Characteristics of current benzodiazepine users as indicators of differences in physical and mental health

The relationship between characteristics of benzodiazepine exposure and hea lth-status was examined in order to investigate risk profiles of benzodiaze pine users. In the only pharmacy of a Dutch community of 13,500 inhabitants , all current benzodiazepine users that presented with a benzodiazepine pre scription in November 1994 were invited to participate. On the basis of the RAND-36 questionnaire, summary scores for both physical and mental health were calculated, the Physical Component Summary (PCS) an d the Mental Component Summary (MCS). After dichotomization with a cut-off point indicating seriously impaired health and after the combination of the PCS and MCS, four different categories of health status could be identifie d. We used logistic regression to study the relation between these four dif ferent groups with respect to benzodiazepine exposure. In total a group of 360 current benzodiazepine users was studied. Results showed that almost on e-third of the participants had no significant impaired health; this group was further classified as reference group. We classified three other groups : one with physical problems (31%), one with mental problems (18%), and one with a combination of the two (22%). Multivariate analysis showed differen ces in risk factors for an impaired health status. The group with impaired physical health was associated with self-reported indication for muscle rel axation, hypnotic use, and a high CDS (Chronic Disease Score). The group wi th impaired mental health was associated with more frequent consulting of a mental health care specialist and with a low sense of self-efficacy. The g roup with both impaired physical as well as mental health was associated wi th a higher incidence of widowhood, a lower sense of self-efficacy, a high CDS, using benzodiazepines more than prescribed, and reporting depression a s reason for their benzodiazepine use. In particular, two groups need critical examination: a group of apparently healthy users with long-term benzodiazepine use; and a frail group with imp aired physical and mental health and using a higher dose than prescribed. P atient counseling and management of these four groups can be tailored to th e specific needs of each group.