Cognitive-behavioural, pharmacological and psychosocial predictors of outcome during tapered discontinuation of benzodiazepine

Eighty‐six participants wishing to stop benzodiazepine and who met DSM‐IV (Diagnostic and Statistical Manual of Mental Disorders, 4th ed. American Psychological Association, 1994) criteria for anxiety disorder or insomnia were assessed pre‐ and post‐taper on clinical, pharmacological and psychosocial measures. An initial cohort of 41 participants received treatment as usual (taper only) plus physician counselling in the same clinic setting. A second cohort of 45 participants were randomly allocated to group cognitive–behavioural therapy (CBT) plus taper, or group support (GS) plus taper. At 3 months follow‐up, the outcomes in both the CBT and the GS subgroups were equivalent. Intention to treat analysis revealed a slight advantage to the CBT over the GS group and the CBT group showed higher self‐efficacy post‐taper. Over all 86 participants, a high‐baseline level of psychological distress, anxiety and dosage predicted a poor outcome, but increase in self‐efficacy contributed to a successful outcome particularly in those with initially poor baseline predictors. Although there was a decrease in positive affect during preliminary stages of tapered discontinuation compared to baseline, there was no significant overall increase in negative affect. Copyright © 2008 John Wiley & Sons, Ltd.