Skip to main content
Download PDF

Mental health problems and their related factors among seafarers: a scoping review

BMC Public Health volume 22, Article number: 282 (2022) Cite this article

Abstract

Background

Seafarers are often reported to be engaged in a dangerous physical and psychosocial work environment. However, mental health status among seafarers has not been focused on compared with physical health issues. Systematic, comprehensive reviews of mental health problems and their relevant factors are lacking. This review aimed to clarify beneficial approaches to the mental health problems faced among seafarers using a scoping review to systematically map the evidence regarding mental health issues and their related factors.

Methods

Studies were searched on MEDLINE/PubMed, Science Direct, Academic search complete using EBSCOhost databases, SCOPUS, EMBASE, and Web of science on 20, August 2020. This scoping review was conducted based on the framework of Arksey and O’Malley and Preferred Reporting items for Scoping Reviews flow diagram. The inclusion criteria were studies which determined the relationship between factors relevant to working conditions or working environment, and mental health in seafarers, and etc. Data were narratively summarized and reported.

Results

Twenty-four were included in this review while two major findings were clarified. Firstly, the prevalence of stress, depressive symptoms, and burnout have been mentioned for decades. Secondly, factors related to mental health and psychological issues can be categorized as individual and work environmental factors. The individual factors include experience, age, health status (high BMI, poor sleep, and diabetics), and resilience. The work environmental factors consist of two parts. Job demands comprise pressure from contractors/customers/time, working hours, ship department, job title, voyage episodes, period of seafaring, noise, and vibration. The job resources included instrumental support, team cohesion, shipboard caring and effort-reward imbalance.

Conclusions

A beneficial approach to mental health problems faced among seafarers is necessary to understand comprehensively at individual and organization levels. Promoting health behaviors, training resilience, and managing obesity and chronic diseases comprise individual level strategies. Providing seafarers with adequate instrumental support, and practical support to communicate with customers, managing their distinct work-rest hours and adequate effort-reward balance comprise organization level methods.

Peer Review reports

Introduction

Seafarers are often reported to be engaged in a dangerous physical and psychosocial work environment [1,2,3]. Risk factors against health conditions include heat, cold, noise and vibration, multiculturalism and multinationalism, social isolation and loneliness, separation from spouses and families, piracy, and criminalization on board [3,4,5]. Seafarer’s tasks are characterized by hierarchical work structure, shift work, and indistinct work-rest areas [6]. These job demands for seafarers impact on physical health, and psychological issues, such as turnover intention, job dissatisfaction levels, and in some cases cause a variety of mental health problems: stress, depression, burnout, and, at its worst, suicidal ideation [3, 7]. A related review of the suicidal rate demonstrated that 5.9% of seafarers died by suicide from 1960 to 2009 [3]. Mental health status among seafarers should be emphasized.

Mental health status among seafarers have not been focused on compared with physical health issues [2]. Studies on mental health status among seafarers are limited to the latest three review articles. The first one showed that the number of studies on psychological functioning and various aspects of mental health among maritime workers was low by study classification, accounting for only 10.61% of the total [8]. The second one reported that mental health status could be evaluated using the prevalence of suicide and missing at sea rates of seafarers, who are assumed to have committed suicide. Missing at sea cases might have resulted from personal factors and seafaring work environment, although this was unreferred to in the studies using an association or causal relationship study design [3]. The last one focused on risk of depression and suicide based on the evidence of stress and loneliness even when studies on the depression and suicide among seafarers were scarce and fragmented [7]. This indicates that systematic comprehensive reviews on mental health problems and their related factors are not available and scoping reviews are lacking in seafarer area. In 2012, the UK and Australia launched a valuable project related to mental health to optimize health status and well-being among seafarers [3].

Studies focusing on well-being or psychological aspects of health among seafarers have not been extensively conducted compared with research concerning physical health even though working conditions of seafarers are physically and psychosocially dangerous. Thus, the present review aimed to clarify beneficial approaches to mental health problems faced by seafarers using a scoping review to map systematically the evidence regarding mental health issues and their related factors.

Methods

This scoping review was conducted based on the framework of Arksey and O’Malley methodological framework [9] and the Preferred Reporting items for Scoping Reviews flow diagram (PRISMA-ScR) [10].

This review was guided by two review questions: “what mental health problems or psychological issues are described in the literature topics among seafarers?” and “which factors are related to mental health problems among seafarers?”

Searching strategy

Studies were searched using electronic databases: MEDLINE/PubMed, Science Direct, Academic search complete through EBSCOhost databases, SCOPUS, EMBASE, and Web of science to identify relevant published articles. Relevant research was searched 20 August 2020. Studies were limited to peer-reviewed, written in English and published from 2010 to 2020.

Eligibility criteria

Research questions guided the searching terms and eligibility criteria. The determined inclusion and exclusion criteria are shown in Table 1. Studies meeting the inclusion criteria were eligible for review regardless of age, gender, race and country of the subjects. The studies included those conducted in term of observational studies, qualitative, mix methods and experimental research designs among workers in the maritime industry. However, reviews, letters, editorials, conference papers, policy statements and books were excluded. Full texts had to be published and available in English language.

Table 1 Inclusion and exclusion criteria
Full size table

Study selection

All the identified studies were imported into an EndNote 20 [11]. After removing any duplicates, the predetermined eligibility criteria were applied to assess the identified studies using a two-step process. Firstly, title and abstract of studies were broadly screened to exclude studies that were obviously irrelevant to the topic of the present review by the two authors. Secondly, two authors independently scrutinized the full text of studies based on the inclusion and the exclusion criteria in Table 1. Whenever decisions of selected studies differed among the authors, issues were discussed until consensus was reached with the research team. The PRISMA-ScR flow diagram [10] describing the process of study selection is depicted in Fig. 1.

