2010 BC Guide in Determining Fitness to Drive

Negative symptoms are characterized by the absence of thoughts and behaviours that wouldotherwise be expected. This may be manifested as limited ability to think abstractly, toexpress emotion, to initiate activities, or to become motivated.The onset of Schizophrenia can occur at any age, but most typically appears in early adulthood.Many individuals with Schizophrenia have recurring acute psychotic attacks (consisting ofpositive and/or disorganized symptoms) throughout their life, which are typically separated byintervening periods in which they usually experience residual or negative symptoms. It is nowrecognized that early intervention (promptly at the time of the first psychotic break) is veryimportant in preventing major cognitive impairment resulting from this condition.Personality disorders (Axis II)There are a number of personality disorders identified in the DSM-IV-TR, including: Borderline Personality Disorder Schizotypal Personality Disorder Anti-Social Personality Disorder, and Narcissistic Personality Disorder.Onset typically occurs during adolescence or in early adulthood. The disorder affects thought,emotion, interpersonal relationships, and impulse control. Symptoms include difficulty gettingalong with people and the presence of consistent behaviours that deviate markedly from societalexpectations. The prognosis depends on whether the person has an awareness and acceptance ofthe disorder and its manifestations, and is willing to engage in treatment.Mental retardation (Axis II)The DSM-IV-TR defines Mental Retardation as significantly sub-average intellectualfunctioning (an IQ of 70 or below), with onset before the age of 18 years, and concurrent deficitsor impairments in adaptive functioning.Suicidal ideationSuicidal ideation is defined as having thoughts of suicide or taking action to end one’s own life,irrespective of whether the thoughts include a plan to commit suicide. Studies indicate that morethan 90% of all suicides are associated with psychiatric disorders.InsightFor individuals with psychiatric disorders, insight is an important factor in their ability to adhereto treatment and respond appropriately to their condition. In general, individuals with sufficientinsight are those who are aware of any cognitive limitations caused by their disorder and whohave the judgment and willingness to adapt their driving to these limitations.229