European and US Aeromedical Authority Guidance for Neurocognitive Evaluation of Airline Pilots With Mental Disorders

Abstract

Commercial airline pilots must exhibit specific neurocognitive skills and aptitudes to perform their safety-critical roles. This review addresses neuropsychological assessment in mental disorders derived from guidance developed by European and US aviation authorities as well as indications in the current literature in relation to major depression and suicidality, self-harm, attention-deficit/hyperactivity disorder, posttraumatic stress disorder, and bipolar disorder in aeromedical evaluations. Several studies show that cognitive functioning may be impaired during major depression. The results of neurocognitive assessments provide useful information about a pilot’s performance. Obstacles to referring crew for neuropsychological testing are the paucity of neuropsychological specialists to undertake assessments and aeromedical examiners’ varied training and experience in assessing mental health problems of pilots in general.