Psychotropic Drug Use Among the Elderly: Risk Factors Involved in Long-Term Use

Abstract

This study explores the environmental, clinical, and personality factors that are associated with increased chronic psychotropic drug consumption in elderly patients. We collected data from 88 elderly individuals living in nursing homes, home-dwellings, and residential homes between December 2003 and June 2004. We assessed each subject's (1) current (previous four weeks) and chronic (>90 days) psychotropic drug consumption, (2) mood and anxiety (GHQ), and (3) personality (Temperament and Character Inventory). We found that 63% of the elderly subjects studied had used psychotropic drugs at least once and that one out of three elderly chronically consumed psychotropic drugs. Personality factors like harm avoidance and low level of persistence seem to be associated with chronic consumption.

RÉSUMÉ

Cette étude a pour objectif d’explorer les facteurs environnementaux, cliniques et de personnalité pouvant être associés à l’accroissement de la consommation chronique de médicaments psychotropes chez les personnes âgées.

Nous avons menée notre étude, de décembre 2003 et juin 2004, auprès de 88 personnes âgées résidant en maison de retraite, à leur domicile ou en résidence pour personne âgée (foyer logement). Pour chaque sujet nous avons évalué: 1) La consommation actuelle (au moins 4 semaines) et chronique (> à 90 jours) de médicaments psychotropes, 2) l’anxiété, la dépressivité, le dysfonctionnement social et les plaintes somatiques, 3) la personnalité (Temperament and Character Inventory, TCI, Cloninger).

Nous avons mis en évidence que 63% des personnes âgées avaient déjà consommé au moins une fois dans leur vie un médicament psychotropes et qu’actuellement 1 personne sur 3 consomment ces médicaments de façon chronique.

Des facteurs de personnalité tels que l’évitement de la douleur (Harm Avoidance) et un faible niveau de persistance, semblent être associés à une consommation chronique.

RESUMEN

Este estudio tiene como objetivo explorar los factores ambientales, clínicos y de personalidad que pueden estar asociados al crecimiento del consumo crónico de medicamentos psicotrópicos en personas de edad.

Llevamos a cabo nuestro estudio entre diciembre de 2003 y junio de 2004 e incluimos 88 personas de edad, residentes en asilos de ancianos, casas de ancianos o en su propia casa.

En cada caso evaluamos: 1. el consumo actual (dentro las últimas cuatro semanas) y crónico (mayor de 90 días) de medicamentos psicotrópicos. 2. El nivel de ansiedad, depresión, la alteración del funcionamiento social y las quejas somáticas. 3. La personalidad (Temperament and Character Inventory, TCI, Cloninger).

Evidenciamos que el 63% de las personas de edad habían tomado, al menos una vez en la vida, algún medicamento psicotrópico y que actualmente una de cada tres personas toman medicamentos de manera crónica.

Los factores de personalidad tales como la evitación del dolor (Ham Avoidance) y un pobre nivel de persistencia parecen estar asociados a la utilización crónica de medicamentos psicotrópicos.

Keywords :

• psychotropic drug use
• elderly
• personality
• chronic use

THE AUTHORS

Valérie Aubron is currently a Ph.D. student at University Victor Segalen of Bordeaux II, France, and holds a teaching and research position at University François Rabelais of Tours, Tours, France. His research and clinical interest include risk-taking behaviors, substance use (alcohol, marijuana, and psychotropic drug), personality factors, and externalizing behaviors such as Attention Deficit Hyperactivity Disorder.

Vincent Camus, M.D., Ph.D., Psychiatrist, is head of the Clinique Psychiatrique Universitaire, Department of Psychiatry at the University Hospital in Tours, France, and Professor of psychiatry at the Université François Rabelais de Tours, France. He is affiliated to the INSERM U930 research unit. He chairs the Section of Old Age Psychiatry at the World Psychiatric Association. His main clinical and research interest is the psychiatry of the elderly, particularly late-life affective disorders and their links with neurodegenerative and vascular disorders.

Badiâa Bouazzaoui, Engineer, Ph.D. in Psychology, is currently working in the EA 2114 “Vieillissement et Développement Adulte” and UMR CNRS 6215 “Langage, Mémoire et Développement Cognitif (LMDC)” laboratories of the University François-Rabelais of Tours, Tours, France. Her main research interests are related to cognitive aging (age-related declines in basic mechanisms of cognition as memory or information integration in judgment tasks). Her research themes also include social psychology (social perceptions and cross cultural differences).

Antoine Pelissolo, M.D., Psychiatrist, is Head of an anxiety clinic at Pitié-Salpêtrière Hospital (Paris) and Head of the psychiatric emergency unit at Pitié-Salpêtrière Hospital (Paris). His research interests include clinical and therapeutic research on anxiety disorders: gaze avoidance in social anxiety (objective measure of visual scanpath), virtual reality treatment and cognitive remediation for phobia, emotional processing in anxiety, and physical treatments for obsessive-compulsive disorders (deep brain stimulation and transcranial magnetic stimulation), psychometric studies of anxiety disorders, and personality.

Grégory Michel, Ph.D. in Clinical Psychology, is Professor of Psychopathology at the University Victor Segalen of Bordeaux II., France. He has been working at Psychiatry Hospital of Adolescents and Adults in Paris since 1994. Currently, in laboratory research of psychology, his main interests are related to risk-taking behaviors, psychoactive substance use, violent behaviors, and personality factors.