Efficacy of cognitive behavioral self-help therapy for depression disorder to withdraw from long-term benzodiazepine use

QIAN Guoying; CAI Lili; FEI Jinfeng; YANG Shengliang; ZHONG Hua

doi:10.16766/j.cnki.issn.1674-4152.003641

Volume 22 Issue 8

Aug. 2024

Turn off MathJax

Article Contents

Abstract

References

Article Navigation > Chinese Journal of General Practice > 2024 > 22(8): 1381-1384

QIAN Guoying, CAI Lili, FEI Jinfeng, YANG Shengliang, ZHONG Hua. Efficacy of cognitive behavioral self-help therapy for depression disorder to withdraw from long-term benzodiazepine use[J]. Chinese Journal of General Practice, 2024, 22(8): 1381-1384. doi: 10.16766/j.cnki.issn.1674-4152.003641

Citation:

QIAN Guoying, CAI Lili, FEI Jinfeng, YANG Shengliang, ZHONG Hua. Efficacy of cognitive behavioral self-help therapy for depression disorder to withdraw from long-term benzodiazepine use[J]. Chinese Journal of General Practice, 2024, 22(8): 1381-1384. doi: 10.16766/j.cnki.issn.1674-4152.003641

Citation:

QIAN Guoying, CAI Lili, FEI Jinfeng, YANG Shengliang, ZHONG Hua. Efficacy of cognitive behavioral self-help therapy for depression disorder to withdraw from long-term benzodiazepine use[J]. Chinese Journal of General Practice, 2024, 22(8): 1381-1384. doi: 10.16766/j.cnki.issn.1674-4152.003641

PDF( 442 KB)

Efficacy of cognitive behavioral self-help therapy for depression disorder to withdraw from long-term benzodiazepine use

doi: 10.16766/j.cnki.issn.1674-4152.003641

Department of Psychiatry, Huzhou Third Municipal Hospital, Huzhou, Zhejiang 313000, China

Funds:

2020RC036

2019GY07

Received Date: 2023-11-23
Available Online: 2024-11-19

Abstract

Abstract

Objective To evaluate the efficacy and security of tapering off long-term benzodiazepine (BZD) use for depression disorder, and to evaluate the value of additional cognitive behavioral therapy-self help (CBT-SH). Methods An 8-week randomized controlled trial was conducted in which 80 patients with depression who returned to the Huzhou Third Municipal Hospital from April 2020 to March 2022 and met the enrollment criteria were assigned to tapering off plus CBT-SH (intervention group, n=40), or tapering off alone (control group, n=40). The patients ' mental symptoms, sleep quality, and physical status were assessed before and after intervention, and the withdrawal symptoms were assessed after intervention. The discontinuation rate of BZD and withdrawal symptoms between the two groups were compared after intervention. Results At the end of 8th week, the discontinuation rate of BZD in the intervention group was higher than that in the control group [52.5% (21/40) vs. 27.5% (11/40), P=0.017]; the daily dose of BZD in the intervention group was lower than that in the control group [0.0 (0.0, 3.8) mg/d vs. 3.0 (0.0, 4.8) mg/d, P=0.035]. The withdrawal symptoms mainly showed feeling faint, noise sensitivity and dizziness. The frequency of withdrawal symptoms in the intervention group was lower than that in the control group [50.0% (20/40) vs. 77.5% (31/40), P=0.011], the scores of benzodiazepine withdrawal symptom questionnaire (BWSQ) in the intervention group were significantly lower than that in the control group (P<0.05). There were no significant differences in the scores of the 17-item Hamilton depression scale (HAMD-17), Hamilton anxiety scale (HAMA), and Pittsburgh sleep quality index (PSQI) between the two groups (P>0.05). No clinically significant changes were found in somatic indices in all patients. Conclusion In patients with stabilized depression disorder, the addition of CBT-SH can be used during the time of benzodiazepine withdrawal to enhance the discontinuation rate of benzodiazepine and reduce withdrawal symptoms.
- Depression disorder,
- Benzodiazepines,
- Tapered hypnotic agents,
- Cognitive behavioral therapy

FullText(HTML)

References(23)

