Benzodiazepine use and multidimensional health burden in severe psychiatric disorders: Impaired quality of life, metabolic comorbidities, and adverse effects in a large cross-sectional study.

Abstract

Background: Benzodiazepines (BZ) are widely prescribed to patients with severe mental illnesses, yet their long-term impact on global health remains underinvestigated. While their symptomatic benefits are acknowledged, data on their associations with quality of life (QoL), metabolic comorbidities, and side effects are limited.

Methods: In this cross-sectional study, we analyzed clinical data from 1,248 patients with schizophrenia, bipolar disorder (BD), or major depressive disorder at a psychiatric center in Marseille, France. Associations between BZ use and key outcomes - including QoL (Short Form Health Survey [SF-36], EuroQol-5 Dimensions [EQ-5D], and Schizophrenia Quality of Life Questionnaire - 18 items [SQoL-18]), metabolic parameters, and treatment side effects (Udvalg for Kliniske Undersøgelser Side Effect Rating Scale [UKU scale]) - were examined using multivariate regression analyses.

Results: BZ use was significantly associated with lower QoL scores on physical and mental health domains of the SF-36 (p < 0.001), increased impairment across EQ-5D dimensions, and reduced subjective well-being (SQoL-18, p = 0.043). BZ users also presented higher rates of obesity, diabetes, and metabolic syndrome (all p < 0.05). Furthermore, BZ use was independently associated with a higher burden of side effects across UKU subscales, particularly in the psychiatric domain (emotional blunting, anxiety, and depressive symptoms; p = 0.003).

Conclusion: These findings suggest that BZ use in severe psychiatric disorders may be linked to a substantial multidimensional health burden, including reduced QoL, greater side effect profile, and increased metabolic risk. These results highlight the need for evaluation of long-term BZ use and the promotion of safer alternative treatments.