Fig. 1
figure 1

PRISMA-ScR flow diagram describing the process of study selection

Full size image

Quality assessment

Although the phase on quality assessment was not discussed in the framework of Arksey and O’Malley [9], the methodologic quality in nonrandomized trials/studies were independently assessed by two reviewers applying the critical appraisal tool standardized by the Joanna Briggs Institute (JBI). This means cross-sectional studies (8 criteria) were categorized concerning the quality of the article as high (≥ 7 score), moderate (5-6 score), and low (< 5 score) [12]. Qualitative studies (10 criteria) were categorized as high (≥ 9 score), moderate (7-8 score), and low (<7 score) [13]. Studies exhibiting less than moderate quality were eliminated from the present review.

Charting the data

Included studies were reviewed for characterizing general information: authors, publication year, country, study design, data collection, number of subjects, indicators, mental health problems, and related factors. They were charted int a Microsoft Excel database by the first author and verified by the other authors.

Collating, summarizing, and reporting the results

The characteristics charted in the Microsoft Excel database were narratively summarized. Type of study, mental health or psychological issues, statistically significant factors in quantitative studies and all factors in qualitative studies were classified in domains for reporting and discussing.

Results

Searching and selecting the studies

A total of 3,790 studies were identified through the electronic databases. Of these, 1,505 were excluded because of duplicating. The titles and abstracts of 2,285 studies were screened to ensure they met the inclusion criteria. Next, 109 full texts were assessed for eligibility. Finally, 25 studies were selected for quality assessment.

Twelve studies possessed high quality using the critical appraisal tool, and 12 exhibited moderate quality. One study showing lower than moderate quality was excluded. Consequently, 24 studies were included in the present review (Table 2).

Table 2 Characteristics of included studies
Full size table

General characteristics of included studies

The general characteristics of 24 studies are demonstrated in Table 2. Sixteen studies were conducted in Europe [14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29], five in Asia [6, 30,31,32,33] two in North America [34, 35] and one in South America [36]. Twenty-two studies were quantitative [6, 14,15,16,17,18,19,20,21,22,23,24, 26,27,28, 30,31,32,33,34,35,36] and two were qualitative [25, 29].

Regarding study design, many applied cross-sectional designs. As to the data collection, five quantitative studies collected data using face to face questionnaires (two study locations were unidentified [19, 36], one study used a piloting training center [35], and two studies were conducted at a health examination hospital [18, 20]). Five studies distributed questionnaires using online surveys [16, 17, 24, 31, 33]. Five studies distributed questionnaires on board [6, 21, 22, 27, 28]. Two studies trained the captain and crews to serve as a co-researcher for collecting data on board [30, 32]. Two studies included subjects obtained by distributing questionnaire sheets using letters [15, 23]. One study’s data were collected using both face to face administered questionnaires and online method [26]. Four studies used biometrically surveys. (one study determined cortisol level in saliva [14], two studies used physical activity and heart rate armband monitors [27, 28], and one study used venous blood to assess hormone levels [32]). Two studies used secondary seafarer’s health data [19, 34], and one study used semi structured interviews cooperating with secondary health data and self-administered questionnaires [19]. Two qualitative studies applied focus group and interviews with seafarers [25, 29].

The number of subjects of quantitative studies ranged from 52 to 1,930. The participants of one study comprised female Chinese seafarers [32]. The others did not specifically identify sex. One study recruited seafarers with or without type 2 diabetics [19].

Mental health problems and psychological issues among seafarers

Mental health problems and psychological issues among seafarers were explored in 18 quantitative studies. The incidence of mental illness among international seafarers, such as mood swing, and social withdrawal, totaled 3.9 per 100,000 person-years [34].

Stress among seafarers was reported in seven studies [14,15,16,17, 27, 28, 30]. Two studies revealed seafarers had perceived stress related to physical and mental work environment [27, 28]. One study showed that 65% of total subjects were stressed, that deck officers were the most mentally stressed and that deck rating personnel were the most physically stressed [28]. Another reported that 37.8% of seafarers during port stay, defined as after docking at the port until the departure, experienced physical and mental stress, and that this proportion was larger than those of seafarers involving river and sea passages [27]. Cortisol levels in saliva were the highest among deck officers, followed by deck ratings and engine room personnel, and was highest among seafarers on duty during port stay [14]. One study pointed out that 51.5 to 66.5% of seafarers experienced work-related psychosocial stress reporting worries about family members, financial situation, ship safety, sea piracy, port state control and occupational strain [30]. Similarly, one study reported that 28.3% of seafarers exhibited stress that demotivated seagoing [15]. In addition, two studies reported similar perceived stress scores [16, 17]. One study showed that stress differed by ethnicity on an international ship. East Asian seafarers had higher perceived stress scores than another ethnic seafarers, such as Caucasian, Latino/Hispanic and South Asian seafarers [16].

Burnout syndrome among seafarers was reported in two studies [6, 18]. The prevalence of burnout syndrome was 10.8% which differed among seafarer’s rank and job: officers rank (10.7%), ratings (4.5%), and galley staff (25%) [18]. However, one study demonstrated that the burnout score of personal issues was higher than that of work-related issues [6].

Depressive symptoms, anxiety, and loneliness and isolation were reported in five studies [15, 19, 30, 35, 36]. Three studies showed 14.5 to 49% of seafarers reported depressive symptoms [30, 35, 36]. Furthermore, 34 and 46% of seafarers with type 2 diabetes also reported depressive symptoms and anxiety, respectively [19]. One study showed that 30% of Danish seafarers felt isolation or loneliness [15].

Factors related to mental health and psychological issues among seafarers

The factors related to mental health and psychological issues among seafarers were divided in two: individual and work environmental factors. Work environmental factors were based on the Job Demand-Resources Model [37].

Individual factors

Experience of seafaring and age were referred to four studies [16, 20, 21, 23]. Those experiencing longer seafaring correlated with lower stress at sea [16]. Those at greater age were associated with psycho-emotional strain [20], but negatively associated with intention to leave [21], while younger age was a factor related to low decision latitude [23].

