Journal
GENERAL HOSPITAL PSYCHIATRY
Volume 62, Issue -, Pages 49-55Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.genhosppsych.2019.11.008
Keywords
Hypnotic; Long-term use; Retrospective cohort study
Categories
Funding
- JSPS KAKENHI [24791256]
- Health and Labor Sciences Research Grants [H29-Seishin-Ippan-001, 19GC1012]
- National Center of Neurology and Psychiatry, Japan [29-1]
- Grants-in-Aid for Scientific Research [24791256] Funding Source: KAKEN
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Objective: Patients with chronic insomnia are prone to long-term use of hypnotics. Reported risk factors include aging, female sex, and comorbid psychiatric disorders. However, most previous studies have been cross-sectional cohort studies. Method: We conducted a retrospective cohort study using medical service payment data for 330,000 people to determine the duration of prescription of hypnotics and the risk factors for long-term use. We followed up 3981 patients (2382 M, 1599 F, age 40.3 +/- 12.4 years) who were prescribed hypnotics for the first time between April 2005 and March 2008. Results: Of these 3981 patients, 59.6% were prescribed hypnotics for only 1 month, 11.3% were prescribed hypnotics for 2 consecutive months, and 10.1% of patients continued receiving prescriptions for the entire 12-month observation period. In multiple logistic time-dependent Cox analyses, use of antidepressants, mean dose of hypnotics, and advanced age were significantly associated with long-term use of hypnotics (p < 0.01). In an analysis of the association between long-term use of hypnotics and prescribed dosage, high monthly dose, advanced age, and department of first visit were significantly associated with long-term use (p < 0.01). Conclusion: These clinical indicators may be effective for early identification of patients with insomnia who are at high risk of developing physical dependence on hypnotics.
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