Depression is a common mental disorder with known cognitive deficits, but little is known about the relationship between depression and driving ability. Besides the influence of depression on driving ability, antidepressant treatment may also affect performance. Because of their therapeutic effects, antidepressants may counteract a possible negative influence of depression on driving ability. On the other hand, specifically in the first weeks of antidepressant treatment before the therapeutic effect is apparent, antidepressants may have no positive or even additional detrimental effects on driving ability. Negative effects may be caused by mild adverse cognitive side effects of SSRI (Specific Serotonin Reuptake Inhibitors) type antidepressants. The importance of the present study is to gain insight in the influence of depression, as well as the time course of the interaction between depression effects and those of pharmacological treatment, with regard to driving and cognition. Actual driving performance and cognitive performance of 24 patients with unipolar depressive disorder (based on DSM-IV criteria(American Psychiatric Association, 1994)) without antidepressant treatment and 23 patients with unipolar depressive disorder who were treated with an SSRI type antidepressant for 6-52 weeks were compared to matched controls. A third patient group who receives SSRI treatment for less than 3 weeks is also being tested, but data collection is ongoing for this group. Effects of depression and treatment effects were assessed using cognitive tests assessing memory, attention and psychomotor speed, and two standardized on-the-road driving tests: the standard deviation of the lateral position (SDLP) and the car-following test. Depression severity was assessed using various depression rating scales, including the Hamilton Depression Rating Scale (HDRS). The results show that, in accordance with the hypotheses, depression is associated with a significant and quite robust reduction of driving ability as was measured by the SDLP. Secondly, successful treatment of depression with a SSRI-type antidepressant seems to alleviate not only depressive symptoms but also improved driving ability. However, performance in this SSRI treated group was still significantly worse than that of their matched healthy controls, cognitive. Further information about IMMORTAL can be found on the website see http://www.immortal.or.at/ (Author/publisher)
Samenvatting