Fitness-to-Drive in Persons with Psychiatric Disorders and Those Using Psychotropic Medications

摘要

Background: There is concern that mental illnesses, and/or medications associated with their treatment, can affect fitness-to-drive. Internationally, occupational therapists are the professional group that most commonly assesses fitness-to-drive. Objective: A systematic review of the literature was done to identify and appraise the scientific evidence on fitness-to-drive amongst people with mental illness and those using psychotropic medications. Results: Fourteen studies were retrieved. In eight, mental illness was linked to higher traffic accident rates. Some psychotropic medications have the potential to negatively affect fitness-to-drive, especially in the starting phase of treatment, or when adjusting medications. Newer anti-depressants have been shown to improve specific pre-requisite skills for driving. Although newer antipsychotic medications improve cognitive skills, these improvements do not translate into driving-related tasks. Conclusion: Accident rates are higher among sub-groups of individuals including those having the most severe degree of mental illness and those using specific psychotropic medications such as benzodiazepines. These findings are sufficient to argue the need for attention on standardized screening and assessment of fitness-to-drive in psychiatric patients.