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  1. Vincent Gouttebarge1,2,
  2. Haruhito Aoki3,
  3. Gino Kerkhoffs2
  1. 1World Players' Union FIFPro, Hoofddorp, The Netherlands
  2. 2Academic Medical Center, Amsterdam, The Netherlands
  3. 3St. Marianna University School of Medicine, Kawasaki, Japan


    Background In contrast to the extensive amount of information available about their physical health, scientific knowledge about the mental well-being of professional footballers is scarce. In addition, the potential relation of musculoskeletal injuries with the mental well-being of professional footballers has not been studied yet.

    Objective To explore the mental well-being (distress, anxiety depression, sleep disturbance, adverse alcohol use) of professional footballers over twelve months and to assess its relation with musculoskeletal injuries.

    Design Observational prospective cohort study with a follow-up period of twelve months was conducted.

    Setting Professional football in five European countries: Finland, France, Norway, Spain and Sweden.

    Patients (or Participants) A total of 540 professional footballers were enrolled (mean age at recruitment was 27 years; mean career duration was 8 years; 55% from the highest national level).

    Interventions (or Assessment of Risk Factors) The total number of time-loss (>4 weeks) injuries occurred during a player's career was examined by a single question.

    Main Outcome Measurements Distress, anxiety depression, sleep disturbance, adverse alcohol use were self-reported through validated scales.

    Results Among professional footballers, twelve-month incidence was 12% for distress, 37% for anxiety/depression, 19% for sleep disturbance and 14% for adverse alcohol use. At baseline, professional footballers who had sustained two or more time-loss injuries during their career were 2.5 to 3.5 times more likely to report distress, anxiety depression, sleep disturbance or adverse alcohol use.

    Conclusions A professional football team typically drawn from a squad of 25 players can expect in one season at least three players to struggle with their mental well-being. This study empowers the need of an interdisciplinary approach to the clinical care and support in professional football.

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