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.
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-todrive
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