| Poster | Poster Session 05 Program Schedule
02/15/2024
02:30 pm - 03:45 pm
Room: Shubert Complex (Posters 1-60)
Poster Session 05: Neuropsychiatry | Addiction/Dependence | Stress/Coping | Emotional/Social Processes
Final Abstract #18
Aviation Mental Health: A Systematic Review of Depression and Suicide in Airline Pilots
Arlene Chang, Northwood High School, Irvine, United States
Paul Lewis, Columbia University Vagelos College of Physicians and Surgeons, New York City, United States
Category: Psychiatric Disorders
Keyword 1: depression
Objective:
The Germanwings Disaster of 2015 involved one pilot deliberately crashing the plane into the French Alps, committing aircraft assisted suicide. This disaster raised awareness about pilot mental health during a time when the mental welfare of pilots was often overlooked. This systematic review aims to examine depression and suicidal ideation in the context of aviation pilots.
Participants and Methods:
A systematic review was conducted following PRISMA guidelines using four databases: PubMed, Cochrane, Google Scholar, and PsycInfo. Various iterations of keywords such as “aviation mental health,” “depression,” “pilots,” and “aircraft assisted suicide,” were searched. A total of 469 articles were found and filtered based on titles and abstracts, and then full body texts yielding 26 relevant articles for the final analysis. Articles were excluded due to other psychiatric conditions (ADHD), language (other than English), and relevance (focused on general aviation medicine).
Results:
Depression in pilots from airline companies, unions, and aviation organizations had a higher prevalence rate (12.6%) than the general population (6%: OR 2.26), similar to other stressful professions such as flight attendants, doctors, and firefighters. 12.6% of 1848 surveyed pilots in one study scored ≥ 10 on the Patient Health Questionnaire (PHQ-9), and 4.1% of pilots reported suicidal thoughts in the past two weeks. Female pilots had a greater proportion of having at least one day of poor mental health in the last month (55.2%) compared to male pilots (45.6% OR: 1.47). Factors that contribute to higher depression and suicidal ideation rates in pilots consisted of unusual work schedules, frequent jetlag, mental stress in the cockpit, burnout, and noise as an environmental stressor. Of pilots frequently consuming substances like alcohol, 16.2% of them met the depression threshold. From 1990 to 2001, use of unreported antidepressants in 61 pilots involved in accidents were detected, which could potentially be a danger if the medication in question produced side effects incompatible with flying. From 1993 to 2012, 24 (0.33%) of 7244 flight accidents were due to aircraft assisted suicides. About half of these suicides had an identifiable stressor including illness, legal issues, and relationship problems. Additionally, it was approximated that five in six aircraft assisted suicides occurred when the pilots were left alone in the cockpit. 56.1% of 3765 surveyed pilots anonymously reported a history of healthcare avoidance for their mental illness due to fear of losing their aeromedical certificate. Support programs that screen for pilot’s mental health without any repercussions have been deemed promising interventions for promoting health seeking behavior.
Conclusions:
Mental illness like depression is especially prevalent in pilots. Due to the low number of reports of aircraft assisted suicides, depression cannot be correlated with fatal flight accident risk or danger to passengers. However, considering the prevalence of depression in pilots, further analysis of the factors influencing pilot mental health may improve understanding of the role of mental illness in flight accidents and elucidate avenues for intervention for improving pilot wellbeing.
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