Benzodiazepine use among older adults with schizophrenia spectrum disorder: prevalence and associated factors in a multicenter study

Abstract

Objectives:Data on psychotropic medications of older patients with schizophrenia spectrum disorder are scarce. Specifically, information about the use of benzodiazepines among older patients with schizophrenia spectrum disorder is very limited. Because benzodiazepine use in older patients has been associated with many disabling side effects, its use in actual practice must be described and questioned. This study aimed at exploring the prevalence of benzodiazepine use and the clinical factors associated with such use among older patients with schizophrenia spectrum disorder.Methods/Design:Data from the Cohort of individuals with Schizophrenia Aged 55 years or more (CSA) were used to examine the prevalence of benzodiazepine use among older patients with schizophrenia spectrum disorder. Demographic and clinical characteristics associated with benzodiazepine prescription were also explored.Results:The prevalence of benzodiazepine use was 29.8% of older patients with schizophrenia spectrum disorder. These patients were significantly more likely to have medical comorbidities, cognitive and social functioning impairments, to report a lifetime history of suicide attempt, to be institutionalized, and to have been hospitalized in a psychiatric service in the past year compared to those without a benzodiazepine prescription (all p<0.05). There were no between-group differences in schizophrenia severity and psychiatric comorbidity.Conclusions:Although it can be hypothesized that benzodiazepine prescription is part of a short-term therapeutic strategy toward patients with more severe trouble or comorbid disorders, our results suggest a strong link between benzodiazepine prescription and a particularly vulnerable subpopulation of older patients with schizophrenia spectrum disorder.

Late‐onset and nonlate‐onset schizophrenia: A comparison of clinical characteristics in a multicenter study

“…Cross‐sectional data were drawn from the CSA study, a cohort of 353 in‐ (34.1%) or outpatients (65.9%) aged 55 years or more with an International Classification of Diseases, 10th edition (ICD‐10) diagnosis of schizophrenia (82.4%) or schizoaffective disorder (17.6%). More detailed description of the study methodology can be found elsewhere 25–31 . Participants were recruited between February 2010 and June 2013 from 63 French state hospital psychiatric departments, each of them covering one mutually independent catchment area 32 .…”

“…In this report, we sought to examine potential differences between patients of similar age with LOS and NLOS as to sociodemographic and clinical characteristics of schizophrenia, comorbidity, psychotropic medications, quality of life, functioning, and mental health care utilization. To this purpose, we took advantage of the Cohort of older adults with Schizophrenia Aged 55 years or more (CSA) study, 25–30 a multicenter sample of 353 older adults with schizophrenia or schizoaffective disorder.…”

Plus ça change? Benzodiazepine prescription in older patients with schizophrenia is common but best avoided

“…Importantly, none of these trials were conducted in the elderly. Therefore, this poorly developed evidence base cannot explain or justify the widespread use of benzodiazepines in older patients with schizophrenia reported by Schuster et al (2019). This is especially true when the weak evidence for efficacy is considered in the context of the many adverse consequences of benzodiazepine use in younger and older patients.…”

“…In this issue, a paper by Schuster et al (2019) explores an important aspect of the pharmacological treatment of older patients with schizophrenia or schizoaffective disorder the use of benzodiazepines. The authors describe 353 participants from 63 clinical centers across France in the "Cohort of Individuals with Schizophrenia Aged 55 Years or More."…”

Self-rated health in older adults with schizophrenia: advances and future directions

“…Smeets-Janssen et al (2020) have reported that in older schizophrenia patients, early-and late-onset ages form a continuum, with data showing one normally distributed population. Schuster et al (2020) have revealed that benzodiazepine use among OAS spectrum disorder is associated with medical comorbidities as well as cognitive and social functioning impairments. All these studies and many others highlight the intertwined nature of mental and physical health in schizophrenia, and the study by Cohen et al (2019) bears further testimony to that.…”