CHAPTER


DOI :10.26650/B/SS32.2022.04.12   IUP :10.26650/B/SS32.2022.04.12    Full Text (PDF)

Mood Disorders and Suicidal Behaviors in Pilots

Derya Deniz

It could be said that there is currently a significant increase in the incidence of mood disorders including depression. According to the DSM V, the diagnostic book for mental disorders, mood disorders are classified as bipolar and related disorders and depressive disorders. Even though the incidence of these disorders is lower in pilots compared to the general population, these disorders have aspects related to flight safety due to their nature causing weakening of cognitive capacities or self-harm. Pilots are expected to be emotionally stable, calm, and tolerant to stress, to be agile and brave when appropriate, and to continue to work unrelentingly in the face of difficulties due to the nature of their job. However, mood disorders may develop because of problems in one’s private life, economic difficulties, professional responsibilities, problems about the sense of belonging in corporate life, and the sense of social isolation due to long working hours and travel. It is seen that pilots who experience one of these disorders may avoid seeking treatment because of fear of stigmatization, punishment among colleagues, or fear of being regarded as unsuitable for the occupation. In the history of aviation, there are numerous cases of suicide caused by ‘hidden’ mood disorders of pilots. Therefore, following the mental health processes of the pilots, taking protective measures, and enabling support mechanisms in case of problems are considered important steps in the aviation sector. It should be said that it would be beneficial to conduct a mental health screening in the field and to conduct research on the identification of specific psychological problems.


DOI :10.26650/B/SS32.2022.04.12   IUP :10.26650/B/SS32.2022.04.12    Full Text (PDF)

Pilotlarda Duygudurum Bozuklukları ve İntihar Davranışı

Derya Deniz

İçinde bulunduğumuz çağda depresyon da dâhil olmak üzere duygudurum bozukluklarının görülme sıklığında büyük bir artışın olduğu söylenebilir. Mental bozuklukların tanı kitabı olan DSM V’e göre duygudurum bozuklukları, bipolar ve ilişkili bozukluklar ile depresyon bozuklukları olarak sınıflandırılmaktadır. Genel topluma göre pilotlarda görülme sıklığı daha az olsa da bu bozuklukların bilişsel kapasitede zayıflamaya ya da kendine zarar vermeye yol açan doğası nedeniyle uçuş emniyetini ilgilendiren yönleri bulunmaktadır. Pilotların görevleri gereği duygusal olarak dengeli ve soğukkanlı bir yapıda olması; strese toleranslı, yeri geldiğinde atak ve cesur olması, zorluklar karşısında da yılmadan çalışmaya devam etmesi beklenir. Ancak özel hayattaki problemler, ekonomik güçlükler, mesleki sorumluluklar, kurumsal aidiyette yaşanan problemler, uzun çalışma saatleri ve yolculukların yarattığı sosyal izolasyon hissi nedeniyle duygudurum bozuklukları gelişebilir. Bu bozukluklardan birini yaşayan pilotlar damgalanma, meslektaşları arasında cezalandırılma ya da mesleğe uygun görülmeme korkuları nedeniyle tedaviye başvurmaktan kaçınabilmektedir. Havacılık tarihinde, pilotların -gizledikleri- duygudurum bozuklukları nedeniyle oluşan pek çok intihar vakası bulunmaktadır. Bu nedenle havacılık sektöründe pilotların akıl sağlığı sürecini takip etmek, koruyucu tedbirler almak, sorun yaşamaları halinde onları destekleyecek mekanizmaları devreye sokmak önemli adımlar olarak gözükmektedir. Mevcut riskleri saptama adına sahada psikolojik sağlık taraması yapılmasının ve özgün psikolojik problemlerin tespiti hakkında araştırma yapmanın yararlı olacağı söylenmelidir.



