Skip to main content
Erschienen in: European Archives of Psychiatry and Clinical Neuroscience 8/2009

01.12.2009 | Original Paper

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

verfasst von: Alexander Brunnauer, Gerd Laux, Sarah Zwick

Erschienen in: European Archives of Psychiatry and Clinical Neuroscience | Ausgabe 8/2009

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat 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 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
2.
Zurück zum Zitat 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 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
3.
Zurück zum Zitat 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 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
4.
Zurück zum Zitat 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 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
5.
Zurück zum Zitat Green MF, Kern RS, Heaton RK (2004) Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS. Schizophr Res 72:41–51CrossRefPubMed Green MF, Kern RS, Heaton RK (2004) Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS. Schizophr Res 72:41–51CrossRefPubMed
6.
Zurück zum Zitat 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 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
7.
Zurück zum Zitat Edlund MJ, Conrad C, Morris P (1989) Accidents among schizophrenic outpatients. Compr Psychiatry 30:522–526CrossRefPubMed Edlund MJ, Conrad C, Morris P (1989) Accidents among schizophrenic outpatients. Compr Psychiatry 30:522–526CrossRefPubMed
8.
Zurück zum Zitat Waller JA (1965) Chronic medical conditions and traffic safety: a review of the California experience. N Engl J Med 273:1413–1420PubMedCrossRef Waller JA (1965) Chronic medical conditions and traffic safety: a review of the California experience. N Engl J Med 273:1413–1420PubMedCrossRef
9.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat Soyka M, Kagerer S, Brunnauer A (2005) Driving ability in schizophrenic patients: effects of neuroleptics. Int J Psychiatr Clin Pract 9(3):168–174CrossRef 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.
Zurück zum Zitat Tanida K, Poeppel E (2006) A hierarchical model of operational anticipation windows in driving an automobile. Cogn Process 7:275–287CrossRefPubMed Tanida K, Poeppel E (2006) A hierarchical model of operational anticipation windows in driving an automobile. Cogn Process 7:275–287CrossRefPubMed
17.
Zurück zum Zitat Rapoport MJ, Banina MC (2007) Impact of psychotropic medications on simulated driving: a critical review. CNS Drugs 21(6):503–519CrossRefPubMed Rapoport MJ, Banina MC (2007) Impact of psychotropic medications on simulated driving: a critical review. CNS Drugs 21(6):503–519CrossRefPubMed
18.
Zurück zum Zitat Bukasa B, Kisser R, Wenninger U (1990) Computergestützte Leistungsdiagnostik bei verkehrspsychologischen Eignungsuntersuchungen. Diagnostica 36:148–165 Bukasa B, Kisser R, Wenninger U (1990) Computergestützte Leistungsdiagnostik bei verkehrspsychologischen Eignungsuntersuchungen. Diagnostica 36:148–165
19.
Zurück zum Zitat Karner T, Biehl B (2001) Über die Zusammenhänge verschiedener Versionen von Leistungstests im Rahmen der verkehrspsychologischen Diagnostik. Z Verkehrssicherheit 42:53–63 Karner T, Biehl B (2001) Über die Zusammenhänge verschiedener Versionen von Leistungstests im Rahmen der verkehrspsychologischen Diagnostik. Z Verkehrssicherheit 42:53–63
20.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat Harvey PD, Keefe RS (2001) Studies of cognitive change in patients with schizophrenia following novel antipsychotic treatment. Am J Psychiatry 158:176–184CrossRefPubMed Harvey PD, Keefe RS (2001) Studies of cognitive change in patients with schizophrenia following novel antipsychotic treatment. Am J Psychiatry 158:176–184CrossRefPubMed
25.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat Sax KW, Strakowski SM, Keck PE Jr (1998) Attentional improvement following quetiapine fumarate treatment in schizophrenia. Schizophr Res 33:151–155CrossRefPubMed Sax KW, Strakowski SM, Keck PE Jr (1998) Attentional improvement following quetiapine fumarate treatment in schizophrenia. Schizophr Res 33:151–155CrossRefPubMed
32.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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
Metadaten
Titel
Driving simulator performance and psychomotor functions of schizophrenic patients treated with antipsychotics
verfasst von
Alexander Brunnauer
Gerd Laux
Sarah Zwick
Publikationsdatum
01.12.2009
Verlag
D. Steinkopff-Verlag
Erschienen in
European Archives of Psychiatry and Clinical Neuroscience / Ausgabe 8/2009
Print ISSN: 0940-1334
Elektronische ISSN: 1433-8491
DOI
https://doi.org/10.1007/s00406-009-0014-4

Weitere Artikel der Ausgabe 8/2009

European Archives of Psychiatry and Clinical Neuroscience 8/2009 Zur Ausgabe

Demenzkranke durch Antipsychotika vielfach gefährdet

23.04.2024 Demenz Nachrichten

Wenn Demenzkranke aufgrund von Symptomen wie Agitation oder Aggressivität mit Antipsychotika behandelt werden, sind damit offenbar noch mehr Risiken verbunden als bislang angenommen.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

„Psychotherapie ist auch bei sehr alten Menschen hochwirksam!“

22.04.2024 DGIM 2024 Kongressbericht

Die Kombination aus Medikamenten und Psychotherapie gilt als effektivster Ansatz bei Depressionen. Das ist bei betagten Menschen nicht anders, trotz Besonderheiten.

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

22.04.2024 DGIM 2024 Nachrichten

Um Menschen nach der Flucht aus einem Krisengebiet bestmöglich medizinisch betreuen zu können, ist es gut zu wissen, welche Erkrankungen im jeweiligen Herkunftsland häufig sind. Dabei hilft eine Internetseite der CDC (Centers for Disease Control and Prevention).

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.