References

[1]	SOYKA M, WILD I, CAULET B, et al. Long-term use of benzodiazepines in chronic insomnia: a European perspective[J]. Front Psychiatry, 2023, 14: 1212028. DOI: 10.3389/fpsyt.2023.1212028.
[2]	AOKI Y, TAKESHIMA M, TSUBOI T, et al. A comparison between perceptions of psychiatric outpatients and psychiatrists regarding benzodiazepine use and decision making for its discontinuation: a cross-sectional survey in Japan[J]. Int J Environ Res Public Health, 2023, 20(7): 5373. DOI: 10.3390/ijerph20075373.
[3]	张欢, 冯俊慧, 徐芳芳, 等. 精神病专科医院住院患者苯二氮卓艹类药物应用调查[J]. 中国药物依赖性杂志, 2020, 29(5): 377-382. ZHANG H, FENG J H, XU F F, et al. Survey on the application of benzodiazepines in inpatients in psychiatric hospitals[J]. Chin J Drug Depend, 2020, 29(5): 377-382.
[4]	郭为, 王健, 高文斌, 等. 单纯认知行为疗法与认知行为疗法结合催眠药物递减方案治疗失眠障碍的疗效观察[J]. 中华内科杂志, 2019, 58(1): 56-62. doi: 10.3760/cma.j.issn.0578-1426.2019.01.010 GUO W, WANG J, GAO W B, et al. A comparison study of cognitive behavioral therapy alone versus combination with tapered hypnotic agents in patients with chronic insomnia[J]. Chin J Intern Med, 2019, 58(1): 56-62. doi: 10.3760/cma.j.issn.0578-1426.2019.01.010
[5]	时雨欣, 夏仲, 戎伟. 门诊森田疗法与认知行为疗法辅助治疗慢性失眠的对照研究[J]. 中华全科医学, 2021, 19(8): 1318-1321. doi: 10.16766/j.cnki.issn.1674-4152.002050 SHI Y X, XIA Z, RONG W. Control study on outpatient Morita therapy and cognitive behavioural therapy in the adjuvant treatment of chronic insomnia[J]. Chinese Journal of General Practice, 2021, 19(8): 1318-1321. doi: 10.16766/j.cnki.issn.1674-4152.002050
[6]	陈小央, 任文, 邱艳, 等. 认知行为疗法的临床应用现状[J]. 中华全科医学, 2022, 20(10): 1755-1759. doi: 10.16766/j.cnki.issn.1674-4152.002696 CHEN X Y, REN W, QIU Y, et al. Review of clinical aplication of cognitive behavioural therapy[J]. Chinese Journal of General Practice, 2022, 20(10): 1755-1759. doi: 10.16766/j.cnki.issn.1674-4152.002696
[7]	TAKESHIMA M, OTSUBO T, FUNADA D, et al. Does cognitive behavioral therapy for anxiety disorders assist the discontinuation of benzodiazepines among patients with anxiety disorders? A systematic review and meta-analysis[J]. Psychiatry Clin Neurosci, 2021, 75(4): 119-127. doi: 10.1111/pcn.13195
[8]	王继辉, 吴小立, 甘照宇, 等. 广泛性焦虑障碍两种方法撤减苯二氮䓬药物的对照研究[J]. 中山大学学报(医学科学版), 2013, 34(1): 118-123. WANG J H, WU X L, GAN Z Y, et al. Efficacy of cognitive-behavioral self-help therapy for generalized anxiety disorder to withdraw from long-term benzodiazepine use[J]. Journal of Sun Yat-Sen University(Medical Sciences), 2013, 34(1): 118-123.
[9]	司天梅, 刘铁桥, 张朝辉, 等. 苯二氮卓艹类药物的药理学[J]. 中国药物滥用防治杂志, 2017, 23(2): 70-74. SI T M, LIU T Q, ZHANG C H, et al. Pharmacology of benzodiazepines[J]. Chinese Journal of Drug Abuse Prevention and Treatment, 2017, 23(2): 70-74.
[10]	蔡耀婷, 宋锦平. 数字认知行为治疗在睡眠障碍病人中的应用现状[J]. 护理研究, 2020, 34(19): 3439-3442. doi: 10.12102/j.issn.1009-6493.2020.19.012 CAI Y T, SONG J P. Application status of digital cognitive behavior therapy in patients with sleep disorders[J]. Chinese Nursing Research, 2020, 34(19): 3439-3442. doi: 10.12102/j.issn.1009-6493.2020.19.012
[11]	杨璐璐, 康尹之, 张菀凌, 等. 网络化认知行为治疗在失眠障碍中的应用和研究进展[J]. 南方医科大学学报, 2020, 40(1): 142-146. YANG L L, KANG Y Z, ZHANG W L, et al. Application and research progress of internet-based cognitive behavioral therapy for insomnia disorder[J]. J South Med Univ, 2020, 40(1): 142-146.