References

  • Akiskal H.S. (2000). Mood disorders. Introduction and overwiev. BJ Sadock, VA Sadock (Ed.) Comprehensive Textbook of Psychiatry (7.baskı) içinde (1284-1298). Baltimore: Lippincott Williams and Wilkins; 1284-1298. google scholar
  • Alec, R. (2000). Psychiatric emergencies suicide. Sadock, VA Sadock (Ed.), Comprehensive Textbook of Psychiatry (8. Baskı) içinde (2031-2040). Philadelphia: Williams & Wilkins Press. google scholar
  • Al-Shawaf, L., Conroy-Beam, D.,Asao, K. ve Buss, D.M.(2016). Human Emotions: An Evolutionary Psychological Perspective. Emotion Review,8(2),173-186. google scholar
  • American Association of Sociolog (2013). AAS homepage. (8 Ağustos 2013 tarihinde http://www.suicidology. org/home adresinden alınmıştır.) google scholar
  • American Psychiatric Association (APA) (2013). Mental bozuklukların tanısal ve sayımsal el kitabı. (Köroğlu, E. Çev.). Ankara: Hekimler Yayın Birliği. google scholar
  • Ateşçi, F.Ç., Kuloğlu, M., Tezcan, E. ve Yıldız, M. (2003). İntihar girişimi olan bireylerde birinci ve ikinci eksen tanıları, Klinik Psikiyatri,5,22-27. google scholar
  • Australian Transport Safety Bureau. (2017). The operational search for MH370. (Publication No. AE-2014-054). (20.08.2021 tarihinde https://www.atsb.gov.au/ media. adresinden alınmıştır.) google scholar
  • Baltaş, Z. ve Baltaş, B.(2013). Stres ve başa çıkma yolları. İstanbul: Remzi Kitabevi. google scholar
  • Bamberger, P.(2009). Employee help-seeking: Antecedents, consequences and new insights for future research. Martocchio JJ, Liao H (Ed.) Research in personnel and human resources management içinde (49-98). UK: Emerald Group Publishing Limited. google scholar
  • Band, P., Deschamps, M., Fang, R., Le, N. ve Gallagher, R. P. (1998). Long term disability rates in a cohort of Air Canada pilots. Aviation, Space, and Environmental Medicine, 69(12), 1137-1140. google scholar
  • Batıgün, A. D. (2005). İntihar olasılığı: Yaşamı sürdürme nedenleri, umutsuzluk ve yalnızlık açısından bir inceleme. Türk Psikiyatri Dergisi, 16 (1), 29- 39. google scholar
  • Black, D.W., Winokur, G. ve Nasrallah, A. (1988). Effect of psychosis on suicide, risk in 1593 patients with unipolar and bipolar affective disorders. Am J Psychiatry, 7,849-880. google scholar
  • Bobo, W.V.(2017). The diagnosis and management of bipolar I and II disorders: Clinical practice update. Mayo Clin Proceedings, 92(10):1532-1551. google scholar
  • Bor, R., Field, G. ve Scragg, P. (2002). The mental health of pilots: An overview. Counseling Psychology Quarterly, 15(3),239-256. DOI: 10.1080/09515070210143471. google scholar
  • Bownds D.M. (1999). Biology of mind. Origins and structures of mind, brain and conciousness. New York: Wiley Press. google scholar
  • Bureau d’Enquetes et d’Analyses pour la securite de l’aviation çivile (2016). Accident d’un Airbus A320-211 immatricule D-AIPX exploite par Germanwings, vol GWI18G, survenu le 24/03/15 â Prads-Haute-Bleone. (20.08.2021 tarihinde https://www.bea.aero/uploads/tx_elydbrapports/BEA2015-0125.en-LR.pdf. adresinden alınmıştır.) google scholar
  • Chaturvedi, A. K. (2010). Postmortem aviation forensic toxicology: an overview. Journal of Analytical Toxicology, 34(4), 169-176. google scholar
  • Cox, D. W., Ghahramanlou-Holloway, M., Greene, F. N., Bakalar, J. L., Schendel, C. L., Nademin, M. E., ... ve Kindt, M. (2011). Suicide in the United States Air Force: Risk factors communicated before and at death. Journal of Affective Disorders, 133(3), 398-405. google scholar
  • Cullen, S. A., Drysdale, H. C. ve Mayes, R. W. (1997). Role of medical factors in 1000 fatal aviation accidents: case note study. BMJ, 314(7094), 1592. google scholar
  • Çakmak, S. (2016). Depresyonla giden duygudurum bozukluklarında ruminasyonla giden üstbilişler. Yayınlanmamış Uzmanlık Tezi, Gaziosmanpaşa Üniversitesi Tıp Fakültesi Ruh Sağlığı ve Hastalıkları Anabilim Dalı, Tokat. google scholar
