A statistical study on the relationship between mental illness and traffic accidents--a pilot study.

Eelkema, Robert C.; Brosseau, James D.; Koshnick, R; McGee, Casey

doi:10.2105/ajph.60.3.459

Cited by 47 publications

(11 citation statements)

References 10 publications

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“…Most of the excess accidental deaths are from falls and aspiration [22]. Some older studies in the US [23] and Denmark [24] did not find an increased rate for road traffic accidents while others found an approximately two-fold incidence of traffic accidents per mile driven by schizophrenic outpatients compared to healthy controls [25,26] (for review see [27]). Similar results were reported in a more recent study by Edlund et al [28] indicating that the absolute mortality from road traffic accidents is reduced in schizophrenia but, since fewer people with schizophrenia drive, the risk per mile driven is probably increased.…”

Section: Risk Of Accidents In Schizophreniamentioning

confidence: 99%

Driving ability in schizophrenic patients: effects of neuroleptics

Soyka¹,

Kagerer²,

Brunnauer³

et al. 2005

International Journal of Psychiatry in Clinical Practice

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Recent studies indicate that individuals with schizophrenia have a two-fold incidence of traffic accidents. Cognitive and psychomotor impairment as a core feature of schizophrenia and the effects of neuroleptic treatment play an essential role in this respect. Few experimental studies have been conducted so far looking at the effects of neuroleptics on driving ability in schizophrenia. Controlled, randomised trials are totally missing. The limited database indicates that most schizophrenic patients show significant impairment in cognitive functions relevant for driving ability compared to healthy controls. There is some but limited evidence that patients under novel atypical neuroleptics show less impairment compared to conventional neuroleptics. More clinical and experimental studies are warranted.

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Section: Risk Of Accidents In Schizophreniamentioning

confidence: 99%

Driving ability in schizophrenic patients: effects of neuroleptics

Soyka¹,

Kagerer²,

Brunnauer³

et al. 2005

International Journal of Psychiatry in Clinical Practice

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“… • Each of the mental illness groups showed a statistically higher violation rates than the control group, particularly in reckless driving, negligent driving and driving with defective equipment. CEBM: level 4 AAN: Class III Eelkema (1970) [ 48 ]; USA; N To examine the correlation between mental illness and crashes N = 238, driving records from a hospital (1960); with matched comparison group ( n = 290) Quantitative: Epidemiological analysis of secondary data Measures: • Crashes • Violations pre and post hospitalisation • Patients discharged from the hospital showed higher crash and violation rates per year. • Greater crash ratio (>1) was found in people with psychosis and psychoneurosis; however, these groups had better records compared to the matched comparison group post discharge (crash ratio < 1).…”

Section: Resultsmentioning

confidence: 99%

“…From this study it appears that those with personality disorders are having crashes due to the behavioural manifestations of their condition; that is, they undertake risky behaviours that impact on their ability to drive safely. Elkema, Brosseau, Koshnick, and McGee [ 48 ] also reported the highest crash rate of those with mental health conditions was those with personality disorders. In this study, it was noted that the behavioural traits demonstrated by those with personality disorders were very different in substance to those with significant mental illness due to depression and bi-polar disorders, associated with an impairment of executive level function.…”

Section: Resultsmentioning

confidence: 99%

“…While psychiatrists may focus on the impact of medication on fitness-to-drive, occupational therapists are able to take clients for on-road driving tests and have been noted to emphasise the driver’s physical status, cognitive skills, impulsivity levels and driving history [ 44 , 46 ] to assist determine fitness-to-drive. Focussing on impulsivity levels may be regarded as important, since impulsivity can be related to risk taking behaviours and difficulty self-regulating; characteristics present in the profile of those drivers most likely to crash [ 38 , 48 , 49 ]. Menard et al [ 44 ] additionally found that occupational therapists paid attention to the client’s perception of their driving ability, factors impacting on their driving capabilities, and identifying goals related to driving.…”

