Opinion: Alcohol & Health, Drinking & Driving

Finding Links between DUI Offenders and Mental Health

In settings where mental health disorders are common, but secondary to other problems, such as driving under the influence (DUI) offender programs, clients often do not undergo comprehensive screening for psychiatric disorders. Increasing evidence indicates that DUI offenders have high rates of other non-substance-related mental health issues, as well as alcohol-related problems1,2,3. Although there are multiple factors that contribute to the decision to drive under the influence, it is likely that experiencing more than one mental health disorder – comorbidity – contributes to DUI behavior and recidivism4,5.

We conducted a study to determine the extent of psychiatric comorbidity among DUI recidivists (offenders who have been convicted of DUI more than once)6. Over 700 DUI offenders entering a two-week inpatient treatment facility for court-sentenced repeat DUI offenders completed a computer-guided interview ( the Composite International Diagnostic Interview7) with a counselor during intake. The interview collected information about multiple different mental health disorders.

Almost all of the offenders in our sample qualified for alcohol abuse or dependence in their lifetime. But more strikingly, almost half had both a substance-related disorder (e.g., alcohol abuse) and a non-substance-related psychiatric disorder, such as bipolar disorder, in their lifetime. Figure 1 shows the prevalence of different disorders in our sample, compared to the general population.

Figure 1. Lifetime Prevalence of Psychiatric Disorders in Repeat DUI Offender Sample and GeneralUSPopulation6

Comorbidity1

Note. General population rates derived from the National Comorbidity Survey Replication8.

In addition to elevated rates of substance use disorders, repeat DUI offenders had significantly higher rates of bipolar disorder, anxiety, PTSD, and conduct disorder than the general population. Figure 2 shows the extent of mental health problems in our sample, compared to the general population.

Figure 2. Extent of Psychiatric Disorders in Repeat DUI Offender Sample and General US Population6

Comorbidity2

Note. General population rates derived from the National Comorbidity Survey Replication8.

These results suggest that DUI treatment needs to begin to identify and address mental health issues beyond alcohol use disorders. It is likely that for some offenders, these underlying mental issues drive both their alcohol use and DUI behavior.


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Footnotes Less
  • 1. Lapham SC, Smith E, C'De Baca J, et al. Prevalence of psychiatric disorders among persons convicted of driving while impaired. Archives of General Psychiatry. Oct 2001;58(10):943-949.
  • 2. Lapham SC, C'De Baca J, McMillan GP, Lapidus J. Psychiatric disorders in a sample of repeat impaired-driving offenders. Journal of studies on alcohol. Sep 2006;67(5):707-713.
  • 3. Oslin DW, O'Brien CP, Katz IR. The disabling nature of comorbid depression among older DUI recipients. American Journal of Addiction. 1999;8(2):128-135.
  • 4. Cavaiola AA, Strohmetz DB, Abreo SD. Characteristics of DUI recidivists: A 12-year follow-up study of first time DUI offenders. Addictive Behaviors. 2007;32(4):855-861.
  • 5. McMillen DL, Adams MS, Wells-Parker E, Pang MG, Anderson BJ. Personality traits and behaviors of alcohol-impaired drivers: a comparison of first and multiple offenders. Addictive Behaviors. 1992;17(5):407-417.
  • 6. Shaffer HJ, Nelson SE, LaPlante DA, LaBrie RA, Albanese MJ, Caro G. The epidemiology of psychiatric disorders among repeat DUI offenders accepting a treatment sentencing option Journal of Consulting and Clinical Psychology. 2007;75(5):795-804.
  • 7. Kessler RC, Ustun TB. The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Int J Methods Psychiatr Res. 2004;13(2):93-121.
  • 8. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. Jun 2005;62(6):593-602.

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