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

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Abstract

Background

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 (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.

Methods

A 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.

Results

A 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.

Conclusions

There 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 material

The online version of this article (10.1186/s12888-017-1481-1) contains supplementary material, which is available to authorized users.

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Author and article information

Contributors

Carolyn A. Unsworth: c.unsworth@cqu.edu.au

Anne M. Baker: Anne.Baker@acu.edu.au

Man H. So: heysh1121@gmail.com

Priscilla Harries:

ORCID: http://orcid.org/0000-0003-3123-6799

priscilla.harries@brunel.ac.uk

Desmond O’Neill: Desmond.ONeill@amnch.ie

Journal

Journal ID (nlm-ta): BMC Psychiatry

Journal ID (iso-abbrev): BMC Psychiatry

Title: BMC Psychiatry

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-244X

Publication date (Electronic): 31 August 2017

Publication date PMC-release: 31 August 2017

Publication date Collection: 2017

Volume: 17

Electronic Location Identifier: 318

Affiliations

[1 ]ISNI 0000 0001 2193 0854, GRID grid.1023.0, Central Queensland University, ; Melbourne, Australia

[2 ]ISNI 0000 0001 2194 1270, GRID grid.411958.0, Australian Catholic University, ; Melbourne, Australia

[3 ]ISNI 0000 0001 0724 6933, GRID grid.7728.a, Brunel University London, ; London, UK

[4 ]ISNI 0000 0004 1936 9705, GRID grid.8217.c, Trinity College, ; Dublin, Republic of Ireland

Author information

Priscilla Harries http://orcid.org/0000-0003-3123-6799

Article

Publisher ID: 1481

DOI: 10.1186/s12888-017-1481-1

PMC ID: 5579945

PubMed ID: 28859696

SO-VID: 0899725c-dc85-42bc-b145-76e3826c0bb6

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.