Unsworth Carolyn A, Baker Anne M, So Man H, Harries Priscilla, O'Neill Desmond
Central Queensland University, Melbourne, Australia.
Australian Catholic University, Melbourne, Australia.
BMC Psychiatry. 2017 Aug 31;17(1):318. doi: 10.1186/s12888-017-1481-1.
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.
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.
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.
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.
关于精神分裂症、应激/焦虑障碍、抑郁症、人格障碍和强迫症（以下简称为“精神健康状况”）患者的驾驶适宜性，现有证据有限。本文旨在系统检索并分类所有已发表的关于该人群驾驶的研究，然后对重点并非药物对驾驶影响的驾驶适宜性评估相关论文进行批判性评价。
对三个数据库（CINAHL、PSYCHINFO、EMBASE）从建库至2016年5月进行系统检索，以识别所有关于驾驶和精神健康状况的文章。使用美国神经病学学会和循证医学中心的方案对符合纳入标准（包括与驾驶适宜性评估相关数据）的论文进行批判性评价。
共有58篇文章符合所研究的精神健康状况患者驾驶的纳入标准，其中16篇包含数据且明确聚焦于驾驶适宜性评估。驾驶适宜性评估通过三种方式报告：1）影响精神健康状况患者安全驾驶能力的因素，2）评估精神健康状况患者驾驶适宜性的健康专业人员的能力和认知，3）事故率。由于缺乏对照以及无法汇总不同诊断组的数据，已发表研究的证据水平较低。支持驾驶适宜性的证据相互矛盾。
精神健康状况患者驾驶领域的文献相对较少，且研究驾驶适宜性的整体质量较低。迫切需要开展有年龄匹配对照的大规模纵向研究，以确定不同状况对驾驶适宜性的影响。
