【摘要】 目的 了解目前在心理咨询和精神科门诊病人中,苯二氮类药物(BZD)应用和依赖的情况,以及苯二氮(艹卓)类药物依赖问卷(BDEPQ)在评估BZD依赖中的价值。方法 在近年上海市精神卫生中心的8830名门诊病人中,随机抽取使用BZD二月以上的病人198名。通过邮寄BDEQP,“BZD撤药症状问卷”(BWSQ)和“依赖自评分级问卷”(SRD)进行信访调查,并开设专门门诊,免费邀请被调查者来院咨询面谈。结果 调查发现门诊病人中BZD的应用较广泛,处方者超过50％。在应用BZD超过二月的病人中,依赖比例相当高。在完成调查的102例中,符合ICD-10诊断标准的58例,占56.9％。单用一种的,49.2％,合用二种以上的,90％依赖。用BDEPQ评估的结果与ICD-10诊断的一致性较高,Kappa值为0.799。如以BDEPQ>或=31为诊断指标,符合率(敏感性)为93.1％。三种问卷中,BDEPQ的效果最好,ROC为0.94。结论 BZD很容易产生依赖,尤其是长时间或多品种合用。精神科医生在临床使用BZD时应予注意。BDEPQ是一种较好的BZD依赖问卷,可作诊断筛选之用。更多还原

【Abstract】 To investigate the dependence of benzodiazepine(BZD) in outpatients of mental hospital, and evaluate the accuracy of a questionnaire, BDEPQ, for detecting BZD dependence. Methods The authors randomly selected 198 outpatients who had taken BZD for more than two months in total 8830 outpatients since 1995, mailed them a set of BDEPQ, BWSQ, and 3RD, and asked them to complete them. If necessary, they could visit the authors free of charge. Results 58 cases (56. 9%) of the 102 patients who completed the BDEPQ can be diagnosed as BZD dependence according to ICD-10 criteria. The dependence rate in those who only took one kind of BZD was 49. 2%, while those who took more than one kind, 90%. The agreement between BDEPQ and ICD-10 is better than the other two scales; the Kappa coefficient is 0. 799. If>or = 31 was used as cut-off point for diagnosis of BZD dependence, accuracy (sensibility) was 93.1%. ROC analysis of BDEPQ was 0. 94. Conciusions BZD dependence is common in outpatients of mental hospital. BDEPQ can be used as a useful tool for the diagnosis of BZD dependence.更多还原