[12]	李巧莹, 张惠, 张馨月, 等. 远程交互式认知行为治疗对慢性失眠症的短期疗效[J]. 临床医药文献杂志, 2019, 6(19): 58-59. LI Q Y, ZHANG H, ZHANG X Y, et al. Short-term efficacy of remote interactive cognitive behavioral therapy for chronic insomnia[J]. Journal of Clinical Medical Literature, 2019, 6(19): 58-59.
[13]	GAO Y, GE L, LIU M, et al. Comparative efficacy and acceptability of cognitive behavioral therapy delivery formats for insomnia in adults: a systematic review and network meta-analysis[J]. Sleep Med Rev, 2022, 64: 101648. DOI: 10.1016/j.smrv.2022.101648.
[14]	ULMER C S, BOSWORTH H B, ZERVAKIS J, et al. Provider-supported self-management cognitive behavioral therapy for insomnia (Tele-Self CBTi): protocol for a randomized controlled trial[J]. Contemp Clin Trials, 2023, 125: 107060. DOI: 10.1016/j.cct.2022.107060.
[15]	HO F Y, CHAN C S, LO W Y, et al. The effect of self-help cognitive behavioral therapy for insomnia on depressive symptoms: an updated meta-analysis of randomized controlled trials[J]. J Affect Disord, 2020, 265: 287-304. doi: 10.1016/j.jad.2020.01.062
[16]	余炬成, 陈斯婧, 陈勰, 等. 失眠的非药物治疗[J]. 中国临床医生杂志, 2023, 51(12): 1389-1393. doi: 10.3969/j.issn.2095-8552.2023.12.002 YU J C, CHEN S J, CHEN X, et al. Non-drug treatment of insomnia[J]. Chinese Journal for Clinicians, 2023, 51(12): 1389-1393. doi: 10.3969/j.issn.2095-8552.2023.12.002
[17]	杨文娟, 孔令钰, 徐亚辉. 自助认知行为干预对慢性失眠患者睡眠状态及睡眠质量的影响[J]. 临床医学工程, 2022, 29(11): 1579-1580. doi: 10.3969/j.issn.1674-4659.2022.11.1579 YANG W J, KONG L Y, XU Y H, et al. Influence of self-help cognitive behavior intervention on sleep status and sleep quality of patients with chronic insomnia[J]. Clinical Medicine & Engineering, 2022, 29(11): 1579-1580. doi: 10.3969/j.issn.1674-4659.2022.11.1579
[18]	CHAPOUTOT M, PETER-DEREX L, BASTUJI H, et al. Cognitive behavioral therapy and acceptance and commitment therapy for the discontinuation of long-term benzodiazepine use in insomnia and anxiety disorders[J]. Int J Environ Res Public Health, 2021, 18(19): 10222. DOI: 10.3390/ijerph181910222.
[19]	NAKAJIMA A, KANIE A, ITO M, et al. Cognitive behavioral therapy reduces benzodiazepine anxiolytics use in Japanese patients with mood and anxiety disorders: a retrospective observational study[J]. Neuropsychiatr Dis Treat, 2020, 16: 2135-2142. doi: 10.2147/NDT.S263537
[20]	连晓东, 黄楚明. 认知行为疗法联合非苯二氮卓艹类药物降阶梯疗法对轻中度失眠症的治疗效果[J]. 山东第一医科大学(山东省医学科学院)学报, 2023, 44(3): 209-214. LIAN X D, HUANG C M. The therapeutic efficacy of cognitive behavioral therapy combined with non-BZDs de-escalation therapy on mild to moderate insomnia[J]. Journal of Shandong First Medical University & Shandong Academy of Medical Sciences, 2023, 44(3): 209-214.
[21]	BASIŃSKA-SZAFRAŃSKA A. Delayed crises following benzodiazepine withdrawal: deficient adaptive mechanisms or simple pharmacokinetics? Detoxification assisted by serum-benzodiazepine elimination tracking[J]. Eur J Clin Pharmacol, 2022, 78(1): 101-110. doi: 10.1007/s00228-021-03205-x
[22]	COSCI F, CHOUINARD G. Acute and persistent withdrawal syndromes following discontinuation of psychotropic medications[J]. Psychother Psychosom, 2020, 89(5): 283-306. doi: 10.1159/000506868
[23]	潘英, 倪海华. 食欲素受体拮抗剂用于失眠症治疗的研究进展[J]. 中国基层医药, 2020, 27(9): 1149-1152. doi: 10.3760/cma.j.issn.1008-6706.2020.09.028 PAN Y, NI H H. Research progress of orexin receptor antagonist in the treatment of insomnia[J]. Chinese Journal of Primary Medicine and Pharmacy, 2020, 27(9): 1149-1152. doi: 10.3760/cma.j.issn.1008-6706.2020.09.028

