Occurrence of mental health symptoms and disorders in current and former elite athletes: a systematic review and meta-analysis

Abstract

ObjectivesTo present an overview of the existing epidemiological evidence regarding the occurrence of mental health symptoms and disorders among current and former elite athletes.DesignSystematic review and meta-analysis.Data sourcesFive electronic databases were searched from inception to November 2018: PubMed (MEDLINE), SportDiscus via EBSCO, PSycINFO via ProQuest, Scopus and Cochrane.Eligibility criteria for selecting studiesWe included original quantitative studies that were written in English, were conducted exclusively among current or former elite athletes, and presented incidence or prevalence rates of symptoms of mental disorders.ResultsTwenty-two relevant original studies about mental health symptoms and disorders among current elite athletes were included: they presented data especially on symptoms of distress, sleep disturbance, anxiety/depression and alcohol misuse. Meta-analyses comprising 2895 to 5555 current elite athletes showed that the prevalence of mental health symptoms and disorders ranged from 19% for alcohol misuse to 34% for anxiety/depression. Fifteen relevant original studies about mental health symptoms and disorders among former elite athletes were included: they similarly presented data especially about symptoms of distress, sleep disturbance, anxiety/depression and alcohol misuse. Meta-analyses comprising 1579 to 1686 former elite athletes showed that the prevalence of mental health symptoms and disorders ranged from 16% for distress to 26% for anxiety/depression.ConclusionsOur meta-analyses showed that the prevalence of mental health symptoms and disorders ranged from 19% for alcohol misuse to 34% for anxiety/depression for current elite athletes, and from 16% for distress to 26% for anxiety/depression for former elite athletes.

Mental health and psychological well-being among professional rugby league players from the UK

“…These equivocal findings from meta-analyses, scoping reviews and systematic reviews regarding depressive and anxiety symptoms1–5 may be due to differences in the content of questionnaires used in these studies, which have not been validated for elite athletes. Some studies9 10 assessed anxiety using the General Anxiety Disorder (GAD) scale,11 whereas another study8 used the General Health Questionnaire (GHQ-12) 12.…”

“…Although elite athletes often epitomise the fit and healthy archetype, research over recent years suggests that they are still as likely, if not more likely, to be at risk of experiencing mental health symptoms. Several meta-analyses and/or reviews indicate that playing sport at the highest level is associated with significant mental health symptoms such as depressive and anxiety symptoms 1–5. It has been suggested that this may be due to the significant pressures of being an elite athlete, including high training loads, stress of competition and insufficient recovery 4.…”

“…The prevalence of depressive and anxiety symptoms among elite athletes is equivocal. For example, a meta-analysis, containing nine studies that assessed a combined score of anxiety and depressive symptoms, revealed that 33.6% of athletes reported symptoms of anxiety/depression 3. Another scoping review reported that elite athletes reported depressive symptoms between 4% and 68% and anxiety between 6% and 14.6% 1.…”

Elite coaches have a similar prevalence of depressive symptoms to the general population and lower rates than elite athletes

“…A recent meta-analysis illustrated the prevalence of symptoms of depression and anxiety in elite athletes to be as high as 34%. 1 In New Zealand elite athletes were found to have a prevalence of 21% for depressive symptoms 2 while 14% of the adult population has been diagnosed with depression in their lifetime. 3 An international professional rugby study, which included New Zealand players, found the prevalence for depressive and anxiety symptoms to be 28%.…”

Addressing mental health in elite athletes as a vehicle for early detection and intervention in the general community

“…What we do know is that athletes performing within elite settings report symptoms of clinical and subthreshold disorders at similar, if not slightly higher rates to healthy adults. These symptoms are hypothesised to relate to a range of competitive, organizational and personal stressors that can occur within the context of sport; such as heightened stress and pressure to perform, injuries, time away from support networks through exhausting travel schedules, public scrutiny and post-career transition (especially when non-voluntary) to a non-athletic identity (Gorczynski, Coyle, & Gibson, 2017;Gouttebarge et al, 2019;Gouttebarge, Frings-Dresen, & Sluiter, 2015;Gulliver, Griffiths, Mackinnon, Batterham, & Stanimirovic, 2015;Henriksen et al, 2019;Hughes & Leavey, 2012;Reardon et al, 2019;Rice et al, 2016Rice et al, , 2019.…”