The Bendep-SRQ is a self-report questionnaire which is developed to provide people who use sleeping tablets or tranquillisers which belong to the group of benzodiazepines (BZDs) a reliable impression of the severity of benzodiazepine dependence.
The Bendep-SRQ reflects the severity of benzodiazepine dependence by means of a profile of the following 4 scales:
The psychometric properties (scalability, reliability and validity) of the Bendep-SRQ scales have been assessed elaborately. Look, if desired, at the referencelist of scientific reports on the Bendep-SRQ.
If you use a sleeping tablet or tranquilliser belonging to the group of benzodiazepines, you can respond below to the items of the Bendep-SRQ. If you respond to all the items, your scores on the Bendep-SRQ scales will be computed and sent back to your e-mail adress. Until further notice, no fee will be charged.
Age (in years):
What is your Civil State?
unmarried and never been married
What is the highest level of ecucation which you have finished?
Which benzodiazepines do you use?
You can choose more than one benzodiazepine!
clobazam (Frisium, Urbadan)
clorazepinezuur (Clorazepaat, Tranxene)
diazepam (Valium, Stesolid)
temazepam (Normison, Euhypnos, Levanxol)
I have been using the benzodiazepine which I use the longest for (in months):
All the statements in this questionnaire are only about the sleeping tablets and tranquillisers indicated above; they do not refer to other types of medication, e.g. for high blood pressure.
Please judge the statements as they have applied to you yourself over the past six months. Always choose one of the answers, otherwise the results of this questionnaire will less reliable.
Indicate the extent to which each statement applies to you by choosing the most appropriate answer.
1. I take another dose of medication on time, because otherwise I would suffer complaints.
that is absolutely untrue for me
that is untrue for me
that is partly true, partly untrue for me
that is true for me
that is absolutely true for me
2. When I feel stressed, I take extra medication.
3. I get nervous if my medication is out of reach
4. I would like to give up taking the medication
5. Other people have urged me to use less medication.
6. After taking my medication I feel full of energy.
7. I take more medication than is written on the label.
8. I know ways of getting medication without a prescription.
9. Once I took far too much medication in one go.
10. To get a prescription I have to exaggerate my complaints.
11. I feel guilty after taking extra medication.
12. I feel safe when I have my medication with me.
13. At present, the medication is less effective than it used to be.
14. I take more medication when I am feeling stressed.
15. My medication is gone too quickly.
16. After taking my medication, I appreciate the things around me more.
17. The medication is getting me into trouble.
18. I alter what is written on the prescription.
19. The medication means that I can face my problems again.
20. I have been thinking about giving up the medication.
21. Just before I take my medication, that is the only thing I can think about.
22. I spend a great deal of time thinking about medication.
23. To get a prescription I exaggerate my complaints.
24. At present, I use more medication than I used to so that I can keep feeling good.
25. I would change my doctor if he refused to prescribe any more medication.
26. I take my medication to really make me feel good.
27. I think the medication is destroying my life.
28. I go and get a new prescription before the appointed time.
29. I take a lot of medication in one go.
30. The medication has led to problems with my family.
If you have never considered trying to cut down on your medication use or stopping, you are not required to answer any of the questions below and you have finished the questionnaire. You can submit your data by clicking below on the butto n: Submit. If you are not content with the answers you have given, you can erase them all by clicking the button: Undo. Subsequently, you can start again.
Please continue if you have ever tried to use less or stop!
If you do not continue, go to the bottom of the this site to interprete your scores on 3 of the 4 Bendep-SRQ scales.
Using fewer sleeping tablets or tranquillisers can lead to complaints. Below a list of examples of these complaints is given. Please indicate the extent to which you were troubled by each of the complaints the last time you tried to use less or stop by choosing the most appropriate answer.
none or hardly any trouble
quite a lot of trouble
a great deal of trouble
a very great deal of trouble
32. Feeling depressed
34. Difficulty with concentrating
35. Pressure or pain in the head
36. Slower or confused thoughts
38. Easily confused or distracted
You can submit your data by clicking below on the button: Submit. If you are not content with the answers you have given so far, you can erase them all by clicking on the button: Undo. Subsequently, you can start again.
Interpretation of scores
If you want to interprete your scores on the Bendep-SRQ scales with respect to the normative group general practice patients*, click
(*see: Kan et al. Latent Trait Standardization of the Benzodiazepine Dependence Self-Report Questionnaire using the Rasch scaling model)
Questions, remarks or other reactions?
Send them to: