Further evidence on the interplay between benzodiazepine and Z-drug abuse and emotion dysregulation

Background: Long-term benzodiazepine (BDZ)/Z-drug use, which is a risk factor for dependence, is frequent in neuropsychiatric conditions, especially emotional disorders. Also, BDZ/Z-drug misuse is associated with increased emotion dysregulation symptoms. This study aimed to investigate neuropsychiatric distress in patients with BZD/Z-drug use disorder, with particular attention to emotional symptoms. Methods: Forty-two patients hospitalized for BZD/Z-drug use disorder (males/females= 20/22) were enrolled and dichotomized into a high-dose and a low-dose BZD/Z-drug user group. Neuropsychiatric distress was measured using standardized measures. The relationship between symptom profiles and BZD/Z-drug use disorder severity was explored using t-tests and negative binomial regression analyses. Results: Twenty-seven patients (61.9%) presented with one or more psychiatric disorders, mostly an emotional disorder. Ten patients had a lifetime history of suicide attempt(s) (23.8%), while 11 presented recent suicidal ideation (26.2%), which resulted in suicidal behavior in 2 cases. High rates of depression, anxiety, and emotion dysregulation were reported. The high-dose BZD/Z-drug user group presented with higher depressive symptoms (p = 0.016) and emotion dysregulation (p = 0.044) than the low-dose BZD/Z-drug user group. Further, the higher the depressive symptomatology, the more severe was the BZD/Z-drug abuse (p = 0.028). Limitations: Long-term patterns of BDZ/Z-drug use disorder among patients with emotional disorders and the role of other potential risk factors, such as gender, other substance use disorder, and personality disorders, need further investigation in larger samples. Conclusions: This study showed high emotional symptoms among patients with BZD/Z-drug use disorder, with severe depression being associated with a more severe BZD/Z-drug dependence.