2010 BC Guide in Determining Fitness to Drive

19.4 Effect of psychiatric disorders on functional ability to drivePsychiatric disorders can result in either a persistent or episodic impairment of the functionsnecessary for driving.The role of insightAn individual’s level of insight is a critical consideration when assessing the risk of an episodicimpairment of functional ability due to a psychiatric disorder.Individuals with good insight are more likely to be diligent about their treatment regime and toseek medical attention and avoid driving when experiencing acute episodes. Poor insight may beevidenced by non-compliance with treatment, trivializing the individual’s role in a crash orrepeated involuntary admissions to hospital, often as a result of discontinuing prescribedmedication. 9Mood disorders - Major Depressive Disorder, Bipolar Disorder, Dysthymia (Axis I)Cognitive abilities that may be affected by mood disorders include: attention and concentration memory information processing reaction time, and psychomotor functioning.Anxiety disorders (Axis I)The research on the effects of anxiety disorders on functional ability is limited. Findings fromstudies examining the effects of anxiety disorders on cognitive functioning are equivocal.Neurobiological studies suggest that medial and temporal lobe structures are affected in anxietydisorders. These are structures that are responsible for memory and higher order executivefunctioning. From a clinical perspective, the potential for diminished attention, or perseveratingon errors (including “freezing”) in the face of unexpected risks on the road may be of concern fordriving.9 Determining Medical Fitness to Operate Motor Vehicles – CMA Driver’s Guide, 7 th edition, 2006, pg. 33233