Psychoactive substance use and dependence among elderly Tunisian patients followed in outpatient psychiatry unit

Abstract

Summary The aims of our study were to evaluate the consumption of psychoactive substances among elderly patients followed in outpatient psychiatry, to assess benzodiazepine (BZD) and tobacco dependence and to identify potential factors related to this dependence. This was a cross-sectional, descriptive and analytical study, which included elderly patients followed in an outpatient Psychiatric Unit over a period of six months from January to June 2016. Data collection was conducted using a standardized questionnaire for sociodemographic, clinical, therapeutic and psychoactive substance use characteristics. Nicotine dependence levels were assessed using the Fagerstrom Test for Nicotine Dependence and BZD dependence was assessed using the French scale “Echelle cognitive d’attachement aux benzodiazepines”. One hundred patients aged over 65 years participated in this study. The sample comprised 40 BZD users, 34 tobacco users, 19 users of hypnotics (antihistamines) and 13 users of stimulants. The dependence assessment indicated that 79% of the BZD users were dependent on BZD and 52.9% of the smokers presented either high or very high nicotine dependence. BZD use was correlated with female gender ( P = 0.022) and depressive disorders ( P = 0.006). Tobacco use was significantly correlated with male gender ( P P = 0.041), having low socioeconomic status ( P P = 0.035). This study confirms the conclusions of other international studies and demonstrates the widespread dependence on psychoactive substances among elderly psychiatric patients. There is a need to improve the assessment of addictions among the elderly using age-specific indicators of dependency.