Health status was documented in four studies [18,19,20, 35]. Poor sleep quality or insomnia predicted psycho-emotional strain, fatigue [20], burnout [18], and depressive symptoms [35]. Those presenting type 2 diabetics were more than twice as likely to exhibit depressive symptoms and anxiety [19]. High BMI also was positively related to depressive symptoms among both general seafarers [35] and presenting type 2 diabetes [19].

Dispositional resilience and psychological capital work for positive psychology were represented as a protective factor in three studies [16, 17, 22]. Dispositional resilience was associated with lower stress [16, 17] and high job satisfaction levels [17], and psychological capital including resiliency was related to job satisfaction levels [22].

Work environmental factors

Job demands

Pressure from contractors/customers/time and job stress in seafaring were negatively associated with job satisfaction levels [21] and positively associated with intention to leave [21, 31].

Long working stretches, more than 9 h daily, were related to psycho-emotional strain [20] and burnout [18].

Department on the ship was shown in two studies [26, 28]. One study demonstrated different mental and physical stress: the deck officer department introduced more mental stress, and deck ratings and engine personnel departments led to more physical stress [28]. Another showed that department on the ship predicted job satisfaction levels and burn out. Those in the deck department experienced higher burnout and lower job satisfaction levels than those in the engine department [26].

Job title was shown to be associated with psychological issues in two studies [17, 23]. Job title was classified in two groups: (1) officers such as captains and engineers and (2) nonofficers such as ratings or crew, and caterers. Having a lower job title was related to job decision latitude [23]. Ratings and caterers had higher job satisfaction levels than officers of deck and engine divisions [17].

Voyage episodes indicated different stress. Staying during port introduced more mental stress than that in river passage and sea passages [27]. The number of ports landed in weekly was related to job decision latitude [23].

Seafaring duration comprised a specific job demand in the maritime field. Short periods between - two to four months, favorable ratio between working and free days, and regular shifts were associated with high job and life satisfaction levels [24]. Seafaring after 2.6 months from the voyage start was more likely to produce psycho-emotional strain [20]. Among female Chinese seafarers, seafaring - two to three months introduced mental health problems, such as anxiety, somatization [32]. Seafaring over six months was related to depressive symptoms among seafarers with type 2 diabetes [19].

Ship noise and vibration, meaning a physical environment, were a subjective strain in the seafaring field in two studies [20, 27]. However, they had no effect on objective strain (heart rate and energy expenditure of physical activity) [27].

Two qualitative studies [25, 29] demonstrated the job demands identified through interviewing and collecting focus group data. Job demand included workload (stress and commercial pressure, and rest), shore leave, signing off and so on [29]. Job demand was characterized as circadian disturbance, workload, difficulty of work and work intrusions, introduced fatigue, poor working climate and increased turnover intention [25].

Job resources

Higher instrumental work support was a predictor of high job satisfaction levels [17] and low perceived stress at sea [16, 17].

Only one study reported team cohesion were a predictor of high job satisfaction levels [21].

A shipboard caring including laissez-faire leadership style were predictors of high job satisfaction levels [21]. Lack of care by a shipboard superior and/or a shipping company were related to burnout [18].

Effort-reward imbalance were related to burnout [6]. Reward (high salary, family benefits, and training opportunities) were predictors of high job satisfaction levels [33].

Discussion

This up-to-date scoping review systematically mapped the results of studies examining seafarer’s mental health or psychological issues and their related factors over the past decade. This review included 24 studies representing 92% and 8% using quantitative and qualitative research designs. Regarding study design, all included studies employed a cross-sectional design. This highlights the need for further research using designs such as longitudinal study, case-control, or cohort study. As to collecting data, various methods were used, such as using face to face methods, surveying online, distributing questionnaire on board etc. This may have entailed that collecting data was difficult.

The current review highlighted the prevalence of mental health problems and psychological issues: stress ranged from 28 to 65% [15, 28]; depressive symptoms from 14 to 49% [30, 35, 36]; and burn out at 10.8% [18] during the past decade. However, the prevalence varied in a wide range. This may be explained from the heterogeneity of studies, use of different instruments, time frames, data collection methods, and multiple nationalities of seafarers.

To our knowledge, this review illustrated the wide range of individual and work environmental factors related to mental health and psychological issues.

Among individual factors, longer seafaring experience was one of the protective factors [16], and greater age increased psycho-emotional strain [20]. According to a related study, aid workers in aid organizations such as humanitarian assistance, and nongovernmental organizations showed older age and longer work experience played important roles as protective factors of mental health outcomes. Work experience corresponded to, but older age contrasted with the present study results. However, this should be compared cautiously because populations differ. Younger age was related to low decision latitude [23]. This result was supported by similar studies reporting age was associated with decision latitude among general practitioners in a community setting [38] and associated with depression among navy personnel assigned to an active-duty ship [39].

Poor sleep or insomnia exhibited a relationship with psycho-emotional strain, burnout, and depressive symptoms [18, 20, 35]. Seafarers have the possibility to sacrifice their sleep duration to catch up on work even as poor sleep habits occur among doctors, nurses, emergency services providers, gasoline station attendants, truck drivers, and others working 24-hour shifts [40]. This was supported by the related longitudinal studies and systematic reviews showing that poor sleep and insomnia produced depression at least twice the number of times as those of young and elderly men patients with insomnia [41,42,43,44].

Health status, high BMI and type 2 diabetes were risk factors for depressive symptoms among seafarers [19, 35]. High BMI showed a strong association with depressive symptoms in adolescent and worker age group [45, 46]. Overweight status may influence bodily inflammation preceding depression [46]. In general, the risk of developing depression is increased nearly twice among people with diabetes, but the linkage between them remains unclear. Biochemical changes such as arousal of the nervous system, could account for an increased risk of depression among individuals with diabetes [47], although glycemic control (HbA1c) and average blood glucose level showed no significant association with depression [48]. These results suggested that seafarers with high BMI and type 2 diabetics should be screened for depression while onboard.

