Inflight anxiety conditions presenting with "break-off" symptoms

The psychological dimension of disorientation is explored through two experienced pilots who developed inflight anxiety conditions. These were associated with "break-off" symptoms, which are inflight sensations of separation from the ground, the environment, and the aircraft. Following extensive psychiatric and medical evaluations, one aviator was diagnosed as having agoraphobia without panic disorder, and the other as having an otherwise unspecified anxiety disorder. These patient reports demonstrate the need for the clinical aerospace medicine specialist to investigate inflight anxiety conditions for underlying neuropsychiatric disorders. The reports also contrast some of the historical aeromedical concepts with modern psychiatric diagnostic nomenclature.