  • Çetingüç, M. (2019). Havacılık ve uzay psikolojisi. Ankara: Nobel Akademik Eğitim ve Yayıncılık. google scholar
  • DeHoff, M.C. ve Cussick, S.K. (2018). Mental health in commercial aviation - depression & anxiety of pilots. International Journal of Aviation Aeronautics and Aerospace, 5(5), 1-15. google scholar
  • Donaldson, J.S. (2012). JetBlue pilot rage likely not panic; Drugs or brain tumor possible. ABC News. (20.08.2021 tarihinde http://abcnews.go.com/Health/jet-blue-pilot-deeper-problems- panic-attack-medical/ story?id=16019970 adresinden alınmıştır.) google scholar
  • Dubovsky, S.L., Davies,. R. ve Dubovsky, A.N. (2003). Mood disorders. Hales RE, Yudofsky SC (Ed.). Textbook of Clinical Psychiatry (4.baskı) içinde (439-542). Washington: American Psychiatric Publishing. google scholar
  • Durham, J. ve Bliss, T. (2019). Depression and anxiety in pilots: a qualitative study of SSRI usage in U.S. aviation and evaluation of FAA standards and practices compared to ICAO states, Collegiate Aviation Review International, 37 (2), 78-109. google scholar
  • Durkheim, E. (1897). Suicide, a study in sociology (1951 Edition, J. A. Spaulding, & G. Simpson, Trans.). London: Routledge. google scholar
  • Ertemir, D. (2021). Ticari havayolu pilotlarının psikiyatrik değerlendirmesi. İstanbul: Clinart Stratejik Araştırmalar. google scholar
  • Eşel, E. ve Özsoy, S. D. (2003). İntihar (özkıyım). Anadolu Psikiyatri Dergisi, 4, 175-185. google scholar
  • Evans, A. (2013) Mental health/depression in aviation [PowerPoint presentation]. Delivered at the meeting of the International Civil Aviation Organization (ICAO), Bucharest, Romania. (20.08.2021 tarihinde https:// pdfs.semanticscholar.org/ presentation/adfe/986660f7512a16fe2ee68afd5d0bcd4a00b9.pdf adresinden alınmıştır.) google scholar
  • Fawcett, J., Sheftner, W. ve Clark, D. (1987). Clinical predictors of suicide inpatiens with major affective disorder: A controlled prospective study. Am J Psychiatry, 144,35-40. google scholar
  • Fernandez, M. (2012). Passengers restrain captain after crisis on JetBlue flight. The New York Times. (20.08.2021 tarihinde http://www.nytimes.com/2012/03/28/us/jetblue-captain-is- restrained-after-midair-crisis.html. adresinden alınmıştır.) google scholar
  • Flight Safety Foundation (FSF). (2016). FSF statement on Germanwings accident report. Press release, sabotage/ intentional acts, 2016 FSF press releases. (20.08.2021 tarihinde https://flightsafety.org/fsf-statement-on-germanwings-accident-report/ adresinden alınmıştır.) google scholar
  • Frijda, N. H. (1986). The emotions. Cambridge: Cambridge University Press. google scholar
  • Frijda, N. H. (1993). Moods, emotion episodes and emotions. M. Lewis, & J. Haviland (Ed.), Handbook of emotions içinde (381-403). New York: Guilford Press. google scholar
  • (PDF) Mood. Available from: https://www.researchgate.net/publication/260918119_Mood [accessed Jul 05 2021]. google scholar
  • Gladstone, R. (2016). Pilot of vanished Malaysian flight had deviant route on his simulator, minister says. The New York Times. (20.08.2021 tarihinde https://www.nytimes.com/2016/08/05/world/asia/malaysia-airlines-mh370.html adresinden alınmıştır.) google scholar
  • Gould, M.S., Greenberg, T., Velting, D.M. ve Shaffer, D. (2003). Youth suicide risk and preventive interventions: A review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 386-405. google scholar
  • Gross, J. J. (2001). Emotion regulation in adulthood: Timing is everything. Current Directions in Psychological Science, 10, 214-219. google scholar
  • Gross, J. J. ve Levenson, R. W. (1997). Hiding feelings: The acute effects of inhibiting positive and negative emotions. Journal of Abnormal Psychology, 106, 95-103. google scholar
  • Henrikson, M.M., Hillevi, M.A. ve Marttunen, M.J. (1993). Mental disorders and comorbidity in suicide. Am J Psychiatry, 150,935-940. google scholar
  • Hocaoğlu, Ç. (2013). İki uçlu bozukluk ve intihar davranışı. Journal of Mood Disorders, 3(5). google scholar