Dispositional resilience plays a role in protective factors among seafarers [16, 17]. Resilience works as a personal resource of resistant stress, growth, and personal development that may foster the ability to cope with the environment [49] among general adults [50] as well as active duty mariners [51]. Resilience is also a resource of coping with job demand and development of job resilience [52]. Thus, resilience is also effective for seafarers to prevent mental health problems. Since resilience is improved by training [53], it should be therefore suggested to be included in a seafarer’s pre-onboard program.

Among the job demands in work environmental factors, over 9 h of daily work introduced psycho-emotional strain [20] and burnout [18] among seafarers. Similarly, among those working over 40 h weekly and averaging more than 8 h daily reported negative impacts with mental health consisting of burnout [54], depressive symptoms [55,56,57], stress, suicidal ideation [55] and well-being [56].

Deck department and engine department are the two main departments on a ship. In general, deck officers are responsible for paperwork similar to white collar workers, and ratings and engine personnel are responsible for engine work similar to blue collar workers. In this review, deck officers experienced more mental stress, a higher possibility of burnout, and lower satisfaction levels than ratings and engine personnel, while ratings and engine personnel were more physically stressed than deck officers [28]. This was contrary to the results of the study showing that blue collar workers had higher perceived stress than white collar workers [58]. Deck officers carry out not only paperwork but also commanding tasks with high work responsibility at remote areas contributing to their higher stress levels than those of general white collar workers.

Job titles in seafarer’s work are classified as officers at a higher rank and nonofficers at a lower rank. The commanding system is based on the work hierarchy concurring with military work. Two earlier military studies reported that lower rank was associated with psychological issues [59, 60]. This study revealed that the lower ranked nonofficers, called ratings or crews and caterers, had higher job satisfaction levels than those of officers in deck and engine departments [17]. This fact did not correspond with those two studies, so evidence may support that the hierarchy command environment in spite of being on a military or merchant ship was associated with psychological issues.

The ship voyage, a unique seafarer’s work condition, consists of port stay, sea passage, and river passage. The result in this review showed that port stay introduced more stress than other episodes [27]. Different tasks of each episode require different demands. Port stay is physically demanding: loading and unloading operations, working as a watch keeper, repairing an engine, refueling, and intaking provision; and psychosocial demanding: requiring contractors or customers [61].

Long seafaring periods can induce mental health problems. This result was consistent with earlier studies that the navy crew during shipboard deployment were more likely to become depressed than those before and after three months deployment [39], and that work environments, involving living alone, were risk factors for depression [62]. The seafarers work and living conditions with limited numbers of people in a limited area for long consecutive periods may cause seafarers mental health problems particularly depression.

Noise constituted a risk in a review of seafaring occupations published in 2010 [4]. Noise still showed a relationship with subjective strain in this review. A related study in a large working population [63] and a longitudinal study [64] also showed strong associations between personal perception of noise level related to depressive symptoms and suicidal ideation. Vibration was in accordance with earlier empirical evidence that whole body-vibration at 3-20 Hz frequency increased mental demand [65].

Job demands in seafaring may have their own specific factors as specific job demands in each occupation cause psychological problems [66]. Psychosocial environment factors including pressure from contractors/customers/time, and poor working environment [21] were directly related to psychological issues.

As to job resources in work environmental factors, instrument support, shipboard caregiving, team cohesion and reward were related to high job satisfaction levels [17, 21, 33]. On the contrary, lack of caregiving and effort-reward imbalance related to burn out [6, 18]. These results were supported by the evidence empirically demonstrating that neither supportive coworkers nor supervisors present had the possibility to increase mental distress in an offshore petroleum industry [67, 68]. Also, the results corresponded to an earlier systematic review with meta-analysis, showing that effort-reward imbalance, high job demand, and low social support were positively associated with mental health disorders, and served as risk factors [69].

Beneficial approaches to mental health problems among seafarers

Beneficial approaches could be derived at individual and organization levels. At the individual level, promoting health behaviors such as healthy diet consumption and physical exercise on the ship is highlighted. Providing information on healthy daily meals using a cooking course and improving fitness facilities are preferred to be provided by the shipping company manager. This allowed seafarers easy access to health behaviors [70]. Training resilience is also important. For this purpose, physical exercise constitutes one specific method including programs combining exercise with resilience training [71, 72]. In particular, promoting health behaviors and developing resilience are emphasized for inexperienced seafarers, young and low ranking seafarers, and those working during port stays. Health management is also needed because obesity and diabetes have been associated with mental health problems. Regular clinical tests for seafarers are required to detect such disorders.

At organization level, a company manager provides seafarers with sufficient instruments, such as quality noise protective equipment because noise from engine is a subjective strain. While on board, seafarers experience high pressure from contractors or customers due to restricted work time. Facilitating practical support for better communication among them is preferred. Seafarers work in unclear work-rest cycles for long hours. Even with the difficulty of securing a safe break-rest location, providing a proper break time is desirable. Effort-reward imbalance constitutes a major source of stress response. This reward includes not only financial but also psychological and career rewards. Lastly, establishing an appropriate promotion system is desired.

Strengths and limitations

This scoping review followed the framework of Arksey and O’Malley [9], the PRISMA-ScR flow diagram [10], and the determined eligibility criteria. Because no restrictions were placed on the study type, a variety of research designs, such as quantitative, qualitative, or mixed-method were included. Then a quality assessment was conducted for the included studies using the standardized critical appraisal tool standardized by JBI [12, 13].

Limitations were encountered concerning study design. First, almost all included studies used the design of a quantitative cross-sectional survey. This is possibly a common method, but a causal relationship between mental health problems and investigated factors needs to be cautiously interpreted. Second, the included studies used self-report and may have resulted in self-reporting bias. Only two studies analyzed the measured outcome of objective parameters. Third, the characteristics of the sampled subjects is biased. Thus, indicating mental health problems among all seafarers would be difficult because job departments or shipping routes were undistinguished such as deck officers, non-officers, and engine personnel, sea or river passage, and types of ship. These factors were likely to introduce different mental health disorders. This highlights the need of further research in the maritime field.

