Welcome to the Benzodiazepine Dependence Self-Report Questionnaire (Bendep-SRQ)

© C.C. Kan, 1999

Introduction

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:

1. Problematic Use
Degree of awareness of problematic BZD use
2. Preoccupation
Degree of preoccupation/obsession with respect to the availability of BZDs
3. Lack of Compliance
Degree of lack of compliance with the therapeutic BZD
4. Withdrawal
Degree of unambiguity of experienced BZD withdrawal
 

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.


Forename(s) respondent:

Surname respondent:

Age (in years):

Sex:

Nationality:


What is your Civil State?

unmarried and never been married
married
divorced
widow(er)
unknown

What is the highest level of ecucation which you have finished?


Which benzodiazepines do you use?
You can choose more than one benzodiazepine!

alprazolam (Xanax)

 

bromazepam (Lexotanil)

brotizolam (Lendormin)

 

chloordiazepoxide (Librium)

clobazam (Frisium, Urbadan)

 

clonazepam (Rivotril)

clorazepinezuur (Clorazepaat, Tranxene)

 

diazepam (Valium, Stesolid)

flunitrazepam (Rohypnol)

 

flurazepam (Dalmadorm)

ketazolam (Unakalm)

 

loprazolam (Dormonoct)

lorazepam (Temesta)

 

lormetazepam (Loramet)

medazepam (Nobrium)

 

midazolam (Dormicum)

nitrazepam (Mogadon)

 

nordazepam (Calmday)

oxazepam (Seresta

 

prazepam (Reapam)

 

 

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.

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

 

3. I get nervous if my medication is out of reach

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

 

4. I would like to give up taking the medication

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

 

5. Other people have urged me to use less medication.

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

 

6. After taking my medication I feel full of energy.

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

 

7. I take more medication than is written on the label.

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

 

8. I know ways of getting medication without a prescription.

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

 

9. Once I took far too much medication in one go.

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

 

10. To get a prescription I have to exaggerate my 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

 

11. I feel guilty after taking extra medication.

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

 

12. I feel safe when I have my medication with me.

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

 

13. At present, the medication is less effective than it used to be.

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

 

14. I take more medication when I am feeling stressed.

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

 

15. My medication is gone too quickly.

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

 

16. After taking my medication, I appreciate the things around me more.

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

 

17. The medication is getting me into trouble.

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

 

 18. I alter what is written on the prescription.

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

 

19. The medication means that I can face my problems again.

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

 

20. I have been thinking about giving up the medication.

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

 

21. Just before I take my medication, that is the only thing I can think about.

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

 

22. I spend a great deal of time thinking about medication.

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

 

23. To get a prescription I exaggerate my 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

 

24. At present, I use more medication than I used to so that I can keep feeling good.

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

 

25. I would change my doctor if he refused to prescribe any more medication.

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

 

26. I take my medication to really make me feel good.

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

 

27. I think the medication is destroying my life.

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

 

28. I go and get a new prescription before the appointed time.

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

 

29. I take a lot of medication in one go.

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

 

30. The medication has led to problems with my family.

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


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.


 

31. Tenseness

none or hardly any trouble
slight trouble
quite a lot of trouble
a great deal of trouble
a very great deal of trouble

 

32. Feeling depressed

none or hardly any trouble
slight trouble
quite a lot of trouble
a great deal of trouble
a very great deal of trouble

 

33. Tiredness

none or hardly any trouble
slight trouble
quite a lot of trouble
a great deal of trouble
a very great deal of trouble

 

34. Difficulty with concentrating

none or hardly any trouble
slight trouble
quite a lot of trouble
a great deal of trouble
a very great deal of trouble

 

35. Pressure or pain in the head

none or hardly any trouble
slight trouble
quite a lot of trouble
a great deal of trouble
a very great deal of trouble

 

36. Slower or confused thoughts

none or hardly any trouble
slight trouble
quite a lot of trouble
a great deal of trouble
a very great deal of trouble

 

37. Shaking

none or hardly any trouble
slight trouble
quite a lot of trouble
a great deal of trouble
a very great deal of trouble

 

38. Easily confused or distracted

none or hardly any trouble
slight trouble
quite a lot of trouble
a great deal of trouble
a very great deal of trouble

 

39. Irritability

none or hardly any trouble
slight trouble
quite a lot of trouble
a great deal of trouble
a very great deal of trouble

 

40. Restlessness

none or hardly any trouble
slight trouble
quite a lot of trouble
a great deal of trouble
a very great deal of trouble


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 here.

 

(*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: ceeskan@zonnet.nl