  • Houdmont, J. (2012). West Midlands police officers’ exposure to work-related stressors: Relationships with individual and organizational health. Nottingham: University of Nottingham. google scholar
  • International Civil Aviation Organization (2012). Manual of civil aviation medicine (3.Edition).Doc 8984. google scholar
  • International Civil Aviation Organization (ICAO) Standards and Recommended Practices Annex 1 to the Convention on International Civil Aviation (2018), Chapter 6. Medical provisions for licencing 6.3.2. Physical and mental requirements 12th ed. google scholar
  • Isometsa, E.(2014). Suicidal behaviour in mood disorders-who, when, and why? Can J Psychiatry, 59(3),120-30. google scholar
  • Isometsa, E.T., Henrikson, M.M. ve Hillevi, M.A. (1994). Suicide in major depression. Am J Psychiatry, 151,530-536. google scholar
  • Kaya, B. ve Kaya, M. (2007). 1960’lardan günümüze depresyonun epidemiyolojisi, tarihsel bir bakış, Klinik Psikiyatri; 10(6), 3-10. google scholar
  • Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R. ve Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593-602. google scholar
  • Koç, M. (2016). Depresif bozukluklar. N. Gürhan (Ed.). Ruh Sağlığı ve Psikiyatri Hemşireliği içinde (475-538). Ankara: Nobel Tıp Kitabevleri. google scholar
  • Küey, L. (1998). Birinci basamakta depresyon: tanıma, ele alma, yönlendirme. Psikiyatri Dünyası,1, 5-12. google scholar
  • Larsen, R. J. (2000). Toward a science of mood regulation. Psychological Inquiry, 11, 129-14. google scholar
  • Latalova, K., Kamaradova, D. ve Prasko, J.(2014). Suicide in bipolar disorder: a review. Psychiatria Danubina,26(2),108-14. google scholar
  • LeDoux, J. E. (1995). Emotion: Clues from the brain. Annual Review of Psychology, 46(1), 209-235. google scholar
  • Lewis, R.J., Johnson,R.D., Whinnery, J.E. ve Forster, E.M. (2007). Aircraft-assisted pilot suicides in the United States, 1993-2002, Archives of Suicide Research, 11(2),149-161, DOI: 10.1080/1381111070124763. google scholar
  • Lollis, B. D., Marsh, R. W., Sowin, T. W. ve Thompson, W. T. (2009). Major depressive disorder in military aviators: a retrospective study of prevalence. Aviation, Space, and Environmental Medicine, 80(8), 734-737. google scholar
  • Mann, J.J., Waternaux, C., Haas, G.L. ve Malone K.M.(1999). Toward a clinical model of suicidal behavior in psychiatric patients. Am J Psychiatry,156,181-9. google scholar
  • Mansell, W.(2007). An integrative formulation-based cognitive treatment of bipolar disorders: Application and Illustration. Journal of Clinical Psyhology: In Session, 63, 447- 461. google scholar
  • Merikangas, K. R., Jin, R., He, J. P., Kessler, R. C., Lee, S., Sampson, N. A., ... ve Zarkov, Z. (2011). Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Archives of General Psychiatry, 68(3), 241-251. google scholar
  • Murphy, G.E. (1990). Suicide and attempted suicide. Psychiatry. PJ Wilner (Ed), Lippincott Basic Books içinde (14-18). New York: New York Publication. google scholar
  • Nesse, R. (1999). Proximate and evolutionary studies of anxiety, stress and depression: synergy at the interface. Neuroscience & Biobehavioral Reviews, 23(7), 895-903. google scholar
  • Nesse, R.M.(1990). Evolutionary explanations of emotions. Human Nature, 1(3), 261-289. google scholar
  • Öztürk, O.M. ve Uluşahin, N.A.(2015). Ruh sağlığı ve bozuklukları (13. Baskı). Ankara: Nobel Tıp Kitapevleri. google scholar
  • Parker, P. E., Stepp, R. J. ve Snyder, Q. C. (2001). Morbidity among airline pilots: the AMAS experience. Aviation Medicine Advisory Service. Aviation, Space, and Environmental Medicine, 72(9), 816-820. google scholar
  • Post, R.M. (2007). Kindling and sensitization as models for affective episode recurrence, cyclicity and tolerance phenomena. Neuroscience and Biobehavioral Research, 31, 858-873. google scholar