Conclusions

This scoping review notes that the prevalence of stress, depressive symptoms, and burnout have been mentioned for decades. The factors related to mental health and psychological issues can be categorized as individual and work environmental factors. These results comprehensively offer beneficial approaches to mental health problems among seafarers at individual and organization levels. They include promoting health behaviors, developing resilience, and managing obesity and chronic diseases at the individual level. At the organization level, providing seafarers with adequate instrument support, delivering practical support to communicate with customers, managing their distinct work-rest hours and sustaining an adequate effort-reward balance. Further studies are needed in the maritime field such as longitudinal, or experimental studies for empirical evidence.

Availability of data and materials

Because the study is a scoping review of published studies, the full references of this study have been provided in the references list.

Abbreviations

BMI:

Body Mass Index

JBI:

Joanna Briggs Institute

PRISMA-ScR:

Preferred Reporting items for Scoping Reviews flow diagram

MBI:

Maslach Burnout Inventory

MJSS:

Minnesota Job Satisfaction Scale

PSS-4:

Perceive stress scale assessment

SDS:

Zung Self Rating Depression Scale

CBI:

Copenhagen Burnout Inventory

STAI:

State-Trait Anxiety Inventory

References

  1. Oldenburg M, Hogan B, Jensen HJ. Systematic review of maritime field studies about stress and strain in seafaring. Int Arch Occup Environ Health. 2013;86(1):1–15. https://doi.org/10.1007/s00420-012-0801-5.

    Article  CAS  PubMed  Google Scholar 

  2. Slišković A, Penezić Z. Occupational stressors, risks and health in the seafaring population. Rev Psychol. 2015;22(1-2):29-40. https://hrcak.srce.hr/162052. Accessed 22 Sep 2021.

  3. Iversen RT. The mental health of seafarers. Int Marit Health. 2012;63(2):78-89.https://journals.viamedica.pl/international_maritime_health/article/view/26143. Accessed 22 Sep 2021.

  4. Oldenburg M, Baur X, Schlaich C. Occupational risks and challenges of seafaring. J Occup Health. 2010;52(5):249–56. https://doi.org/10.1539/joh.K10004.

    Article  PubMed  Google Scholar 

  5. Carotenuto A, Molino I, Fasanaro AM, Amenta F. Psychological stress in seafarers: a review. Int Marit Health. 2012;63(4):188-94. https://journals.viamedica.pl/international_maritime_health/article/view/26129. Accessed 22 Sept 2021.

  6. Chung YS, Lee PT-W, Lee J-K. Burnout in seafarers: its antecedents and effects on incidents at sea. MPM. 2017;44(7):916–31. https://doi.org/10.1080/03088839.2017.1366672.

    Article  Google Scholar 

  7. Mellbye A, Carter T. Seafarers’ depression and suicide. Int Marit Health. 2017;68(2):108–14. https://doi.org/10.5603/IMH.2017.0020.

    Article  PubMed  Google Scholar 

  8. MacLachlan M, Kavanagh B, Kay A. Maritime health: a review with suggestions for research. Int Marit Health. 2012;63(1):1-6. https://journals.viamedica.pl/international_maritime_health/article/view/26150. Accessed 22 Sep 2021.

  9. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32. https://doi.org/10.1080/1364557032000119616.

    Article  Google Scholar 

  10. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467–73. https://doi.org/10.7326/M18-0850.

    Article  PubMed  Google Scholar 

  11. The EndNote Team. EndNote. EndNote 20. Philadelphia, PA: Clarivate; 2013.

    Google Scholar 

  12. Joanna Briggs Institute. Checklist for analytical cross-sectional studies: Critical appraisal tools for use in JBI systematic reviews. 2020. https://joannabriggs.org/sites/default/files/2020-08/Checklist_for_Analytical_Cross_Sectional_Studies.pdf. Accessed 20 Aug 2020.

  13. Joanna Briggs Institute. Checklist for qualitative research: Critical appraisal tools for use in JBI systematic reviews. 2020. https://joannabriggs.org/sites/default/files/2020-08/Checklist_for_Qualitative_Research.pdf. Accessed 20 Aug 2020.

  14. Oldenburg M, Jensen HJ. Saliva cortisol level as a strain parameter for crews aboard merchant ships. Chronobiol Int. 2019;36(7):1005–12. https://doi.org/10.1080/07420528.2019.1604540.

    Article  PubMed  Google Scholar 

  15. Haka M, Borch DF, Jensen C, Leppin A. Should I stay or should I go? Motivational profiles of Danish seafaring officers and non-officers. Int Marit Health. 2011;62(1):20-30. https://journals.viamedica.pl/international_maritime_health/article/view/26203. Accessed 20 Aug 2020.

  16. Doyle N, MacLachlan M, Fraser A, Stilz R, Lismont K, Cox H, et al. Resilience and well-being amongst seafarers: cross-sectional study of crew across 51 ships. Int Arch Occup Environ Health. 2016;89(2):199–209. https://doi.org/10.1007/s00420-015-1063-9.

    Article  PubMed  Google Scholar 

  17. McVeigh J, MacLachlan M, Vallières F, Hyland P, Stilz R, Cox H, et al. Identifying predictors of stress and job satisfaction in a sample of merchant seafarers using structural equation modeling. Front Psychol. 2019;10(70):1–13. https://doi.org/10.3389/fpsyg.2019.00070.

    Article  Google Scholar 

  18. Oldenburg M, Jensen HJ, Wegner R. Burnout syndrome in seafarers in the merchant marine service. Int Arch Occup Environ Health. 2013;86(4):407–16. https://doi.org/10.1007/s00420-012-0771-7.

