Are People with OCD at Higher Risk for Serious Car Accidents?

What you need to know

• People with obsessive-compulsive disorder (OCD) do not have a significantly increased risk of serious transport accidents or driving-related criminal convictions compared to the general population.
• Women with OCD had a small (20%) increased risk of serious transport accidents, but this was likely due to lower accident rates in women overall rather than OCD itself.
• The presence of other mental health conditions, especially ADHD, anxiety, and substance use disorders, increased accident risk in people with OCD.

Understanding OCD and driving concerns

Obsessive-compulsive disorder (OCD) is a mental health condition characterized by persistent, unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that a person feels compelled to perform to relieve anxiety. Some people with OCD experience fears related to driving, such as worrying they might accidentally hit someone with their car or cause an accident. These concerns can be very distressing and may lead to excessive checking behaviors or avoidance of driving altogether.

Given these driving-related fears and behaviors, researchers wanted to investigate whether people with OCD actually have a higher risk of being involved in serious transport accidents or receiving driving-related criminal convictions compared to the general population.

How the study was conducted

This study used data from several nationwide registers in Sweden to examine a large population of over 5.7 million adults. The researchers identified 23,126 individuals diagnosed with OCD and compared their outcomes to those of people without OCD. They looked at three main outcomes:

1. Injuries or deaths due to any type of transport accident
2. Injuries or deaths specifically due to motor vehicle accidents
3. Criminal convictions related to traffic offenses (like reckless driving)

The study also examined how other mental health conditions that commonly co-occur with OCD, such as ADHD, anxiety disorders, and depression, might influence these outcomes.

Key findings on accident and conviction risks

Overall, the study found that people with OCD did not have a significantly increased risk of serious transport accidents or driving-related criminal convictions compared to the general population. Some specific findings include:

• Women with OCD had a small (approximately 20%) increased risk of serious transport accidents compared to women without OCD. However, this increase was relatively minor.

• Men with OCD did not have an increased risk of accidents compared to men without OCD.

• Neither men nor women with OCD had a significantly different risk of criminal convictions related to traffic offenses.

• When the researchers looked only at siblings (where one had OCD and one did not), they found no significant differences in accident or conviction risks. This suggests that family factors shared between siblings may account for some of the small increased risk seen in women.

The impact of other mental health conditions

An important finding of this study was that the presence of other mental health conditions alongside OCD had a much stronger influence on accident and conviction risks than OCD itself. In particular:

• People with both OCD and ADHD had a significantly higher risk of accidents and convictions compared to those with just OCD or neither condition.

• Other conditions that increased risks when present alongside OCD included anxiety disorders, post-traumatic stress disorder, substance use disorders, and personality disorders.

• Interestingly, people with both OCD and autism spectrum disorders had a lower risk of accidents, possibly because they may be less likely to drive regularly.

What this means for people with OCD

These findings provide reassuring evidence for people with OCD who may worry about their ability to drive safely. The results suggest that:

• Having OCD alone does not significantly increase your risk of being in a serious accident or receiving a driving-related conviction.

• The driving-related fears experienced by some people with OCD do not translate to an actual increased risk on the road.

• Managing other co-occurring mental health conditions, especially ADHD, may be more important for reducing accident risk than OCD-specific symptoms.

Implications for treatment and licensing

For healthcare providers and licensing authorities, this study suggests that:

• A diagnosis of OCD alone should not be seen as a reason to restrict driving privileges.

• Treatment for OCD patients with driving-related fears can incorporate this objective data to help reduce anxiety.

• Screening for and managing other mental health conditions, particularly ADHD, may be beneficial in reducing accident risk for people with OCD.

Conclusions

• OCD does not significantly increase the risk of serious transport accidents or driving-related criminal convictions.
• Other mental health conditions that often co-occur with OCD have a stronger influence on accident risk.
• People with OCD can be reassured that their condition alone does not make them unsafe drivers.

While this study provides valuable insights, it’s important to note that it focused on serious accidents requiring hospital care or resulting in death. Further research on minor accidents or near-misses could provide additional information. Additionally, individual experiences with OCD can vary widely, so people with significant driving-related symptoms should still work with their healthcare providers to ensure safe driving practices.