Mataix-Cols David, Fernández de la Cruz Lorena, Brander Gustaf, Andersson Erik, D'Onofrio Brian M, Rück Christian, Larsson Henrik, Lichtenstein Paul, Sidorchuk Anna
Department of Clinical Neuroscience, Child and Adolescent Psychiatry Research Centre, Karolinska Institutet, Gävlegatan 22B, 8th floor, 113 30 , Stockholm, Sweden.
Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Soc Psychiatry Psychiatr Epidemiol. 2022 Sep;57(9):1817-1827. doi: 10.1007/s00127-021-02182-x. Epub 2021 Nov 15.
Individuals with obsessive-compulsive disorder (OCD) often report driving-related obsessions, such as fears of causing accidents, but the risk of transport accidents in OCD is unknown. We investigated whether individuals with OCD have an increased risk of serious transport accidents and convictions due to traffic offenses and explored the role of psychiatric comorbidities.
We included all individuals ≥ 18 years living in Sweden between 1997 and 2013 (N = 5,760,734). A total of 23,126 individuals had a diagnosis of OCD in the National Patient Register. We also identified 16,607 families with full siblings discordant for OCD. Cox proportional hazards regression models estimated hazard ratios (HRs) with 95% confidence intervals (CIs) for the risk of three outcomes in individuals with OCD, compared to unexposed individuals and their unexposed full siblings: injuries or deaths due to transport accidents, injuries or deaths due to motor vehicle accidents, and convictions related to traffic offenses. Psychiatric comorbidities were systematically adjusted for.
Women, but not men, with OCD had a marginally increased risk of serious transport accidents (adjusted HR = 1.20 [95% CI 1.13-1.28]) and motor vehicle accidents (adjusted HR = 1.20 [95% CI 1.09-1.31]), compared to unaffected individuals. Neither women nor men with OCD had a significantly increased risk of convictions. The sibling comparisons showed no significant associations. When psychiatric comorbidities were adjusted for, several observed associations became non-significant or inversed (HRs and 95% CIs below one).
The risks of serious transport accidents and driving-related criminal convictions in OCD are negligible and heavily influenced by psychiatric comorbidity.
患有强迫症（OCD）的个体经常报告与驾驶相关的强迫观念，例如害怕引发事故，但强迫症患者发生交通事故的风险尚不清楚。我们调查了强迫症患者发生严重交通事故及因交通违法被定罪的风险是否增加，并探讨了精神共病的作用。
我们纳入了1997年至2013年居住在瑞典的所有≥18岁的个体（N = 5,760,734）。在国家患者登记处，共有23,126名个体被诊断为强迫症。我们还识别出16,607个家庭，其同胞兄弟姐妹中一方患有强迫症而另一方未患病。Cox比例风险回归模型估计了强迫症患者与未暴露个体及其未暴露的同胞兄弟姐妹相比，发生三种结局的风险的风险比（HR）及95%置信区间（CI）：因交通事故导致的受伤或死亡、因机动车事故导致的受伤或死亡以及与交通违法相关的定罪。对精神共病进行了系统调整。
与未患病个体相比，患有强迫症的女性而非男性发生严重交通事故（调整后HR = 1.20 [95% CI 1.13 - 1.28]）和机动车事故（调整后HR = 1.20 [95% CI 1.09 - 1.31]）的风险略有增加。患有强迫症的女性和男性被定罪的风险均未显著增加。同胞比较未显示出显著关联。当对精神共病进行调整后，一些观察到的关联变得不显著或相反（HR及95% CI低于1）。
强迫症患者发生严重交通事故及与驾驶相关的刑事定罪的风险可忽略不计，且受精神共病的影响很大。
