Brief reactive psychosis in naval aviation

Five naval aviation personnel diagnosed with brief reactive psychosis (BRP) have appeared before the Special Board of Flight Surgeons (SBFS) at the Naval Aerospace Medical Institute (NAMI). These cases demonstrate the challenges in diagnosis and disposition that face the clinical aeromedical specialist in evaluating the aviator who develops psychiatric symptoms. We discuss the aeromedical factors that must be considered when contemplating returning aviators with psychiatric diagnoses to flying duties. Sudden behavioral changes in aviation personnel require a systematic assessment, thorough documentation, and continuing reevaluation. The differentiation between organic and functional etiologies may be difficult. Final disposition may require consultation with experienced physicians skilled in both aviation psychiatry and neurology.