PDF icon Download PDF
Flugmedizin · Tropenmedizin · Reisemedizin - FTR 2018; 25(04): 167-179
DOI: 10.1055/a-0655-1666
Flugmedizin
Georg Thieme Verlag KG Stuttgart · New York

Update psychische Gesundheit von Piloten

Update Pilot Mental Health
Jörg Siedenburg
Uetersen
› Author Affiliations
Further Information

Publication History

Publication Date:
16 August 2018 (online)

Also available ateRef
   Permissions and Reprints
Preview

ZUSAMMENFASSUNG

Die Luftfahrt gilt als ultrasicheres System. Fehler, Zwischenfälle und Unfälle können jedoch katastrophale Konsequenzen haben. Wegen der Häufigkeit psychischer Veränderungen in der Allgemeinbevölkerung und deren Zunahme sowie einiger Ereignisse in den letzten Jahren ist das Thema psychische Gesundheit von Piloten zunehmend wichtiger geworden. Der wichtige Einfluss auf die Flugsicherheit wurde von verschiedenen Arbeitsgruppen herausgestellt. Bei den fliegerärztlichen Untersuchungen wird empfohlen, psychische Veränderungen mehr in den Blickpunkt zu nehmen. Deren Anteil an Incapacitations hat im Gegensatz zu den traditionell im Fokus stehenden organischen Veränderungen in den vergangenen Jahren zugenommen. Erschwerend ist die Tatsache, dass die meisten Veränderungen im Intervall zwischen 2 turnusmäßigen Untersuchungen zu erwarten sind. Außerdem erschwert das damit verbundene Stigma die Selbstoffenbarung. Weiterhin liegen im Bereich der Psychologie und Psychiatrie kaum einfache Tests vor, die psychische Veränderungen in der Zukunft ausschließen können. Verschiedene Vorschläge werden diskutiert, die Vorbeugung, Diagnose, damit auch die Möglichkeit einer Behandlung und das Vertrauen zwischen Piloten und Fliegerärzten optimieren sollen.

ABSTRACT

Aviation is an ultrasafe system. However, errors, incidents and mishaps may have catastrophic consequences. Mental health of pilots has come into the focus of the public and aviation medicine, because mental diseases are common in the general population, and have an increasing incidence, and because of several events in the past years. The important impact on flight safety has been pointed out by several working groups. Therefore, it is recommended to focus more on mental disorders during aero-medical examinations. Their role in incapacitations has increased in the past, in contrast to organic changes that are traditionally in the focus. The fact that most changes occur during the interval between 2 periodic examinations makes things not easier. Furthermore, there are no tests in psychology and psychiatry that can rule out mental abnormalities for the future. Several proposals are discussed that are intended to optimise prevention, diagnosis and therefore the possibilities for treatment, and the trust between pilots and their aero-medical examiners.