Section: Discussionmentioning

confidence: 99%

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A systematic review of evidence for fitness-to-drive among people with the mental health conditions of schizophrenia, stress/anxiety disorder, depression, personality disorder and obsessive compulsive disorder

Unsworth

Baker

et al. 2017

BMC Psychiatry

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BackgroundLimited evidence exists regarding fitness-to-drive for people with the mental health conditions of schizophrenia, stress/anxiety disorder, depression, personality disorder and obsessive compulsive disorder (herein simply referred to as ‘mental health conditions’). The aim of this paper was to systematically search and classify all published studies regarding driving for this population, and then critically appraise papers addressing assessment of fitness-to-drive where the focus was not on the impact of medication on driving.MethodsA systematic search of three databases (CINAHL, PSYCHINFO, EMBASE) was completed from inception to May 2016 to identify all articles on driving and mental health conditions. Papers meeting the eligibility criteria of including data relating to assessment of fitness-to-drive were critically appraised using the American Academy of Neurology and Centre for Evidence-Based Medicine protocols.ResultsA total of 58 articles met the inclusion criteria of driving among people with mental health conditions studied, and of these, 16 contained data and an explicit focus on assessment of fitness-to-drive. Assessment of fitness-to-drive was reported in three ways: 1) factors impacting on the ability to drive safely among people with mental health conditions, 2) capability and perception of health professionals assessing fitness-to-drive of people with mental health conditions, and 3) crash rates. The level of evidence of the published studies was low due to the absence of controls, and the inability to pool data from different diagnostic groups. Evidence supporting fitness-to-drive is conflicting.ConclusionsThere is a relatively small literature in the area of driving with mental health conditions, and the overall quality of studies examining fitness-to-drive is low. Large-scale longitudinal studies with age-matched controls are urgently needed in order to determine the effects of different conditions on fitness-to-drive.Electronic supplementary materialThe online version of this article (10.1186/s12888-017-1481-1) contains supplementary material, which is available to authorized users.

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“…However, it is also true that people with psychiatric disorders may have a higher risk of RTAs. Most dangerous appear to be those with dementia followed, in turn, by hypomania and mania, severe depression with suicidal ideation, personality disorders, and neurotic disorders, including anxiety states 8–10 . The ability to estimate speed is likely to be impaired in people experiencing a hypomanic episode due to increased psychomotor activity and may increase the risk of RTAs.…”

Section: The Literaturementioning

confidence: 99%

‘Fitness to Drive’ in New Zealand: Psychiatric Aspects and the Clinician's Role

Kumar

Pickering²

2001

Australas Psychiatry

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Objectives: The Land Transport Act 1998 of New Zealand requires that medical practitioners must inform the Director of Land Transport if a patient they examine has a mental or physical condition that indicates that the patient should not be permitted to drive. The guidelines issued by the Land Transport Safety Authority (LTSA) for clinicians assessing a consumer’s fitness to drive are under review. The current guidelines for such assessment are controversial. This paper aims to review the evidence for various factors that psychiatrists should consider when assessing a mental health consumer’s fitness to drive. Conclusions: The assessment of fitness to drive should be based on clinical factors and not on diagnosis alone or the legal status of the consumer, as stipulated in the current guidelines. We offer several recommendations regarding the psychiatrist’s role in the new guidelines.

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A statistical study on the relationship between mental illness and traffic accidents--a pilot study.

Cited by 47 publications

References 10 publications

Driving ability in schizophrenic patients: effects of neuroleptics

Driving ability in schizophrenic patients: effects of neuroleptics

A systematic review of evidence for fitness-to-drive among people with the mental health conditions of schizophrenia, stress/anxiety disorder, depression, personality disorder and obsessive compulsive disorder

‘Fitness to Drive’ in New Zealand: Psychiatric Aspects and the Clinician's Role

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