  • Raja, M. ve Azzoni, A. (2004). Suicide attempts: differences between unipolar and bipolar patients and among groups with different lethality risk. Journal of Affective Disorders, 82(3), 437-442. google scholar
  • Rayman, R.B.(2000). Clinical aviation medicine (3.baskı). New York: Castle Conolly Grad. Med. Pub. USA. google scholar
  • Reid, G.R.(2016). Aviation psychiatry. Gradwell, D.P. and Raiford, D.J. (Ed.), Ernsting’s aviation and space medicine (5.baskı) içinde (535-556). Boca Raton (FL): CRC Press. google scholar
  • Reis, C., Mestre, C. ve Canhao, H. (2013). Prevalence of Fatigue in a Group of Airline Pilots. Aviation Space and Environmental Medicine ,84(8):828-33 google scholar
  • Rottenberg, J. (2005). Mood and emotion in major depression. Current Directions in Psychological Science, 14(3), 167-170. google scholar
  • Safran, D.J. ve Greenberg, S.L.(1991). Emotion in human functioning: Theory and therapeutic implications, Safran, D.J; Greenberg, S.L (Ed.), Emotion, psychotherapy and change içinde. New York: The Guilford Press.3-13. google scholar
  • Sani, G., Tondo, L. ve Koukopoulos, A. (2011). Suicide in a large population of former psychiatric inpatients. Psychiatry Clin Neurosci, 65,286-95. google scholar
  • Sayıl, I. (1995). İntihar davranışı ve epidemiyolojisi. O Doğan(ed): Psikiyatrik Epidemioloji’de, İzmir: Ege Psikiyatri Yayınları. 118-23. google scholar
  • Schwark, T., Severin, K. ve Grellner, W. (2008). “I am flying to the stars”—Suicide by aircraft in Germany. Forensic Science International, 179(2-3), e75-e78. google scholar
  • Sivil Havacılık Genel Müdürlüğü (2021). Havacılık sağlık talimatı.Med.B.055. Zihin Sağlığı. google scholar
  • Sivil Havacılık Genel Müdürlüğü (2022). Havacılık personeli akran destek program talimatı. google scholar
  • Stoutt, G. (2015). Depression: A recoverable stall. Just for the health of pilots. (20.08.2021 tarihinde https:// www.faa.gov/licenses_certificates/medical_certification/hop/media/depression.pdf adresinden alınmıştır.) google scholar
  • Sykes, A. J., Larsen, P. D., Griffiths, R. F. ve Aldington, S. (2012). A study of airline pilot morbidity. Aviation, Space, and Environmental Medicine, 83(10), 1001-1006. google scholar
  • Şevik, A.E., Özcan, H. ve Uysal, H. (2012) İntihar girişimlerinin incelenmesi: risk faktörleri ve takip, Klinik Psikiyatri, 15,218-225. google scholar
  • Toftdahl, N. G., Nordentoft, M. ve Hjorth0j, C. (2016). Prevalence of substance use disorders in psychiatric patients: a nationwide Danish population-based study. Social Psychiatry and Psychiatric Epidemiology, 51(1), 129-140. google scholar
  • Tondo, L., Pompili, M., Forte, A. ve Baldessarini, R. J. (2016). Suicide attempts in bipolar disorders: comprehensive review of 101 reports. Acta Psychiatrica Scandinavica, 133(3), 174-186. google scholar
  • Tüzün, D. Ü. (2005). Gençlik döneminde depresyon ve intihar. İ.Ü.Cerrahpaşa Tıp Fakültesi Sürekli Tıp Eğitimi Etkinlikleri. Adolesan Sağlığı Sempozyum Dizisi, 43, 53- 58. google scholar
  • Vuorio, A., Laukkala, T., Navathe, P., Budowle, B., Bor, R. ve Sajantila, A. (2017). Bipolar disorder in aviation medicine, Aerospace Medicine and Human Performance, 88(1),42-47. google scholar
  • Vuorio, A., Laukkala, T., Navathe, P., Budowle, B., Eyre, A. ve Sajantila, A. (2014). Aircraft-assisted pilot suicides: Lessons to be learned. Aviation, space, and environmental medicine, 85(8), 841-846. google scholar
  • Windfuhr, K. ve Kapur, N.(2011). Suicide and mental illness: a clinical review of 15 years findings from the UK National Confidential Inquiry into suicide. British Medical Bulletin, 100,101- 21. google scholar
  • Wu, A.C., Donnelly-McLay, D., Weisskopf, M.G., McNeely, E., Betancourt, T.S. ve Allen, J.G. (2016). Airplane pilot mental health and suicidal thoughts: a cross-sectional descriptive study via anonymous web-based survey, Environmental Health, 15 (121), 1-12. google scholar


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