Relative Articles

[1]	XU Xiaoran, YANG Zihan, NING Jing, SUN Futongyu, TAN Xi. Mendelian randomization study of eczema and depression[J]. Chinese Journal of General Practice, 2024, 22(12): 2012-2015. doi: 10.16766/j.cnki.issn.1674-4152.003786
[2]	ZHOU Ruochen, YE Mengting, YU Fengqiong, ZHOU Xiaoqin. The effect of childhood trauma on somatization symptoms in depressed patients[J]. Chinese Journal of General Practice, 2024, 22(5): 746-749. doi: 10.16766/j.cnki.issn.1674-4152.003494
[3]	ZHU Ting, HUANG Yafang, XIANG Tong, WU Hao. Application and prospects of cognitive-behavioral therapy based digital therapeutics of chronic disease management in the community[J]. Chinese Journal of General Practice, 2024, 22(3): 357-360. doi: 10.16766/j.cnki.issn.1674-4152.003402
[4]	FENG Caiqin, ZHENG Jifeng. Effects of emotional state, metacognition, and serum miRNAs on disease fear in depressed patients[J]. Chinese Journal of General Practice, 2024, 22(9): 1522-1525. doi: 10.16766/j.cnki.issn.1674-4152.003673
[5]	CAO Jiang, ZHANG Yan, YUAN Nahua, ZHU Guidong. Effects of transcranial direct current stimulation on therapeutic effect and cognitive function in patients with depression[J]. Chinese Journal of General Practice, 2024, 22(4): 589-591. doi: 10.16766/j.cnki.issn.1674-4152.003457
[6]	ZHANG Huiling, QIAN Chao, CHEN Ying, YANG Xiaoyan. Application effects of group mindfulness cognitive therapy in patients of depression with sleep disorders[J]. Chinese Journal of General Practice, 2024, 22(2): 284-287. doi: 10.16766/j.cnki.issn.1674-4152.003385
[7]	CHEN Ke-long, CHEN Ling, SONG Cheng-cheng, LI Bin. Effect of Xiaoyao Powder and Banxia Houpu Decoction on cognitive function and event-related potential P300 in patients with liver depression and spleen deficiency depression[J]. Chinese Journal of General Practice, 2022, 20(4): 665-668. doi: 10.16766/j.cnki.issn.1674-4152.002425
[8]	CHEN Shou-lin, ZHU Sheng-zhi, YU Chang, XIE Shu-guang, ZHENG Cheng-ying. Correlation between serum indexes and cognitive function in elderly patients with depression[J]. Chinese Journal of General Practice, 2022, 20(3): 450-453. doi: 10.16766/j.cnki.issn.1674-4152.002375
[9]	LU Sha, CHEN Guang-lie. Improvement of mood, psychological resilience and sleep quality in patients with first-episode depression by networked mindfulness-based cognitive group therapy[J]. Chinese Journal of General Practice, 2022, 20(9): 1506-1508. doi: 10.16766/j.cnki.issn.1674-4152.002635
[10]	CHEN Xiao-yang, REN Wen, QIU Yan, REN Jing-jing. Review of clinical aplication of cognitive behavioural therapy[J]. Chinese Journal of General Practice, 2022, 20(10): 1755-1759. doi: 10.16766/j.cnki.issn.1674-4152.002696
[11]	SHI Yu-xin, XIA Zhong, RONG Wei. Control study on outpatient Morita therapy and cognitive behavioural therapy in the adjuvant treatment of chronic insomnia[J]. Chinese Journal of General Practice, 2021, 19(8): 1318-1321. doi: 10.16766/j.cnki.issn.1674-4152.002050
[12]	YUAN Feng, LI Guang-zao, LIU Shan-shan, ZHANG Rui-rui, CAO Ming-ming, XU Zhi-hui. Application of cognitive behavioural therapy and group games combined with relaxation training in psychological intervention for adolescent cleft lip and palate patients[J]. Chinese Journal of General Practice, 2021, 19(2): 270-273. doi: 10.16766/j.cnki.issn.1674-4152.001785