    Article  CAS  PubMed  Google Scholar 

  19. Jurišić-Eržen D, Benko K, Ljubić S, Jerković R. The prevalence of depression and anxiety in seafarers type 2 diabetic patients. Coll Antropol. 2011;35(4):1067–70.

    PubMed  Google Scholar 

  20. Sąlyga J, Kušleikaitė M. Factors influencing psychoemotional strain and fatigue, and relationship of these factors with health complaints at sea among Lithuanian seafarers. Medicina. 2011;47(12):675–81. https://doi.org/10.3390/medicina47120099.

    Article  PubMed  Google Scholar 

  21. Nielsen MB, Bergheim K, Eid J. Relationships between work environment factors and workers’ well-being in the maritime industry. Int Marit Health. 2013;64(2):80-8. https://journals.viamedica.pl/international_maritime_health/article/view/34689. Accessed 20 Aug 2020.

  22. Bergheim K, Nielsen MB, Mearns K, Eid J. The relationship between psychological capital, job satisfaction, and safety perceptions in the maritime industry. Saf Sci. 2015;74:27–36. https://doi.org/10.1016/j.ssci.2014.11.024.

    Article  Google Scholar 

  23. Tedesco LMR, Ferrara P, Stromillo L, Arnese A, Albano L. Seafarers’ perceptions of job demand: a cross-sectional study. Arch Environ Occup Health. 2018;73(5):278–83. https://doi.org/10.1080/19338244.2017.1342590.

    Article  PubMed  Google Scholar 

  24. Slišković A, Penezić Z. Testing the associations between different aspects of seafarers’ employment contract and on-board internet access and their job and life satisfaction and health. Arh Hig Rada Toksikol. 2016;67(4):351–61. https://doi.org/10.1515/aiht-2016-67-2785.

    Article  PubMed  Google Scholar 

  25. Pauksztat B. ‘Only work and sleep’: seafarers’ perceptions of job demands of short sea cargo shipping lines and their effects on work and life on board. MPM. 2017;44(7):899–915. https://doi.org/10.1080/03088839.2017.1371347.

  26. Tavacioğlu L, Taç U, Eski O, Gökmen N. Burnout and job satisfaction among Turkish oceangoing seafarers. Int Marit Health. 2019;70(4):232–8. https://doi.org/10.5603/IMH.2019.0037.

    Article  PubMed  Google Scholar 

  27. Oldenburg M, Jensen HJ. Stress and strain among merchant seafarers differs across the three voyage episodes of port stay, river passage and sea passage. PLoS One. 2019;14(6):e0217904. https://doi.org/10.1371/journal.pone.0217904.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Oldenburg M, Jensen HJ. Stress and strain among seafarers related to the occupational groups. Int J Environ Res Public Health. 2019;16(7):1153. https://doi.org/10.3390/ijerph16071153.

    Article  PubMed Central  Google Scholar 

  29. McVeigh J, MacLachlan M. A silver wave? Filipino shipmates’ experience of merchant seafaring. Mar Policy. 2019;99:283–97. https://doi.org/10.1016/j.marpol.2018.10.012.

    Article  Google Scholar 

  30. Xiao J, Hung B, Shen H, Liu X, Zhang J, Zhong Y, et al. Association between social support and health-related quality of life among Chinese seafarers: A cross-sectional study. PLoS One. 2017;12(11):e0187275-e. https://doi.org/10.1371/journal.pone.0187275.

    Article  CAS  Google Scholar 

  31. Gu Y, Liu D, Zheng G, Yang C, Dong Z, Tee EYJ. The effects of Chinese seafarers’ job demands on turnover intention: the role of fun at work. Int J Environ Res Public Health. 2020;17(14):5247. https://doi.org/10.3390/ijerph17145247.

    Article  PubMed Central  Google Scholar 

  32. Xia SY, Zhang K, Shang W, Xing M, Chen L. Psychological and physiological effects of long voyage on female seamen in China. Int J Clin Exp Med.2016;9(4):7314-21. www.ijcem.com /ISSN:1940-5901/IJCEM0020472.Accessed 20 Aug 2020.

  33. Yuen KF, Loh HS, Zhou Q, Wong YD. Determinants of job satisfaction and performance of seafarers. Transp Res Part A Policy Pract. 2018;110:1-12. https://doi.org/10.1016/j.tra.2018.02.006. Accessed 20 Aug 2020.

  34. Lefkowitz RY, Slade MD, Redlich CA. Rates and occupational characteristics of international seafarers with mental illness. Occup. Med. (Lond.). 2019;69(4):279-82. https://doi.org/10.1093/occmed/kqz069. Accessed 20 Aug 2020.

  35. Lefkowitz RY, Null DB, Slade MD, Redlich CA. Injury, illness, and mental health risks in United States domestic mariners. J Occup Environ Med. 2020;62(10): 839–41.https://doi.org/10.1097/JOM.0000000000001968.

    Article  PubMed  Google Scholar 

  36. Silva JLLd, Moreno RF, Soares RdS, Almeida JA, Daher DV, Teixeira ER. Common mental disorders prevalence among maritime workers of Rio de Janeiro. Rev pesqui cuid fundam. 2017;9(3):676–81. https://doi.org/10.9789/2175-5361.2017.v9i3.676-681.

    Article  Google Scholar 

  37. Bakker AB, Demerouti E. The job demands-resources model: State of the art. J Manag Psychol. 2007;22(3):309–28. https://doi.org/10.1108/02683940710733115.

    Article  Google Scholar 

  38. Vanagas G, Bihari-Axelsson S. Interaction among general practitioners age and patient load in the prediction of job strain, decision latitude and perception of job demands. A cross-sectional study. BMC Public Health. 2004;4(1):1–6. https://doi.org/10.1186/1471-2458-4-59.

