title: The long-term psychological effect of fatal accidents at sea on survivors: a cross-sectional study of North-Atlantic seamen.
abstract: OBJECTIVE
  This study aimed to ascertain whether disasters at sea had an enduring traumatic effect on psychological functioning, accident proneness, and on their interest to continue working at sea.
  
  
  METHODS
  Crew members of selected sea-disasters were contacted. The chosen disasters were of differing severity and in some cases fatalities had occurred. The disasters had taken place on average 8 years previously. Those who agreed to participate were interviewed in a semi-structured interview. They also answered the CIDI; DIS; GHQ-30; IES, and PTSS-10. One hundred-and-twelve seamen who had been in disasters were compared with a comparison group consisting of 59 peers who had not been in a disaster.
  
  
  RESULTS
  Survivors of fatal disasters experienced more long-lasting negative effects than did others where lives were not lost. They had more frequently unpleasant intrusive thoughts on the IES (p < 0.01) compared with their peers. On the DIS, they also more frequently experienced heightened arousal (p < 0.001), sleep problems (p < 0.01), and nightmares (p < 0.01). The duration of PTSD symptoms from the time of the disaster was on average 18 months. Over 33% of the disaster group had experienced some PTSD symptoms within the past 12 months. Disaster survivors had not quit seamanship as frequently as non-disaster seamen.
  
  
  CONCLUSIONS
  The most severe and long-lasting symptoms were found among those who had been in disasters where one or more crew members had perished. Loss of life in disasters therefore seems significant in the process of creating or extending the endurance of symptoms of psychological vulnerability.
authors.affiliation: The Department of Psychiatry, National University Hospital, Reykjavík, Iceland. andromeda@simnet.is
authors.forename: E
authors.initials: E
authors.lastname: Líndal
authors.forename: J G
authors.initials: JG
authors.lastname: Stefánsson
mesh_terms: D000057:Accident Proneness; D000062:Accidents, Occupational / Q000401:mortality* / Q000523:psychology / Q000706:statistics & numerical data*; D000328:Adult; D003430:Cross-Sectional Studies; D004190:Disasters / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009326:Naval Medicine / Q000706:statistics & numerical data*; D009659:North Sea; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D013995:Time