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Systematic review
Occurrence of mental health symptoms and disorders in current and former elite athletes: a systematic review and meta-analysis
  1. Vincent Gouttebarge1,2,
  2. João Mauricio Castaldelli-Maia3,4,
  3. Paul Gorczynski5,
  4. Brian Hainline6,
  5. Mary E Hitchcock7,
  6. Gino M Kerkhoffs1,2,8,
  7. Simon M Rice9,10,
  8. Claudia L Reardon11,12
  1. 1 Amsterdam UMC, Univ of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, The Netherlands
  2. 2 Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center of Excellence, Amsterdam, The Netherlands
  3. 3 Department of Neuroscience, Medical School, Fundação do ABC, Santo André, Brazil
  4. 4 Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil
  5. 5 Sport and Exercise Science, University of Portsmouth, Portsmouth, UK
  6. 6 National Collegiate Athletic Association (NCAA), Indianapolis, Indiana, USA
  7. 7 Ebling Library for the Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
  8. 8 Amsterdam Center for Evidence-based Sports Medicine, Academic Medical Center, Amsterdam, The Netherlands
  9. 9 Research and Translation, Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
  10. 10 Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
  11. 11 Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
  12. 12 University Health Services, University of Wisconsin, Madison, Wisconsin, USA
  1. Correspondence to Dr Vincent Gouttebarge, Amsterdam UMC, Univ of Amsterdam, Department of Orthopaedic Surgery, Amsterdam, The Netherlands; v.gouttebarge{at}amsterdamumc.nl

Abstract

Objectives To present an overview of the existing epidemiological evidence regarding the occurrence of mental health symptoms and disorders among current and former elite athletes.

Design Systematic review and meta-analysis.

Data sources Five electronic databases were searched from inception to November 2018: PubMed (MEDLINE), SportDiscus via EBSCO, PSycINFO via ProQuest, Scopus and Cochrane.

Eligibility criteria for selecting studies We 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.

Results Twenty-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.

Conclusions Our 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.

  • anxiety
  • depression
  • mental
  • sleep

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: http://creativecommons.org/licenses/by/4.0/.

http://dx.doi.org/10.1136/bjsports-2019-100671

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    Footnotes

    • Correction notice This article has been corrected since it first published online. The open access licence type has been amended.

    • Contributors VG designed the study, reviewed identified papers and selected those matching inclusion criteria, coordinated the data extraction, assessed risk of bias, assisted in performing statistical analyses, edited and critically reviewed the manuscript, and approved the final version of the manuscript. JMC-M designed the study, performed the data extraction, edited and critically reviewed the manuscript, and approved the final version of the manuscript. PG designed the study, performed statistical analyses, edited and critically reviewed the manuscript, and approved the final version of the manuscript. BH designed the study, edited and critically reviewed the manuscript, and approved the final version of the manuscript. MH performed the literature searches, edited and critically reviewed the manuscript, and approved the final version of the manuscript. GK designed the study, reviewed identified manuscripts and selected those matching inclusion criteria, assessed risk of bias, edited and critically reviewed the manuscript, and approved the final version of the manuscript. SR designed the study, performed the data extraction, edited and critically reviewed the manuscript, and approved the final version of the manuscript. CR designed the study, edited and critically reviewed the manuscript, and approved the final version of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.