    Article  Google Scholar 

  39. Arcury-Quandt AE, Harbertson J, Ziajko L, Hale BR. Risk factors for positive depression screening across a shipboard deployment cycle. BJPsych Open. 2019;5(5):e84. https://doi.org/10.1192/bjo.2019.70.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Woo J-M, Postolache TT. The impact of work environment on mood disorders and suicide: evidence and implications. Int J Disabil Hum Dev. 2008;7(2):185–200. https://doi.org/10.1515/ijdhd.2008.7.2.185.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Chang PP, Ford DE, Mead LA, Cooper-Patrick L, Klag MJ. Insomnia in young men and subsequent depression: the Johns Hopkins Precursors Study. Am J Epidemiol. 1997;146(2):105–14.

    Article  CAS  PubMed  Google Scholar 

  42. Jaussent I, Bouyer J, Ancelin M-L, Akbaraly T, Peres K, Ritchie K, et al. Insomnia and daytime sleepiness are risk factors for depressive symptoms in the elderly. Sleep. 2011;34(8):1103–10. https://doi.org/10.5665/SLEEP.1170.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Fong SY-y, Wing YK. Longitudinal follow up of primary insomnia patients in a psychiatric clinic. Aust N Z J Psychiatry. 2007;41(7):611–7. https://doi.org/10.1080/00048670701400016.

    Article  PubMed  Google Scholar 

  44. Baglioni C, Battagliese G, Feige B, Spiegelhalder K, Nissen C, Voderholzer U, et al. Insomnia as a predictor of depression: a meta-analytic evaluation of longitudinal epidemiological studies. J Affect Disord. 2011;135(1-3):10–9. https://doi.org/10.1016/j.jad.2011.01.011.

    Article  PubMed  Google Scholar 

  45. Silva DA, Coutinho EdSF, Ferriani LO, Viana MC. Depression subtypes and obesity in adults: a systematic review and meta-analysis. Obes Rev. 2020;21(3):e12966. https://doi.org/10.1111/obr.12966.

    Article  PubMed  Google Scholar 

  46. Oddy WH, Allen KL, Trapp GS, Ambrosini GL, Black LJ, Huang R-C, et al. Dietary patterns, body mass index and inflammation: pathways to depression and mental health problems in adolescents. Brain Behav Immun. 2018;69:428–39. https://doi.org/10.1016/j.bbi.2018.01.002.

    Article  PubMed  Google Scholar 

  47. Roy T, Lloyd CE. Epidemiology of depression and diabetes: a systematic review. J Affect Disord. 2012;142:S8-S21. https://doi.org/10.1016/S0165-0327(12)70004-6.

    Article  Google Scholar 

  48. Mansori K, Shiravand N, Shadmani FK, Moradi Y, Allahmoradi M, Ranjbaran M, et al. Association between depression with glycemic control and its complications in type 2 diabetes. Diabetes Metab Syndr. 2019;13(2):1555–60.

    Article  PubMed  Google Scholar 

  49. Luthans F, Vogelgesang GR, Lester PB. Developing the psychological capital of resiliency. Human Hum. Resour. Dev. Rev. 2006;5(1):25–44. https://doi.org/10.1177/1534484305285335.

    Article  Google Scholar 

  50. Schetter CD, Dolbier C. Resilience in the context of chronic stress and health in adults. Soc Personal Psychol Compass. 2011;5(9):634–52. https://doi.org/10.1111/j.17519004.2011. 00379.x.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Hourani L, Bender RH, Weimer B, Peeler R, Bradshaw M, Lane M, et al. Longitudinal study of resilience and mental health in marines leaving military service. J Affect Disord. 2012;139(2):154–65. https://doi.org/10.1016/j.jad.2012.01.008.

    Article  PubMed  Google Scholar 

  52. Kobasa SC. Stressful life events, personality, and health: an inquiry into hardiness. J Pers Soc Psychol. 1979;37(1):1–11. https://doi.org/10.1037/0022-3514.37.1.1.

    Article  CAS  PubMed  Google Scholar 

  53. Joyce S, Shand F, Tighe J, Laurent SJ, Bryant RA, Harvey SB. Road to resilience: a systematic review and meta-analysis of resilience training programmes and intervention. BMJ Open. 2018;8:e017858. https://doi.org/10.1136/bmjopen-2017-017858.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Hu N-C, Chen J-D, Cheng T-J. The associations between long working hours, physical inactivity, and burnout. J Occup Environ Med. 2016;58(5):514–8. https://doi.org/10.1097/JOM.0000000000000715.

    Article  PubMed  Google Scholar 

  55. Park S, Kook H, Seok H, Lee JH, Lim D, Cho D-H, et al. The negative impact of long working hours on mental health in young Korean workers. PloS One. 2020;15(8):e0236931. https://doi.org/10.1371/journal.pone.0236931.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Li Z, Dai J, Wu N, Jia Y, Gao J, Fu H. Effect of long working hours on depression and mental well-being among employees in Shanghai: the role of having leisure hobbies. Int J Environ Res Public Health. 2019;16(24):4980. https://doi.org/10.3390/ijerph16244980.

  57. Theorell T, Hammarström A, Aronsson G, Bendz LT, Grape T, Hogstedt C, et al. A systematic review including meta-analysis of work environment and depressive symptoms. BMC Public Health. 2015;15(1):1–14. https://doi.org/10.1186/s12889-015-1954-4.

  58. Dėdelė A, Miškinytė A, Andrušaitytė S, Bartkutė Ž. Perceived stress among different occupational groups and the interaction with sedentary behaviour. Int J Environ Res Public Health. 2019;16(23):4595. https://doi.org/10.3390/ijerph16234595.

    Article  PubMed Central  Google Scholar 

  59. Martins L, Lopes C. Military hierarchy, job stress and mental health in peacetime. Occup Med (Lond.). 2012;62(3):182–7. https://doi.org/10.1093/occmed/kqs006.

