Underreporting of Depression in Australian Commercial Pilots

Abstract

INTRODUCTION: Undiagnosed depression in the aviation industry can have catastrophic consequences such as aircraft-assisted suicide. Depression is often underreported, especially when subjects are aware they are reporting on depression. The aim of the present study was to investigate whether scores on a depression screening tool would vary if it was disguised as a “life stress” questionnaire in a sample of Australian commercial pilots. METHODS: A total of 109 subjects were assigned into either a “Life Stress” survey or a “Depression” survey, both containing the Depression, Anxiety, Stress Scales depression screening tool among other questions relating to either depression or stress to determine any variation in depression scores. RESULTS: A statistically significant difference was found in which the covert group that completed a “life-stress” survey scored higher average depression scores than the control group completing an overt depression inventory. Prevalence of depression was consistent with the general population, with 25% of pilots meeting the threshold for depression within the control group, and this number increased to 41% when using a covert measure to assess depression. DISCUSSION: T his research adds further weight to the potential underreporting of depression in pilots as a function of stigma and fear associated with the label “depression”. Regulators and organizations must proactively minimize exposure to psychological harm, negating the reliance on self-reporting to control psychological risk and recruitment methods must aim to reduce bias against those with disabilities. Nonpunitive environments for pilots to self-assess and report psychological issues will allow better outcomes from expedited treatment.