Key words

mental health - pilots - peer support programmes - aviation safety
 

  • Literatur

  • 1 World Health Organization. Mental health: a state of well-being. Updated August 2014. Im Internet: www.who.int/features/factfiles/mental_health/en/
  • 2 Evers M. Zahl der abgestürzten Jets: 0. Der Spiegel 02/2018
  • 3 Evans S, Radcliffe SA. The annual incapacitation rate of commercial pilots.. Aviat Space Environ Med 2012; 83: 42-49
    CrossrefPubMedSearch in Google Scholar
  • 4 Eißfeldt H, Grasshoff D, Hasse C. et al. Aviator 20130 – Ability Requirements in Future ATM Systems II: Simulations and Experitments.. Forschungsbereicht 2009-28 des Deutschen Zentrums für Luft- und Raumfahrt. 2009
    Search in Google Scholar
  • 5 Hudson M, Herbert K. The practicalities of fittingmental health screening into the time-limited annual medical check and the problem of confidentiality. In: Bor R, Eriksen C, Oakes M, Scragg P. (Eds.). Pilot Health Assessment and Support. London: Routledge; 2017: 208-225
    Search in Google Scholar
  • 6 EU-Kommission. Eingeschränkte Tauglichkeit. EU-Verordnung 1178/2011, Anhang IV
  • 7 International Civil Aviation Association: ICAO Manual of Civil Aviation Medicine. 4th Ed. Montral; ICAO: 2017
  • 8 Aerospace Medical Association Working Group on Pilot Mental Health. Pilot Mental Health: Expert Working Group Recommendations – Revised 2015. Aerosp Med Hum Perform 2016; 87: 505-507
    PubMedSearch in Google Scholar
  • 9 Kessler RC, McGonagle KA, Zhao S. et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey.. Arch Gen Psychiatry 1994; 51: 8-19
    CrossrefPubMedSearch in Google Scholar
  • 10 Ebmeier KP, Donaghey C, Steele JD. Recent developments and current controversies in depression.. Lancet 2006; 367: 153-167
    CrossrefPubMedSearch in Google Scholar
  • 11 Olfson M, Shea S, Feder A. et al. Prevalence of anxiety, depression, and substance use disorders in an urban general medicine practice.. Arch Fam Med 2000; 9: 876-883
    CrossrefPubMedSearch in Google Scholar
  • 12 Deutsche Gesellschaft für Psychiatrie, Psychotherapie, Psycho somatik und Nervenheilkunde 2017
  • 13 Eriksen C, Bor R. Promoting good psychological health amongst pilots.. In: Bor R, Eriksen C, Oakes M, Scragg P. (Eds.). Pilot Health Assessment and Support.. Routledge; London: 2017: 309-324
    Search in Google Scholar
  • 14 Ross J, Griffiths K, Dear K. et al. Antidepressant use and safety in civil aviation: a case-control study of 10 years of Australian data.. Aviat Space Environ Med 2007; 78: 749-755
    PubMedSearch in Google Scholar
  • 15 Fahnenbruck G, Steinhardt G. Peer-to-peer support and development programmes pilots – Time for a holistic approach. In: Bor R, Eriksen C, Oakes M, Scragg P. (Eds.). Pilot Health Assessment and Support. London; Routledge: 2017: 344-366
    Search in Google Scholar
  • 16 Dahlstrom N. Human factors and the factors of the human. In Bor R, Eriksen C, Oakes M, Scragg P. (Eds.). Pilot Health Assessment and Support. London; Routledge: 2017: 245-258
    Search in Google Scholar
  • 17 Friedman E, Bui B. A Psychiatric Formulary for Long-Duration Spaceflight.. Aerosp Med Hum Perform 2017; 88: 1024-1033
    PubMedSearch in Google Scholar
  • 18 Albuquerque C, Fonseca M. Psychosocial stressors associated with being a pilot. In: Bor R, Eriksen C, Oakes M, Scragg P. (Eds.). Pilot Health Assessment and Support.. London; Routledge: 2017: 286-308
    Search in Google Scholar
  • 19 Gibbs S. Peer support programmes for pilots. In: Bor R, Eriksen C, Oakes M, Scragg P. (Eds.). Pilot Health Assessment and Support.. London; Routledge: 2017: 367-381
    Search in Google Scholar
  • 20 Bond FW, Flaxmann PE. The Ability of Psychological Flexibility and Job Control to Predict Learning, Job Performance, and Mental Health.. Journal of Organziational Behavior Management 2006; 26: 113-130