    Article  CAS  Google Scholar 

  60. Fear NT, Rubin GJ, Hatch S, Hull L, Jones M, Hotopf M, et al. Job strain, rank, and mental health in the UK Armed Forces. Int J Occup Environ Health. 2009;15(3):291–8. https://doi.org/10.1179/oeh.2009.15.3.291

    Article  PubMed  Google Scholar 

  61. Gibson V. Supply ship operations.London: Oilfield Puclications Limited; 1999.

    Google Scholar 

  62. Armed Forces Health Surveillance Center (AFHSC). Mental disorders and mental health problems, active component, U.S. Armed Forces, 2000-2011. MSMR. 2012;19(6):11-7. PMID: 22779435.

  63. Yoon J-H, Won J-U, Lee W, Jung PK, Roh J. Occupational noise annoyance linked to depressive symptoms and suicidal ideation: a result from nationwide survey of Korea. PLoS One. 2014;9(8):e105321. https://doi.org/10.1371/journal.pone.0105321.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Beutel ME, Brähler E, Ernst M, Klein E, Reiner I, Wiltink J, et al. Noise annoyance predicts symptoms of depression, anxiety and sleep disturbance 5 years later. Findings from the Gutenberg Health Study. Eur J Public Health. 2020;30(3):487–92. https://doi.org/10.1093/eurpub/ckaa015.

    Article  Google Scholar 

  65. Jalilian H, Gorjizadeh O, Najafi K, Falahati M. Effects of whole body vibration and backrest angle on perceived mental workload and performance. EXCLI Journal. 2021;20:400–11. https://doi.org/10.17179/excli2020-2699.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Bakker AB, Hakanen JJ, Demerouti E, Xanthopoulou D. Job resources boost work engagement, particularly when job demands are high. J Educ Psychol. 2007;99(2):274–84. https://doi.org/10.1037/0022-0663.99.2.274.

    Article  Google Scholar 

  67. Ljoså CH, Tyssen R, Lau B. Mental distress among shift workers in Norwegian offshore petroleum industry—relative influence of individual and psychosocial work factors. Scand J Work Environ Health. 2011;37(6):551–5. https://www.jstor.org/stable/23064891.

  68. Nielsen MB, Tvedt SD, Matthiesen SB. Prevalence and occupational predictors of psychological distress in the offshore petroleum industry: a prospective study. Int Arch Occup Environ Health. 2013;86(8):875–85. https://doi.org/10.1007/s00420-012-0825-x.

    Article  PubMed  Google Scholar 

  69. van der Molen HF, Nieuwenhuijsen K, Frings-Dresen MH, de Groene G. Work-related psychosocial risk factors for stress-related mental disorders: an updated systematic review and meta-analysis. BMJ Open. 2020;10(7):e034849. https://doi.org/10.1136/bmjopen-2019-034849.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Hjarnoe L, Leppin A. Health promotion in the Danish maritime setting: challenges and possibilities for changing lifestyle behavior and health among seafarers. BMC Public Health. 2013;13(1):1–12. https://doi.org/10.1186/1471-2458-13-1165.

    Article  Google Scholar 

  71. Mahaffey BL, Mackin DM, Rosen J, Schwartz RM, Taioli E, Gonzalez A. The disaster worker resiliency training program: a randomized clinical trial. Int Arch Occup Environ Health. 2021;94:9–21. https://doi.org/10.1007/s00420-020-01552-3.

    Article  PubMed  Google Scholar 

  72. Yoshikawa E, Nishi D, Matsuoka YJ. Association between regular physical exercise and depressive symptoms mediated through social support and resilience in Japanese company workers: a cross-sectional study. BMC Public Health. 2016;16(1):1–8. https://doi.org/10.1186/s12889-016-3251-2.

    Article  Google Scholar 

Download references

Acknowledgements

The authors wish to thank the seafarers from shipping companies and the director of the Seafarers Standard Division, Marine Department, Ministry of Transport, Thailand for kindly advising about seafarer’s work. Also, we would like to thank Mr. Thomas McManamon for English language for editing this manuscript. WJ and OK have been financially supported by the Thailand Research Fund (TRF), the National Research Council of Thailand (NRCT), and the Thailand Science Research and Innovation (TSRI) through the Royal Golden Jubilee Ph.D. Program.

Funding

The author(s) disclosed receipts of the following financial support for the review: We appreciate the financial support received from the Thailand Research Fund (TRF), the National Research Council of Thailand (NRCT), and the Thailand Science Research and Innovation (TSRI) through the Royal Golden Jubilee PhD Program (RGJ-PhD) (Grant No. PHD/0186/2560).

Author information

Authors and Affiliations

  1. Department of Public Health Nursing, Faculty of Public Health, Mahidol University, 420/1 Ratchawithi Road., Ratchathewi, 10400, Bangkok, Thailand

    Woraluk Jonglertmontree, Orawan Kaewboonchoo & Plernpit Boonyamalik

  2. Graduate School of Health and Nursing Science, Wakayama Medical University, Mikazura 580, 641-0011, Wakayama, Japan

    Ikuharu Morioka

Authors
  1. Woraluk Jonglertmontree
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Orawan Kaewboonchoo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ikuharu Morioka
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Plernpit Boonyamalik
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors conceptualized the study. WJ and OK screened titles and abstract using the identified inclusion and exclusion criteria and assessed eligible included studies. IM contributed to interpreting data and provided writing guidance of the manuscript. IM and WJ analyzed the data and WJ initially wrote the manuscript. IM, OK, and PS reviewed and critically revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Orawan Kaewboonchoo.

Ethics declarations

Ethics approval and consent to participate

Ethics approval and consent to participate is not applicable to this study.

Consent for publication

Consent for publication is not applicable.

Competing interests

The authors declare that they have no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jonglertmontree, W., Kaewboonchoo, O., Morioka, I. et al. Mental health problems and their related factors among seafarers: a scoping review. BMC Public Health 22, 282 (2022). https://doi.org/10.1186/s12889-022-12713-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12889-022-12713-z

Keywords

BMC Public Health

ISSN: 1471-2458

Contact us