# 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

## TL;DR

Benzodiazepine use in patients with severe psychiatric disorders is linked to lower quality of life, higher metabolic risks, and more side effects, suggesting a need for safer treatment alternatives.

## Contribution

This study reveals the multidimensional health burden of benzodiazepine use in severe psychiatric disorders through a large cross-sectional analysis.

## Key findings

- Benzodiazepine users had significantly lower quality of life scores in physical and mental health domains.
- BZ use was associated with increased rates of obesity, diabetes, and metabolic syndrome.
- Higher side effect burden was observed, particularly in psychiatric symptoms like emotional blunting and anxiety.

## Abstract

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.

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.

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).

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.