnotics use in elderly
Abstract
INTRODUCTION: To examine the prevalence rates and correlates of dependence on, misuse of, and beliefs regarding use of hypnotics in elderly psychiatric patients with long-term use of zolpidem, estazolam, or flunitrazepam. METHODS: A total of 139 psychiatric outpatients 65 or more years of age who used zolpidem, estazolam, or flunitrazepam for at least 3 months were studied. The levels of hypnotic dependence and beliefs regarding hypnotic use (necessity and concern) were assessed. Three patterns of hypnotic misuse in the past 1 month were also explored. The correlates of high dependence, misuse, and unfavorable attitude and high concern toward hypnotic use were examined using logistic regression analyses. RESULTS: A total of 28.8%, 7.9%, 12.2%, and 22.3% of participants reported high dependence on, misuse of, unfavorable attitude toward, and high concern toward hypnotic use, respectively. Males were more likely to report unfavorable attitude toward hypnotic use than females. Elders with significant depression were more likely to report high concern toward hypnotic use than those without significant depression. Elders with high concern toward hypnotic use were more likely to report high dependence on hypnotics than those with low concern. Elders with significant depression and taking zolpidem were more likely to misuse hypnotics than those without significant depression and taking estazolam or flunitrazepam, respectively. DISCUSSION: Clinicians should monitor the possibility of dependence on and misuse of hypnotics among elderly psychiatric patients who had the correlates identified in this study.
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Greater severity of depressive symptoms has been correlated with a higher likelihood of developing Z-drug dependence.
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From Z-drug abuse and dependence: Clinical guideline of the Brazilian Academy of Neurology for diagnosis and management (2025) · cites this paper as [64]
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- Authors
- Yen, C.-F., Ko, C.-H., Chang, Y.-P., Yu, C.-Y., Huang, M.-F., Yeh, Y.-C., Lin, J.-J., & Chen, C.-S.
- Affiliations
- Kaohsiung Medical University (TW)
- University at Buffalo, State University of New York (US)
- Kaohsiung Medical University Chung-Ho Memorial Hospital (TW)
- Chi Mei Medical Center (TW)
- Corresponding author
- Lin, Jin-Jia
- Chen, Cheng-Sheng
- Venue
- Asia-Pacific Psychiatry
- Publisher
- Wiley
- Published
- 2014-10-08
- Volume
- 7
- Issue
- 3
- Pages
- 298-305
- ISSN
- 1758-5864 (ISSN-L)
- OpenAlex
- W1559941986
- Cited by
- 22
- References
- 46
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 3 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 2
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Asia-Pacific Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Taipei Medical University Repository (submittedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- hypnotic dependence, hypnotic misuse, zolpidem, estazolam, flunitrazepam, elderly psychiatric patients, depression, long-term hypnotic use, sex differences
- MeSH terms
- Zolpidem, Aged, Attitude to Health, Estazolam, Female, Flunitrazepam, Humans, Hypnotics and Sedatives, Sleep Initiation and Maintenance Disorders, Male, Psychiatric Status Rating Scales, Pyridines, Sex Factors, Substance-Related Disorders
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