Systematic review: Psychomental reactions of survivors after fatal maritime disasters at sea.

Background: 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.

Materials and 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 post-traumatic stress disorder (PTSD) based on the Total Impact of Event Scale (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.