مطالعه طولی در آلتراسیون درک مصرف کننده و استفاده از داروی خلبان   A longitudinal study on the alteration of consumer perceptions and the use of pilot medication

1. Introduction When passengers board a commercial airliner, there is an expectation that their pilots are not only certified to operate the aircraft but are also medically sound and fit for flight. Pilots must undergo medical examinations every 6e12 months to command commercial airline flights; however, there are a number of medical conditions that could revoke their medical flying credentials. In the past, a pilot suffering from depression would be grounded (removed from flight status). However, within the last five years, the FAA has allowed four antidepressant medications to be prescribed for commercial pilots and established a procedure for their proper use. A prior study (Rice et al., 2015b) examined consumers’ willingness to fly depending on if their pilot was taking certain medications. The data was collected for that study two weeks before the Germanwings accident. The purpose of the current study is to examine if there is a hangover effect on consumers’ willingness to fly after a major aircraft accident attributed to alleged pilot suicide and how that would affect the findings of the original study. 1.1. Mental health and depression in the general population Three hundred and fifty million people suffer from depression in the general population according to the World Health Organization (2012). More importantly, over 80% of those individuals with clinical depression remain undiagnosed every year (Healthline, 2015). Although there are some common factors leading to depression, there is no particular country, region, culture, or even age group more prone to this illness than others. Although depression can occur at any age, the median age of people suffering from this condition is 32 years (Depression and Bipolar Support Alliance, 2015). Extensive medical research has aimed to identify factors that could help people predict which individuals would be more susceptible to depression (National Institute of Mental Health, 2015). We know that a person’s environment and surroundings can have a direct impact on their psychological state, and sudden or complex changes to such environments can lead to the onset of some forms of depression (National Institute of Mental Health, 2015). The most common symptoms of this disorder involve overarching feelings of sadness, hopelessness, pessimism, suicidalhoughts, and many more (Depression and Bipolar Support Alliance, 2015; National Institute of Mental Health, 2015). These symptoms have been substantiated by analyzing the areas of the brain, in depressed patients, that control mood, thinking, sleeping, appetite, and behavior, and comparing the results to patients not depressed. These issues may indirectly affect everyday activities such as sleep, fatigue levels, work efficiency, appetite, sexual interest, and can even affect interpersonal relationships (National Institute of Mental Health, 2015). Not only is depression difficult to predict, but another difficulty arises in that there are numerous types of depression, and they manifest differently in different people. Furthermore, this type of psychiatric illness is not necessarily confined to one episode or instance and can re-manifest itself throughout various stages of life. While depression is treatable, it can reappear many years later when external pressures, stressors, or tragic life events trigger issues into resurfacing (Kendler et al., 2000). While depression can reappear many years later, or an individual may go for extended periods of time without suffering, some individuals may experience persistent depressive disorder. This disorder occurs when the depressed mood lasts for two or more years and includes times of major depressive episodes, as well as episodes with less severe symptoms. However, as previously stated, the illness is highly individualized and people may experience a wide range of severities, durations, and frequencies associated with depression.