    Search in Google Scholar
  • 21 Butler JN. Assessing pilots with ‚the wrong stuff‘: A call for research on emotional health factors in commercial aviators.. International Journal of Selection and Assessment 2002; 10: 168-184
    CrossrefSearch in Google Scholar
  • 22 Bennett S. The pilot life-style: A sociological study of the commercial pilot’s work and home life. University of Leicester, Institute of lifelong learning.
  • 23 Siedenburg J. Fliegendes Personal. In: Letzel S, Nowak D (Hrsg.). Handbuch der Arbeitsmedizin. Akt. 6/15. Landsberg: Ecomed Medizin; F1–F2:1–29
  • 24 Casey M, Lawler B. Behavioural dynamics on the flight deck and implications for mental health. In: Bor R, Eriksen C, Oakes M, Scragg P. (Eds.). Pilot Health Assessment and Support.. London; Routledge: 2017: 325-343
    Search in Google Scholar
  • 25 Vanhoenacker M. Himmelhoch.. München: Hanser 2015; 22: 59
    Search in Google Scholar
  • 26 Nergård V. Airmanship – a qualitative approach. Aviation 2014; 18: 147-156
    CrossrefSearch in Google Scholar
  • 27 Nergård V, Svendsen B. Pilots’ emotions in the Cockpit. In: Bor R, Eriksen C, Oakes M, Scragg P. (Eds.). Pilot Health Assess ment and Support.. London; Routledge: 2017: 382-397
    Search in Google Scholar
  • 28 Bion WR. Learning from Experience.. Northvale: Jason Aronson. 1962
    Search in Google Scholar
  • 29 Reid GF. Aviation Psychiatry. In: Gradwell D , Rainford DJ. Ernsting’s Aviation and Space Medicine. 5th Ed.. Boca Raton: CRC Press; 2016
    Search in Google Scholar
  • 30 Correia R. The use of psychotropic medications and fitness to fly. In Bor R, Eriksen C, Oakes M, Scragg P. (Eds.). Pilot Health Assessment and Support.. London; Routledge: 2017: 229-244
    Search in Google Scholar
  • 31 Gahr M, Connemann BJ, Schönfeldt-Lecuona C. et al Psychopharmaka: Unerwartete Nebenwirkungen.. Dtsch Arztebl. 2017: 114 A-2468
    Search in Google Scholar
  • 32 Campion B. Promoting mental health and well-being in aviation.. In: Bor R, Eriksen C, Oakes M, Scragg P. (Eds.). Pilot Health Assessment and Support.. London; Routledge: 2017: 259-271
    Search in Google Scholar
  • 33 Schultz DP, Schultz SE. Psychology and Work Today. 2010
  • 34 Bureau d’Enquêtes et d’Analyses pour la sécurité de l’aviation civile. Abschlussbericht Unfall am 24. März 2015 in Prads-Haute-Bléone (Alpes-de-Haute-Prevence, Frankreich) mit einem Airbus A320-211 Kennzeichen D-AIPX betrieben von Germanwings. 13. März 2016
  • 35 Siedenburg J. Luftfahrtgesetzgebung und Flugsicherheit.. In: Siedenburg J, Küpper T. (Hrsg.). Moderne Flugmedizin.. Stuttgart; Gentner: 2015
    Search in Google Scholar
  • 36 Siedenburg J. EASA.. In: Siedenburg J, Küpper T. (Hrsg.). Moderne Flugmedizin.. Stuttgart; Gentner: 2015: 58-61
    Search in Google Scholar
  • 37 Deutscher Bundestag. Entwurf eines Fünfzehnten Gesetzes zur Änderung des Luftverkehrsgesetzes. 2015
  • 38 International Civil Aviation Association. Use of psychoactive substances. ICAO; 2011: Annex 1, 1.2.7
  • 39 International Civil Aviation Association. Manual of Evidence- based Training. Montreal: ICAO; 2013
  • 40 Butcher JN. Assessing pilots with „the wrong stuff“: a call for research on emotional health factors in commercial aviators.. International Journal of Selection and Assessment 2002; 10: 168-184
    CrossrefSearch in Google Scholar
  • 41 Europäisches Parlament. Meldung, Analyse und Weiterverfolgung von Ereignissen in der Zivilluftfahrt. EU-Verordnung 376/2014
  • 42 Kenedi C, Friedman SH, Watson D. et al. Suicide and Murder- Suicide Involving Aircraft.. Aerosp Med Hum Perform 2016; 87: 388-396
    PubMedSearch in Google Scholar
  • 43 McFadden KI. Policy improvements for prevention of alcohol misuse by airline pilots.. Hum Factors 1997; 39: 1-8
    CrossrefPubMedSearch in Google Scholar