Observational studyBMJ open2024
Schizophrenia, antipsychotic treatment adherence and driver responsibility for motor vehicle crash: a population-based retrospective study in British Columbia, Canada.
Observational study in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- The Driving Profile of Individuals with Schizophrenia: Cognitive Characteristics, Pharmacological Treatment and Driving Competence-A Scoping Review.Neurology international · 2026Review
- Psychosis and diving.Diving and hyperbaric medicine · 2025Review
- Antipsychotic treatment adherence and motor vehicle crash among drivers with schizophrenia: a case-crossover study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine the relationship between schizophrenia, antipsychotic medication adherence and driver responsibility for motor vehicle crash.
designRetrospective observational cohort study using 20 years of population-based administrative health and driving data.
settingBritish Columbia, Canada.
participantsLicensed drivers who were involved in a police-attended motor vehicle crash in British Columbia over a 17-year study interval (2000-16). EXPOSURES: Incident schizophrenia was identified using hospitalisation and physician services data. Antipsychotic adherence was estimated using prescription fill data to calculate the 'medication possession ratio' (MPR) in the 30 days prior to crash. PRIMARY OUTCOME MEASURES: We deemed drivers 'responsible' or 'non-responsible' for their crash by applying a validated scoring tool to police-reported crash data. We used logistic regression to evaluate the association between crash responsibility and exposures of interest.
resultsOur cohort included 808 432 drivers involved in a police-attended crash and for whom crash responsibility could be established. In total, 1689 of the 2551 drivers with schizophrenia and 432 430 of the 805 881 drivers without schizophrenia were deemed responsible for their crash, corresponding to a significant association between schizophrenia and crash responsibility (66.2% vs 53.7%; adjusted OR (aOR), 1.67; 95% CI, 1.53 to 1.82; p<0.001). The magnitude of this association was modest relative to established crash risk factors (eg, learner license, age ≥65 years, impairment at time of crash). Among the 1833 drivers with schizophrenia, near-optimal antipsychotic adherence (MPR ≥0.8) in the 30 days prior to crash was not associated with lower crash responsibility (aOR, 1.04; 95% CI, 0.83 to 1.30; p=0.55).
conclusionsCrash-involved drivers with schizophrenia are more likely to be responsible for their crash, but the magnitude of risk is similar to socially acceptable risk factors such as older age or possession of a learner license. Contemporary driving restrictions for individuals with schizophrenia appear to adequately mitigate road risks, suggesting more stringent driving restrictions are not warranted.
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