Abstract
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.
Highlights
Limited 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
The second largest category of papers related to assessment of fitness-to-drive, and this topic was further explored in relation to ‘impact of specific mental health conditions on the ability to drive safely’, ‘health professionals’ role in assessing fitness-to-drive’, and ‘crash statistics’
This review has demonstrated that a number of health professionals feel ill-equipped to make fitness-to-drive recommendations for people with mental health conditions
Summary
Limited 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 ( referred to as ‘mental health conditions’). The fitness-todrive of people with mental health conditions may vary within individuals due to both the effects of the illness itself, as well as the impact of psychiatric drugs on driving performance. Individuals diagnosed with mental health conditions may experience reduced attention, visual spatial functioning, impulse control, judgement, as well as alterations in information processing ability and slowed psychomotor reaction times [5,6,7]. These difficulties can all impair driving abilities [8, 9] and may lead to a recommendation not to drive, a restricted driving licence, driving suspension or licence cancellation [10]. It is important that any restriction is based on evidence to the greatest extent possible, and reflects a due balance between mobility and safety [11] as driving cessation is associated with increased levels of depression [12]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
