Systematic review: Psychomental reactions of survivors after fatal maritime disasters at sea
Abstract
Introduction Several studies have shown that accidents and disasters at sea account for a significant share of seafarers’ deaths. Additionally, the experience of a disaster often has a crucial impact on the mental health of survivors. The objective of this systematic review is to analyze the psychomental symptoms and their development over time after a maritime disaster, as well as the scores used to measure the severity of the symptoms. Methods A comprehensive literature search was conducted in the scientific databases PubMed, PubPsych, PsycArticles, and Scopus to identify studies related to fatal maritime disasters. This systematic search yielded 239 studies and twelve were ultimately included in the review after the application of specific exclusion criteria. Results The included studies described the psychomental symptoms of 40 seafarers, 422 navy and US Coast Guard crew members, and 300 passengers who experienced maritime disasters. Survivors of fatal maritime disasters exhibit significant symptoms of posttraumatic stress and depression. The diagnostic screening cut-offs for PTSD based on the IES-Total score were exceeded in a significant number of the survivors. Although symptoms diminish over time, survivors' mental health often remains significantly affected for several years after the disaster. Discussion The symptoms and the severity of PTSD and depression after a maritime disaster and their development over time show parallels with findings from land-based disaster research. Overall, the number of identified studies and their actuality in the field of maritime research are unsatisfactory. This highlights the necessity for additional research in the field of maritime disaster medicine.
Keywords: maritime disasterseafaringPTSDdepressionanxietyIESBDIGHQ
References
- Oldenburg M, Jensen HJ. Stress and strain among merchant seafarers differs across the three voyage episodes of port stay, river passage and sea passage. PLoS One. 2019; 14(6): e0217904.
- Bull RM, Boyle AJ. The maritime environment: a comparison with land-based remote area health care. Aust J Rural Health. 1998; 6(2): 83–88.
- McFarlane A. Psychiatric Morbidity Following Disasters: Epidemiology, Risk and Protective Factors. Disasters and Mental Health. 2005: 37–63.
- Seesicherheits-Untersuchungs-Gesetz - SUG. Gesetz zur Verbesserung der Sicherheit der Seefahrt durch die Untersuchung von Seeunfällen und anderen Vorkommnissen (Seesicherheits-Untersuchungs-Gesetz - SUG). https://www.gesetze-im-internet.de/sug/BJNR181700002.html (August 12, 2024).
- Borch DF, Hansen HL, Burr H, et al. Surveillance of maritime deaths on board Danish merchant ships, 1986-2009. Int Marit Health. 2012; 63(1): 7–16.
- Roberts SE. Fatal work-related accidents in UK merchant shipping from 1919 to 2005. Occup Med (Lond). 2008; 58(2): 129–137.
- Oldenburg M, Baur X, Schlaich C. Occupational risks and challenges of seafaring. J Occup Health. 2010; 52(5): 249–256.
- Newnham EA, Mergelsberg ELP, Chen Y, et al. Long term mental health trajectories after disasters and pandemics: A multilingual systematic review of prevalence, risk and protective factors. Clin Psychol Rev. 2022; 97: 102203.
- Tiyuri A, Rasoulian M, Hajebi A, et al. Psychological impact of the Spring 2019 flood among adult population of Iran. Int J Soc Psychiatry. 2023; 69(8): 1916–1927.
- BECK AT, WARD CH, MENDELSON M, et al. An inventory for measuring depression. Arch Gen Psychiatry. 1961; 4: 561–571.
- Goldberg DP, Hillier VF. A scaled version of the General Health Questionnaire. Psychol Med. 1979; 9(1): 139–145.
- Horowitz M, Wilner N, Alvarez W. Impact of Event Scale: a measure of subjective stress. Psychosom Med. 1979; 41(3): 209–218.
- Norris FH, Friedman MJ, Watson PJ, et al. 60,000 disaster victims speak: Part I. An empirical review of the empirical literature, 1981-2001. Psychiatry. 2002; 65(3): 207–239.
- Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372:n71.
- Líndal E, Stefánsson JG. The long-term psychological effect of fatal accidents at sea on survivors: a cross-sectional study of North-Atlantic seamen. Soc Psychiatry Psychiatr Epidemiol. 2011; 46(3): 239–246.
- Tekin A, Namias N, O'Keeffe T, et al. A Burn Mass Casualty Event Due to Boiler Room Explosion on a Cruise Ship: Preparedness and Outcomes. The American Surgeon™. 2005; 71(3): 210–215.
- Hoiberg A, McCaughey BG. The traumatic aftereffects of collision at sea. Am J Psychiatry. 1984; 141(1): 70–73.
- Eid J, Johnsen BH, Thayer JF. Post-traumatic stress symptoms following shipwreck of a Norwegian Navy frigate — an early follow-up. Personality and Individual Differences. 2001; 30(8): 1283–1295.
- McCaughey BG. US Coast Guard collision at sea. J Human Stress. 1985; 11(1): 42–46.
- Dalgleish T, Joseph S, Yule W. The Herald of Free Enterprise disaster. Lessons from the first 6 years. Behav Modif. 2000; 24(5): 673–699.
- Scottish Intercollegiate Guidelines Network (SIGN). SIGN Grading System 1999 – 2012. https://www.sign.ac.uk/assets/sign_grading_system_1999_2012.pdf (July 22, 2024).
- Dyregrov A, Gjestad R. A maritime disaster: reactions and follow-up. Int J Emerg Ment Health. 2003; 5(1): 3–14.
- Eriksson NG, Lundin T. Early traumatic stress reactions among Swedish survivors of the m/s Estonia disaster. Br J Psychiatry. 1996; 169(6): 713–716.
- Joseph SA, Brewin CR, Yule W, et al. Causal attributions and psychiatric symptoms in survivors of the Herald of Free Enterprise disaster. Br J Psychiatry. 1991; 159: 542–546.
- Taiminen TJ, Tuominen T. Psychological responses to a marine disaster during a recoil phase: experiences from the Estonia shipwreck. Br J Med Psychol. 1996; 69 ( Pt 2): 147–153.
- Thompson J, Chung MC, Rosser R. The Marchioness disaster: preliminary report on psychological effects. Br J Clin Psychol. 1994; 33(1): 75–77.
- Dooley E, Gunn J. The psychological effects of disaster at sea. Br J Psychiatry. 1995; 167(2): 233–237.
- Eid J, Thayer JF, Johnsen BH. Measuring post-traumatic stress: a psychometric evaluation of symptom-and coping questionnaires based on a Norwegian sample. Scand J Psychol. 1999; 40(2): 101–108.
- Neal LA, Busuttil W, Rollins J, et al. Convergent validity of measures of post-traumatic stress disorder in a mixed military and civilian population. J Trauma Stress. 1994; 7(3): 447–455.
- Kendall P, Hollon S, Beck A, et al. Issues and recommendations regarding use of the Beck Depression Inventory. Cognitive Therapy and Research. 1987; 11(3): 289–299.
- Goldberg DP. The detection of psychiatric illness by questionnaire: A technique for the identification and assessment of non-psychotic psychiatric illness. Oxford, England: Oxford U. Press 1972.
- Brewin CR. Systematic review of screening instruments for adults at risk of PTSD. J Trauma Stress. 2005; 18(1): 53–62.
- Sundin EC, Horowitz MJ. Impact of Event Scale: psychometric properties. Br J Psychiatry. 2002; 180: 205–209.
