title: Mental disorders associated with driving under the influence of alcohol and/or drugs: a register-based study.
abstract: OBJECTIVE
  Mental disorders are associated with driving under the influence (DUI), but the evidence is scarce and mostly focused on a limited group of repeat drunken drivers. Thus, the aim of this study was to examine which mental disorders were risk factors for DUI of alcohol only (DUIA), of illicit drugs (DUID) or of alcohol and psychoactive prescription drugs (DUIAP), and whether and how the risk differs over time.
  
  
  METHODS
  A register-based case-control study was conducted. Cases (n=44,188) suspected by the police of DUI during 1997-2007 and controls (n=45,148) were drawn from the general Finnish population. The official national register of hospital treatments was the data source for mental disorders. The effects of mental disorders on DUI were estimated using logistic regression analysis.
  
  
  RESULTS
  Substance use disorders increased the risk of DUI overall. Childhood- and adolescence-onset disorders were a strong predictor of DUID, and bipolar and depressive disorders predicted DUIAP. The risk was highest soon after hospital admission with a psychiatric diagnosis, but it decreased over time.
  
  
  CONCLUSIONS
  Actions to prevent DUI should be developed and implemented during the treatment of mental disorders.
authors.affiliation: School of Health Sciences, University of Tampere, and Department of Psychiatry, Tampere University Hospital, Tampere, Finland. karoliina.karjalainen@thl.fi
authors.forename: Karoliina
authors.initials: K
authors.lastname: Karjalainen
authors.forename: Tomi
authors.initials: T
authors.lastname: Lintonen
authors.forename: Matti
authors.initials: M
authors.lastname: Joukamaa
authors.forename: Pirjo
authors.initials: P
authors.lastname: Lillsunde
mesh_terms: D000328:Adult; D000435:Alcoholic Intoxication / Q000150:complications / Q000453:epidemiology*; D001334:Automobile Driving / Q000523:psychology*; D016022:Case-Control Studies; D017831:Diagnosis, Dual (Psychiatry) / Q000523:psychology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000453:epidemiology*; D063487:Prescription Drug Misuse; D011619:Psychotropic Drugs / Q000009:adverse effects*; D012042:Registries; D012307:Risk Factors; D012727:Sex Characteristics; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology*
chemical_list: D013287:Illicit Drugs; D011619:Psychotropic Drugs