Clinical and Social Determinants of Long-Term Use of Benzodiazepines and its Impact on Quality of Life of Chinese Schizophrenia Patients

Abstract

Aims: To date there have been no studies investigating prescription patterns of benzodiazepine agents (BZDs) in Chinese outpatients with schizophrenia. This study examined the frequency and socio-demographic and clinical correlates of BZD prescription in Hong Kong (HK) and Beijing (BJ), China.

Methods: Five hundred and five clinically stable outpatients with schizophrenia were randomly selected and interviewed in HK and BJ using standardized assessment instruments. Basic socio-demographic and clinical data and psychotropic drug prescriptions were collected at the time of a diagnostic interview.

Results: One-hundred and fifty one (29.9%) patients were prescribed BZDs in the whole sample; 25.1% and 34.8% of the HK and BJ samples, respectively. Use of BZDs was associated with sex, employment status, history of suicide, less use of clozapine, more frequent use of typical antipsychotics (APs), higher doses of APs, severity of positive symptoms, extrapyramidal side effects (EPS) and insomnia. In multiple logistic regression analysis, severity of depressive symptoms, study site, sex, employment status, less use of clozapine and history of suicide remained significantly associated with BZDs.

Conclusion: Although the ethnic and clinical characteristics of the two samples were nearly identical, there was a wide variation in the frequency of BZD prescriptions between HK and BJ suggesting that socio-cultural and economic factors as well as traditions of psychiatric training and practice all played a role in determining the use of BZDs. Prescription of BZDs in either site was not in line with current recommendation.

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