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Hit-and-run: a Swedish nationwide cohort study of serious transport accidents and convictions due to traffic offenses in obsessive-compulsive disorder
Department of Clinical Neuroscience, Child and Adolescent Psychiatry Research Centre, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Department of Clinical Neuroscience, Child and Adolescent Psychiatry Research Centre, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Department of Clinical Neuroscience, Child and Adolescent Psychiatry Research Centre, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden; Science for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden.
Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
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2022 (English)In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 57, no 9, p. 1817-1827Article in journal (Refereed) Published
Abstract [en]

PURPOSE: 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.

METHODS: 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.

RESULTS: 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).

CONCLUSION: The risks of serious transport accidents and driving-related criminal convictions in OCD are negligible and heavily influenced by psychiatric comorbidity.

Place, publisher, year, edition, pages
Springer, 2022. Vol. 57, no 9, p. 1817-1827
Keywords [en]
Accidents, Injuries, Mortality, Motor vehicles, Obsessive–compulsive disorder, Traffic
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:oru:diva-95444DOI: 10.1007/s00127-021-02182-xISI: 000718740600001PubMedID: 34779877Scopus ID: 2-s2.0-85119085304OAI: oai:DiVA.org:oru-95444DiVA, id: diva2:1612483
Funder
The Karolinska Institutet's Research FoundationSwedish Research CouncilForte, Swedish Research Council for Health, Working Life and Welfare
Note

Funding agency:

United States Department of Health & Human Services

National Institutes of Health (NIH) - USA

Available from: 2021-11-18 Created: 2021-11-18 Last updated: 2023-12-08Bibliographically approved

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Larsson, Henrik

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