Résumé :
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[BDSP. Notice produite par INIST-CNRS 9R0xC8lH. Diffusion soumise à autorisation]. In order to explore how the choice of different study designs could influence the risk estimates, a case-crossover and case-time-control study were carried out and their outcomes were compared with those of a traditional case-control study design that evaluated the association between the exposure to psychotropic medications and the risk of having a motor vehicle accident (MVA). A record-linkage database availing data for 3,786 cases and 18,089 controls during the period 2000-2007 was used. The study designs (i.e., case-crossover and case-time-control) were derived from published literature, and the following psychotropic medicines were examined : antipsychotics, anxiolytics, hypnotics and sedatives, and antidepressants, stratified in the two groups selective serotonin reuptake inhibitors (SSRIs) and other antidepressants. Moreover, in order to further investigate the effects of frequency of psychoactive medication exposure on the outcomes of the case-crossover analysis, the data were also stratified by the number of defined daily doses (DDDs) and days of medication use in the 12 months before the motor vehicle accident. Three-thousand seven-hundred fifty-two cases were included in this second part of the case-crossover analysis. The case-crossover design did not show any statistically significant association between psychotropic medication exposure and MVA risk [e.g., SSRIs-Adj. OR=1.00 (95% CI : 0.69-1.46) ; Anxiolytics-Adj. OR=0.95 (95% CI : 0.68-1.31) ]. The case-time-control design only showed a borderline statistically significant increased traffic accident risk in SSRI users [Adj. OR=1.16 (95% CI : 1.01-1.34) ]. With respect to the stratifications by the number of DDDs and days of medication use, the analyses showed no increased traffic accident risk associated with the exposure to the selected medication groups [e.g., SSRIs,
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