Background. Personality psychopathology exerts a significant
and independent effect on the course
of benzodiazepine (BZ) discontinuation, worsening the subjective
severity of withdrawal symptoms
and significantly increasing the occurrence of early taper failures.
Method. One hundred and seventy-one patients participating
a BZ discontinuation programme
were administered several personality measures prior to taper. Patients
were stabilized for 3 weeks
at their baseline BZ dosage and then tapered off 25% per week over 4 weeks,
with the option to
extend up to 6 weeks if necessary.
Results. High levels of passivity and dependency as
assessed by the MMPI Dependence subcluster,
and at a trend level high Eysenck Neuroticism and high TPQ Harm Avoidance
significantly to the prediction of benzodiazepine withdrawal severity.
Though there was a high
correlation between personality measures, psychopathology and adjusted
BZ dose, the effects of
personality on withdrawal severity was significant, particularly in
the initial phases of BZ taper,
when taper severity was still relatively mild.
Conclusions. These findings indicate that clinical decisions
on how to manage BZ tapering should
be guided by personality assessments, in addition to the usual
considerations of BZ dosage, residual
psychopathology, duration of treatment, etc. The potential for difficulty
related to personality traits should be one of the factors weighed
in the risk–benefit assessment made
in the planning of benzodiazepine treatment for patients with anxious symptomatology.