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European Archives of Psychiatry and Clinical Neuroscience

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01-12-2009 | Original Paper

Driving simulator performance and psychomotor functions of schizophrenic patients treated with antipsychotics

Authors: Alexander Brunnauer, Gerd Laux, Sarah Zwick

Published in: European Archives of Psychiatry and Clinical Neuroscience | Issue 8/2009

Abstract

The objective of the study is to compare schizophrenic inpatients under antipsychotic monotherapy regarding simulated driving behaviour and psychomotor functions related to driving ability. Schizophrenic inpatients (n = 80) were tested before discharge to outpatient treatment. Data were collected with the computerized Act & React Testsystem and the Wiener Testsystem measuring visual perception, reaction time, attention, vigilance and stress-tolerance. Besides, patients underwent various driving simulations on a static driving simulator (FT-SR 200). Before discharge to outpatient treatment, about 25% of schizophrenic patients must be considered as severely impaired with respect to driving skills. Differences between treatment groups could be shown both in psychomotor measures and in driving simulator performance with a better test performance of patients treated with atypical antipsychotics. Controlling for age, psychopathologic symptoms and extrapyramidal signs, differences in psychomotor measures were most pronounced in concentration and vigilance. As mental disorders itself pose an increased risk of accidents, counselling patients with respect to differential effects of antipsychotic treatment is of great relevance. In addition to psychomotor tests computer-simulated driving seems to be a useful tool in assessing traffic safety under pharmacologic treatment.

Palmer BW, Heaton RK, Gladsjo JA, Evans JD, Patterson TL, Golshan S, Jeste DV (2002) Heterogeneity in functional status among older outpatients with schizophrenia: employment history, living situation, and driving. Schizophr Res 55:205–215CrossRefPubMed

Brunnauer A, Laux G, Zwick S, David I, Schmauss M, Messer Th, Möller H-J, Hermisson I, Steinberg R, Frommberger (2008) Mobility behaviour of patients with mental illness. Dtsch Z Nervenheilkd 27(suppl):120–121

Hambrecht M, Lammertink M, Klosterkötter J, Matuschek E, Pukrop R (2002) Subjective and objective neuropsychological abnormalities in a psychosis prodrome clinic. Br J Psychiatry 43:30–37CrossRef

Velligan DI, Miller AL (1999) Cognitive dysfunction in schizophrenia and its importance to outcome: the place of atypical antipsychotics in treatment. J Clin Psychiatry 60(Suppl 23):25–28PubMed

Green MF, Kern RS, Heaton RK (2004) Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS. Schizophr Res 72:41–51CrossRefPubMed

Velligan DI, Prihoda DJ, Sui D, Ritch JL, Maples N, Miller AL (2003) The effectiveness of quetiapine versus conventional antipsychotics in improving cognitive and functional outcomes in standard treatment settings. J Clin Psychiatry 64:524–531PubMed

Edlund MJ, Conrad C, Morris P (1989) Accidents among schizophrenic outpatients. Compr Psychiatry 30:522–526CrossRefPubMed

Waller JA (1965) Chronic medical conditions and traffic safety: a review of the California experience. N Engl J Med 273:1413–1420PubMedCrossRef

Elkem RC, Bronssean J, Koshnick R, McGee C (1970) A statistical study on the relationship between mental illness and traffic accidents—a pilot study. Am J Public Health 60:459–469CrossRef

10.

Grabe HJ, Wolf T, Gratz S, Laux G (1999) The influence of clozapine and typical neuroleptics on information processing of the central nervous system under clinical conditions in schizophrenic disorders: implications for fitness to drive. Neuropsychobiology 40:196–201CrossRefPubMed

11.

Brunnauer A, Laux G, Geiger E, Moeller H-J (2004) The impact of antipsychotics on psychomotor performance with regards to car driving skills. J Clin Psychopharmacol 24:155–160CrossRefPubMed

12.

Kagerer S, Winter C, Moeller HJ, Soyka M (2003) Effects of haloperidol and atypical neuroleptics on psychomotor performance and driving ability in schizophrenic patients. Results from an experimental study. Neuropsychobiology 47:212–218CrossRefPubMed

13.

Wylie KR, Thompson DJ, Wildgust HJ (1993) Effects of depot neuroleptics on driving performance in chronic schizophrenic patients. J Neurol Neurosurg Psychiatry 56:910–913CrossRefPubMed

14.

Soyka M, Winter C, Kagerer S, Brunnauer A, Laux G, Moeller H-J (2005) Effects of haloperidol and risperidon on psychomotor performance relevant to driving ability in schizophrenic patients compared to healthy controls. J Psychiatr Res 39(1):101–108CrossRefPubMed

15.

Soyka M, Kagerer S, Brunnauer A (2005) Driving ability in schizophrenic patients: effects of neuroleptics. Int J Psychiatr Clin Pract 9(3):168–174CrossRef

16.

Tanida K, Poeppel E (2006) A hierarchical model of operational anticipation windows in driving an automobile. Cogn Process 7:275–287CrossRefPubMed

17.

Rapoport MJ, Banina MC (2007) Impact of psychotropic medications on simulated driving: a critical review. CNS Drugs 21(6):503–519CrossRefPubMed

18.