[13]	WANG Yong-xin, CHEN Xiu-feng, JIANG Jian-lan, WU Min, GAN Quan, LI Ming-wei. Evaluation of the effect of online classroom based on cognitive behavioral therapy on preventing postpartum depression[J]. Chinese Journal of General Practice, 2021, 19(4): 684-688. doi: 10.16766/j.cnki.issn.1674-4152.001893
[14]	WANG Xiao-jiao, SHEN Bian-hong. Effect of cognitive behavioral therapy for insomnia on sleep quality and mood in patients with alcohol dependence[J]. Chinese Journal of General Practice, 2020, 18(2): 318-321. doi: 10.16766/j.cnki.issn.1674-4152.001235
[15]	DU Yuan, WANG Long, ZHANG Xu-lai, LIU Bao-gui, DAI Jing, WU Hui-ling, XUE Yang, HU Hong-yan, LIU Jin-tong. Control study of exercise' influence on depression's symptom, cognitive function and GABA[J]. Chinese Journal of General Practice, 2019, 17(9): 1547-1550. doi: 10.16766/j.cnki.issn.1674-4152.000994
[16]	ZHANG Jian-guo. Efficacy of the rehabilitation nursing with the seasons' change of time combined with psychological counseling in treating patients with depression of stroke hemiplegia[J]. Chinese Journal of General Practice, 2018, 16(5): 853-855,859. doi: 10.16766/j.cnki.issn.1674-4152.000233
[17]	FANG Fei. Clinical study of sertraline combined with psychotherapy in the treatment of coronary heart disease complicated with depression[J]. Chinese Journal of General Practice, 2017, 15(7): 1204-1206,1262. doi: 10.16766/j.cnki.issn.1674-4152.2017.07.034
[18]	LI Tong. The compliance effects of comprehensive intervention combined cognitive behavioral therapy for the treatment of thyroid cancer patients after surgery[J]. Chinese Journal of General Practice, 2017, 15(8): 1440-1443. doi: 10.16766/j.cnki.issn.1674-4152.2017.08.048
[19]	ZHANG Li-na, DING Ying, CHEN Yan-bo, SUN Guo-qing, ZHANG Lei, TAN Zhong-lin. Research on rotation event-related evoked potentials P500 in patients with first onset of depression during mental rotation tasks[J]. Chinese Journal of General Practice, 2016, 14(9): 1530-1532. doi: 10.16766/j.cnki.issn.1674-4152.2016.09.033
[20]	CHEN Chun-feng, GAO Jing-fang, ZHU Xiang-zhen, QIN Dan-ping, LIU Cai-xia. Efficacy of Sertraline hydrochloride tabletscombined with triple therapyonpeptic ulcer and depression in patients with Helicobacter pylori infection[J]. Chinese Journal of General Practice, 2016, 14(5): 807-809. doi: 10.16766/j.cnki.issn.1674-4152.2016.05.038

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Tables(4)

Get Citation

PDF

XML

Article Metrics

Article views (91) PDF downloads(3)

Efficacy of cognitive behavioral self-help therapy for depression disorder to withdraw from long-term benzodiazepine use

doi: 10.16766/j.cnki.issn.1674-4152.003641

Abstract

References

Relative Articles

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Efficacy of cognitive behavioral self-help therapy for depression disorder to withdraw from long-term benzodiazepine use

doi: 10.16766/j.cnki.issn.1674-4152.003641

Abstract

References

Relative Articles

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Export File

Citation

Format

Content