THE EFFECT OF PERSONALITY ON WITHDRAWAL SEVERITY AND TAPER OUTCOME INBENZODIAZEPINE DEPENDENT PATIENTS

Background. Personality psychopathology exerts a significant and indep endent effect on the course of benzodiazepine (BZ) discontinuation, wo rsening the subjective severity of withdrawal symptoms and significant ly increasing the occurrence of early taper failures. Method. One hund red and seventy-one patients participating in a BZ discontinuation pro gramme were administered several personality measures prior to taper. Patients were stabilized for 3 weeks at their baseline BZ dosage and t hen tapered off 25% per week over 4 weeks, with the option to extend u p to 6 weeks if necessary. Results. High levels of passivity and depen dency as assessed by the MMPI Dependence subcluster, and at a trend le vel high Eysenck Neuroticism and high TPQ Harm Avoidance contributed s ignificantly to the prediction of benzodiazepine withdrawal severity. Though there was a high correlation between personality measures, psyc hopathology and adjusted BZ dose, the effects of personality on withdr awal severity was significant, particularly in the initial phases of B Z taper, when taper severity was still relatively mild. Conclusions. T hese findings indicate that clinical decisions on how to manage BZ tap ering 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 r elated to personality traits should be one of the factors weighed in t he risk-benefit assessment made in the planning of benzodiazepine trea tment for patients with anxious symptomatology.