Bukasa B, Kisser R, Wenninger U (1990) Computergestützte Leistungsdiagnostik bei verkehrspsychologischen Eignungsuntersuchungen. Diagnostica 36:148–165

19.

Karner T, Biehl B (2001) Über die Zusammenhänge verschiedener Versionen von Leistungstests im Rahmen der verkehrspsychologischen Diagnostik. Z Verkehrssicherheit 42:53–63

20.

Brunnauer A, Geiger E, Laux G, Glaser Th, Soyka M, Moeller H-J (2005) Fahrsimulation und psychomotorische Leistungsfähigkeit schizophrener Patienten. Psychopharmakotherapie 12(3):91–96

21.

Brunnauer A, Laux G, Geiger E, Soyka M, Moeller H-J (2006) Antidepressants and driving ability: results from a clinical study. J Clin Psychiatry 67:1776–1781PubMedCrossRef

22.

Dittert S, Soyka M, Winter C, Moeller H-J (1999) Cognition and driving in schizophrenic patients under treatment with risperidone vs. haloperidol. Fortschr Neurol Psychiatr Suppl 2:S70–S73CrossRef

23.

Gallhofer B, Bauer U, Lis S, Krieger S, Gruppe H (1996) Cognitive dysfunction in schizophrenia: comparison of treatment with atypical antipsychotic agents and conventional neuroleptic drugs. Eur Neuropsychopharmacol 6(Suppl 2):S13–S20CrossRefPubMed

24.

Harvey PD, Keefe RS (2001) Studies of cognitive change in patients with schizophrenia following novel antipsychotic treatment. Am J Psychiatry 158:176–184CrossRefPubMed

25.

Bilder RM, Goldman RS, Volavka J, Czobor P, Hoptman M, Sheitman B, Lindenmayer JP, Citrome L, McEvoy J, Kunz M, Chakos M, Cooper TB, Horowitz TL, Lieberman JA (2002) Neurocognitive effects of clozapine, olanzapine, risperidone, and haloperidol in patients with chronic schizophrenia or schizoaffective disorder. Am J Psychiatry 159(6):1018–1028CrossRefPubMed

26.

Tyson PJ, Laws KR, Flowers KA, Tyson A, Mortimer AM (2006) Cognitive function and social abilities in patients with schizophrenia: relationship with atypical antipsychotics. Psychiatry Clin Neurosci 60:473–479CrossRefPubMed

27.

Ramaekers JG, Louwerens JW, Muntjewerff ND, Milius H, de Bie A, Rosenzweig P, Patat A, O’Hanlon JF (1999) Psychomotor, cognitive, extrapyramidal, and affective functions of healthy volunteers during treatment with an atypical (amisulpride) and a classic (haloperidol) antipsychotic. J Clin Psychopharmacol 19:209–221CrossRefPubMed

28.

Rosenzweig P, Canal M, Patat A, Bergougnan L, Zieleniuk L, Bianchetti G (2002) A review of the pharmacokinetics, tolerability and pharmacodynamics of amisulpride in healthy volunteers. Hum Psychopharmacol 17:1–13CrossRefPubMed

29.

Mattila MJ, Patat A, Seppaelea T, Kalska H, Jalava M-L, Vanakoski J, Lavanant C (1996) Single oral doses of amisulpride do not enhance the effects of alcohol on the performance and memory of healthy subjects. Eur J Clin Pharmacol 51:161–166CrossRefPubMed

30.

Velligan DI, Newcomer J, Pultz J, Csernansky J, Hoff AL, Mahurin R, Miller AL (2002) Does cognitive function improve with quetiapine in comparison to haloperidol? Schizophr Res 53:239–248CrossRefPubMed

31.

Sax KW, Strakowski SM, Keck PE Jr (1998) Attentional improvement following quetiapine fumarate treatment in schizophrenia. Schizophr Res 33:151–155CrossRefPubMed

32.

Kivircik Akdede BB, Alptekin K, Kitis A, Arkar H, Akvardar Y (2005) Effects of quetiapine on cognitive functions in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 29:233–238CrossRefPubMed

33.

Kopala LC, Good KP, Milliken H, Buiteman C, Woodley H, Rui Q, Whitehorn D, Love L, Balshaw R, Kiss R, Honer WG (2006) Treatment of a first episode of psychotic illness with quetiapine: an analysis of 2 year outcomes. Schizophr Res 81:29–39CrossRefPubMed

34.

Riedel M, Spellman I, Strassnig M, Douhet A, Dehning S, Opgen-Rhein M, Valdevit R, Engel RR, Kleindienst N, Müller N, Möller HJ (2007) Effects of risperidone and quetiapine on cognition in patients with schizophrenia and predominantly negative symptoms. Eur Arch Psychiatry Clin Neurosci 257:360–370CrossRefPubMed

Title: Driving simulator performance and psychomotor functions of schizophrenic patients treated with antipsychotics
Authors: Alexander Brunnauer
Gerd Laux
Sarah Zwick
Publication date: 01-12-2009
Publisher: D. Steinkopff-Verlag
Published in: European Archives of Psychiatry and Clinical Neuroscience / Issue 8/2009
Print ISSN: 0940-1334
Electronic ISSN: 1433-8491
DOI: https://doi.org/10.1007/s00406-009-0014-4

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Driving simulator performance and psychomotor functions of schizophrenic patients treated with antipsychotics

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