Personality traits and socio-epidemiological status of hospitalised elderly benzodiazepine users

Objective: to define personality traits and socio-epidemiological status of hospitalised elderly chronic benzodiazepine (BZD) users.

Methods: this case controlled study assessed psychological characteristics (using the Millon Clinical Multiaxial Inventory-MCMI-I) and socio-epidemiological status (sex, age, education, marital status and housing) in 40 hospitalised geriatric patients taking BZDs for at least 3 months and 40 non-users, excluding dementia.

Results: comparisons between groups: Compulsive personality pattern was more pronounced in the control group (p = 0.008). Severe personality pathology: a predisposition to borderline disorder was stronger among the BZD-users (p = 0.001). Clinical syndromes: anxiety, dysthymic disorder (p < 0.001) and tendency to alcohol dependence (p = 0.020) prevailed in the BZD-users. No severe syndromes were found. Widowed persons were more prevalent between the BZD-users (p = 0.03). All significant differences resulted from disparities between females. Predictors of BZD-use and clustering of traits: Dysthymic disorder was predictive of BZD-use (odds ratio (OR) 6.3 [95% confidence intervals (CI) 2.2-18.2]). It was strongly correlated with anxiety (r(s) = 0.93) and somatoform disorder (r(s) = 0.71). Dysthymic disorder and alcohol dependence predicted BZD-use in women (OR 15.3 [CI: 2.4-95.7] and OR 9.1 [CI: 1.2-64.9], respectively). There were no specific predictors in men.

Conclusions: chronic elderly BZD-users are typically widowed females with dysthymic disorder, anxiety, predisposition to alcohol dependence and borderline disorder. Before prescribing BZDs, it is important to recognize the nature of the elderly population at risk for BZD-use and to consider a broader-ranging therapeutic management of the predisposing personality traits.