Youth with mood disorders less likely to acquire driver's license and have higher rates of road accidents: JAMA

The findings published in JAMA Network Open suggest that opportunities may exist to improve driving autonomy among youths with mood disorders while concurrently ensuring safe mobility.

Driving is a rite of passage for many youths, symbolizing independence and freedom. However, for those living with mood disorders, the journey to obtaining a driver's license and navigating the responsibilities of driving can be fraught with unique challenges.

Mood disorders, such as bipolar disorder and depression, affect millions of youths worldwide. These conditions can significantly affect several aspects of daily life, including decision-making, impulse control, and emotional regulation—essential skills for safe driving. The understanding of how mood disorders are associated with youth driving outcomes is limited. To widen the knowledge about the same, Christopher E. Gaw, Division of Emergency Medicine, Nationwide Children’s Hospital, Columbus, Ohio, and colleagues aimed to examine the association between the presence of a mood disorder and rates of licensing, crashes, violations, and suspensions among adolescents and young adults.

For this purpose, the researchers undertook a cohort study among New Jersey residents born between 1987 to 2000, age eligible to acquire a driver’s license from 2004 to 2017, and patients of the Children’s Hospital of Philadelphia network within 2 years of licensure eligibility at age 17 years.

Among 1879 youths with and 84 294 youths without a current mood disorder from 2004 to 2017, rates of licensure and driving outcomes among youths who were licensed were compared.

The investigators assessed the acquisition of a driver’s license and first involvement as a driver in a police-reported crash and rates of other adverse driving outcomes. Adjusted rate ratios (aRRs) were estimated for driving outcomes 12 and 48 months following licensure. Survival analysis was used to estimate adjusted hazard ratios (aHRs) for driving and licensing outcomes.

The study led to the following findings:

• Among 86 173 youths (median age at the end of the study, 22.8 years; 49.8% were females), there were 1879 youths with and 84 294 youths without a mood disorder.
• A greater proportion of youths with mood disorders were female (65.2%) compared with those without mood disorders (49.4%).
• At 48 months after licensure eligibility, 75.5% and 83.8% of youths with and without mood disorders, respectively, had acquired a license.
• Youths with mood disorders were 30% less likely to acquire a license than those without a mood disorder (aHR, 0.70).
• Licensed youths with mood disorders had higher overall crash rates than those without mood disorders over the first 48 months of driving (137.8 vs 104.8 crashes per 10,000 driver-months; aRR, 1.19); licensed youths with mood disorders also had higher rates of moving violations (aRR, 1.25) and license suspensions (aRR, 1.95).

In conclusion, the study found that youths with mood disorders were less likely to be licensed and had higher rates of adverse driving outcomes than those without mood disorders.

"These findings suggest that opportunities may exist to enhance driving mobility in this population and elucidate the mechanisms by which mood disorders are associated with crash risk," the researchers wrote.

Reference:

Gaw CE, Metzger KB, Pfeiffer MR, et al. Driver’s Licensure and Driving Outcomes Among Youths With Mood Disorders. JAMA Netw Open. 2024;7(4):e245543. doi:10.1001/jamanetworkopen.2024.5543