Mental health and suicide in former professional soccer players

Abstract

IntroductionThere is growing recognition of an association between contact sports participation and increased risk of neurodegenerative disease, including Alzheimer’s disease and chronic traumatic encephalopathy. In addition to cognitive impairment, a range of mental health disorders and suicidality are proposed as diagnostic features of traumatic encephalopathy syndrome, the putative clinical syndrome associated with chronic traumatic encephalopathy. However, to date, epidemiological data on contact sport participation and mental health outcomes are limited.MethodsFor a cohort of former professional soccer players (n=7676) with known high neurodegenerative mortality and their matched general population controls (n=23 028), data on mental health outcomes were obtained by individual-level record linkage to national electronic records of hospital admissions and death certification.ResultsCompared with matched population controls, former professional soccer players showed lower risk of hospital admission for anxiety and stress related disorders, depression, drug use disorders, alcohol use disorders and bipolar and affective mood disorders. Among soccer players, there was no significant difference in risk of hospitalisation for mental health disorders between outfield players and goalkeepers. There was no significant difference in rate of death by suicide between soccer players and controls.ConclusionsAmong a population of former professional soccer players with known high neurodegenerative disease mortality, hospital admissions for common mental health disorders were lower than population controls, with no difference in suicide. Our data provide support for the reappraisal of currently proposed diagnostic clinical criteria for traumatic encephalopathy syndrome, in particular the inclusion of mental health outcomes.

Association of Field Position and Career Length With Risk of Neurodegenerative Disease in Male Former Professional Soccer Players

“…For example, we could not access information on wider known factors associated with risk of neurodegenerative disease. However, as indirect insights into these factors, we have reported lower cardiovascular deaths and lower hospitalization rates for common mental health disorders, including admissions for drug and alcohol use disorders, among former soccer players. Future studies might consider the association of such factors with neurodegenerative disease outcomes in former contact sports athletes.…”

Mortality from mental disorders and suicide in male professional American football and soccer players: A meta‐analysis

“…From the retrieved articles, seven retrospective studies (total n = 27 477 athletes, 100% male) met all the inclusion criteria (Figure 1, Table 1). [20][21][22][23][24][25][26] Three studies shared the same sample, 20,22,24 and thus, we used only one to calculate the total number of participants. Five studies had a quality score of 8, 20,[22][23][24][25] and the other two had a score of 7 26 and 6, 21 respectively.…”

“…[20][21][22][23][24][25][26] Three studies shared the same sample, 20,22,24 and thus, we used only one to calculate the total number of participants. Five studies had a quality score of 8, 20,[22][23][24][25] and the other two had a score of 7 26 and 6, 21 respectively. Thus, all included studies were considered to have a moderate-high quality.…”

“…The methods used by the studies for identifying participants' vital status and cause of death are detailed in Supplementary file 3. Regarding the comparator group, four studies used a dataset representing the general population, 20,22,23,26 one study included a control group of non-athletic subjects, 25 one used athletes not exposed to repeated head impacts (ie, baseball players), 24 and another one combined both non-athletic controls and athletes that were not exposed to repeated head impacts. 21 Chronic traumatic encephalopathy (CTE) was not assessed as a diagnosis in any of the included studies.…”

Severe Suicidality in Athletes with Chronic Traumatic Encephalopathy: A Case Series and Overview on Putative Ethiopathogenetic Mechanisms

“…The link between contact sports and CTE has been a growing concern for youth athletic associations [22,23] and professional sports leagues [24,25] in recent years, and there is speculation that some of these injuries could develop into SB later in life [26][27][28]. Progressive neuropsychiatric symptoms resulting from CTE could lead to suicidal ideation (SI) and eventually suicidal behaviour (SB), especially the more severe forms of SB such as medical serious suicide attempt (SA) and completed suicide (for recent literature reviews, see [29,30]).…”