Évaluation de la santé mentale et des facteurs psychosociaux chez les élèves officiers de l’école de la marine marchande

Abstract

IntroductionSeveral studies have demonstrated the existence of mental disorders and psychosocial risks among sailors, particularly merchant navy officers. The main risk factors reported are assuming the status of an officer, longer working hours and the consequent reduction in sleep time, loneliness, separation from family, and, more recently, the impact of the COVID-19 pandemic (fear for one's own health and that of one's family, and longer embarkation times). The low decision latitude of crew members compared to that of officers has also been highlighted. To date, no studies have been carried out among merchant navy officer cadets. MethodsA working group including members of the Merchant Navy school and the hospital of the University of Brest was set up. A questionnaire was devised that included demographic and navigational data to which we added the GHQ-12, HAD and Karasek questionnaires. All the students were asked to complete the questionnaire anonymously and submit it electronically. The results of the questionnaires were then analyzed using internationally recognized scoring procedures. A descriptive analysis phase was conducted which was followed by an analysis according to the Karasek scoring categories. ResultsIn all, 170 questionnaires were submitted. The participant population was predominantly male (76.4%), and the average age of the students was 21.7 years. Nearly 20% of the students stated that they had experienced a traumatic event during an on-board training course. We note that the average GHQ-12 is 13.3 and therefore higher than 12. The HAD anxiety and HAD depression averages are 6.9 and 5.37 respectively, with 18.2% and 7.6% of the students included showing signs of anxiety and depression. According to Karasek's classification, we note that the “active” class is the most represented with 29.4% of students, followed by the “tense” and “relaxed” classes with 27.6%. The “passive” class is the least represented with 15.3%. DiscussionThis study demonstrates that the students of the French Merchant Navy Officer Training School evaluated their overall health as average, with a predominance of anxiety disorders but few signs of depression. Signs of “work strain” according to the Karasek questionnaire were found in 1/4 of these young officers. The proportion of cadets showing signs of anxiety and depression according to the HAD questionnaire is similar to that shown in studies among French and European officers. On the other hand, the proportion of cadets classified as “tense” is higher. Concerning traumatic events, in a semi-structured analysis of the students’ first deployments at sea, the main stress factors reported were how the ship was managed, damaged, piracy and then weather conditions. The period of study within the ENSM involves both a period of theoretical learning but also one of practical training. In the highly specific environment of the merchant navy, the impact of psychosocial constraints seems to be significant. These data also raise questions about the impact of the profession as well as that of the SARS CoV-2 pandemic period. This also raises the issue of the fitness of certain students to sail where they showed signs of anxiety and depression at the time of the survey, and of others who are at risk of developing this type of pathology, which is included in the list of criteria for unfitness for sea duty.