[Association Between Grounds for Legal Commitment to a Psychiatric Facility and Assessment of Fitness to Drive: An Orientating Analysis of the Relevance of Driving-Related Medicine to the National Health Service and Other Implicated Actors]

[精神病强制入院理由与驾驶能力评估之间的关联:对驾驶相关医学对国民医疗服务体系及其他相关机构意义的初步分析]

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Abstract

AIM OF THE STUDY: The objective of this analysis was to record the social and epidemiological characteristics of a specific sample population, as well as to identify any associations between a previous commitment to a public facility on legal grounds and subsequent assessments of an individual's fitness to drive as per the National Health Service (or "ÖGD"). METHODS: For the retrospective data analysis, the documents of 87 subjects were evaluated who had been committed to public psychiatric institutions on legal grounds between 2015 and 2019. Using the SAS software package, frequency distributions and statistical relationships were identified between specific features of the commitment to accommodation and the assessment of fitness to drive by means of Chi-squared testing. RESULTS: The average age of the study cohort was 43.5 years (range: 16-82 years; male: 59%). The most frequent grounds for commitment to a facility were suicidal intentions expressed by the person in question. In one third of the cases, these individuals were under the influence of alcohol at the time of commitment to the facility, and drug use was documented in 3 of the 87 cases. In 74% of cases, confinement was solely due to an individual's risk to themselves; in 26% a risk to others was (additionally) identified; and in 20% of those affected, there was verbal and/or physical resistance to commitment to the accommodation facility. In 57% of cases, the medical evaluation raised doubts about the individual's fitness to drive, resulting in the matter being referred on to the driving license authority. Statistically significant associations were demonstrated between: a) the grounds for commitment to a facility; the type of risk; and resistance to commitment being enforced, and b) the results of a fitness-to-drive assessment carried out by the ÖGD. CONCLUSION: The data available on individuals committed to public facilities on legal grounds in connection with driving-related medical issues should be optimised to improve quality, whereby the anonymous registration system, introduced on the basis of the Bavarian Mental Health Act ("BayPsychoKHG"), can make a contribution in this regard. In addition, further qualification measures for effective quality management are necessary for all actors involved.

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