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      Prevalence of depression and anxiety in top-level male and female football players

      research-article
      1 , 2 , 3 , 2 , 3 , 4
      BMJ Open Sport — Exercise Medicine
      BMJ Publishing Group
      Soccer, Sport, Mental

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          Abstract

          Background

          Scientific studies on the prevalence of mental health problems in elite athletes are rare, and most have had considerable methodological limitations, such as low response rate and heterogeneous samples.

          Aims

          To evaluate the prevalence of depression and anxiety in top-level football players in comparison to the general population, and to analyse potential risk factors.

          Methods

          Players of all first league (FL) and of four U-21 football teams in Switzerland were asked to answer a questionnaire on player's characteristics, the Centre of Epidemiologic Studies Depression Scale (CES-D) and the Generalized Anxiety Disorder (GAD-7) scale.

          Results

          All 10 women's FL teams, 9 of 10 men's FL teams and 4 male U-21 teams (n=471 football players) took part in the study. The CES-D score indicated a mild to moderate depression in 33 (7.6%) players and a major depression in 13 (3.0%) players. The GAD-7 score indicated an at least moderate anxiety disorder in 6 (1.4%) players. Compared to the general population, the prevalence of depression was similar and the prevalence of anxiety disorders was significantly (χ 2=16.7; p<0.001) lower in football players. Significant differences were observed with regard to player characteristics, such as age, gender, player position, level of play and current injury.

          Conclusions

          Swiss FL football players had the same prevalence of depression as the general population, while male U-21 players had a higher prevalence of depression. It is important to raise awareness and knowledge of athletes’ mental health problems in coaches and team physicians, and to provide adequate treatment to athletes.

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          Most cited references11

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          Psychological Balance in High Level Athletes: Gender-Based Differences and Sport-Specific Patterns

          Objectives Few epidemiological studies have focused on the psychological health of high level athletes. This study aimed to identify the principal psychological problems encountered within French high level athletes, and the variations in their prevalence based on sex and the sport practiced. Methods Multivariate analyses were conducted on nationwide data obtained from the athletes' yearly psychological evaluations. Results A representative sample of 13% of the French athlete population was obtained. 17% of athletes have at least one ongoing or recent disorder, generalized anxiety disorder (GAD) being the most prevalent (6%), followed by non-specific eating disorders (4.2%). Overall, 20.2% of women had at least one psychopathology, against 15.1% in men. This female predominance applied to anxiety and eating disorders, depression, sleep problems and self-harming behaviors. The highest rates of GAD appeared in aesthetic sports (16.7% vs. 6.8% in other sports for men and 38.9% vs. 10.3% for women); the lowest prevalence was found in high risk sports athletes (3.0% vs. 3.5%). Eating disorders are most common among women in racing sports (14% vs. 9%), but for men were found mostly in combat sports (7% vs. 4.8%). Discussion This study highlights important differences in psychopathology between male and female athletes, demonstrating that the many sex-based differences reported in the general population apply to elite athletes. While the prevalence of psychological problems is no higher than in the general population, the variations in psychopathology in different sports suggest that specific constraints could influence the development of some disorders.
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            Barriers and facilitators to mental health help-seeking for young elite athletes: a qualitative study

            Background Adolescents and young adults experience a high level of mental disorders, yet tend not to seek help. Research indicates that there are many barriers and facilitators to help-seeking for young people in the general community. However there are limited data available for young elite athletes. This study aims to determine what young elite athletes perceive as the barriers and facilitators to help-seeking for common mental health problems. Methods Fifteen elite athletes aged 16–23 years each participated in one of three focus group discussions. In addition to written data, verbal responses were audio taped, transcribed and thematically analysed. Results Participants’ written and verbal data suggested that stigma was the most important perceived barrier to seeking help for young elite athletes. Other notable barriers were a lack of mental health literacy, and negative past experiences of help-seeking. Facilitators to help-seeking were encouragement from others, having an established relationship with a provider, pleasant previous interactions with providers, the positive attitudes of others, especially their coach, and access to the internet. Conclusions Intervention strategies for improving help-seeking in young elite athletes should focus on reducing stigma, increasing mental health literacy, and improving relations with potential providers.
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              Prevalence of and risk factors associated with symptoms of depression in competitive collegiate student athletes.

              To describe the prevalence of symptoms of depression among competitive collegiate student athletes and examine the factors associated with symptoms of depression among this population. A baseline survey of a prospective cohort study. The survey was administered at the preseason team meetings. The sample included 257 collegiate student athletes (167 males and 90 females) who participated in Division I National Collegiate Athletic Association (NCAA)-sponsored sports during the 2005-2006 academic year. Symptoms of depression were measured by the Center for Epidemiological Studies Depression Scale (CESD). Anxiety was measured by the State-Trait Anxiety Inventory (STAI). The Generalized Estimating Equations (GEE) was used to assess the factors associated with symptoms of depression. Twenty-one percent of participants reported experiencing symptoms of depression. Athletes who were female, freshmen, or with self-reported pain were associated with significantly increased odds of experiencing symptoms of depression after adjusting for sports and other covariates. In particular, female athletes had 1.32 greater odds (95% CI, 1.01 to 1.73) of experiencing symptoms of depression compared to male student athletes. Freshmen had 3.27 greater odds (95% CI, 1.63 to 6.59) of experiencing symptoms of depression than their more senior counterparts. Student athletes who reported symptoms of depression were associated with higher scores of State-Anxiety and Trait-Anxiety, respectively (P<0.0001). Our findings provide empirical data for the future study on mental health among collegiate athletes. Further studies on why female and freshmen athletes are at increased risk of experiencing symptoms of depression are also warranted.
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                Author and article information

                Journal
                BMJ Open Sport Exerc Med
                BMJ Open Sport Exerc Med
                bmjosem
                bmjosem
                BMJ Open Sport — Exercise Medicine
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2055-7647
                2016
                19 January 2016
                : 2
                : 1
                : e000087
                Affiliations
                [1 ]Medical School Hamburg (MSH) , Hamburg, Germany
                [2 ]FIFA Medical Assessment and Research Centre (F-MARC) , Zürich, Switzerland
                [3 ]Swiss Concussion Centre (SCC) Schulthess Klinik , Zürich, Switzerland
                [4 ]Department of Neurology, Interdisciplinary Center for Vertigo and Neurological Visual Disorders, University Hospital Zürich , Zürich, Switzerland
                Author notes
                [Correspondence to ] Dr Astrid Junge; Astrid.Junge@ 123456F-MARC.com
                Article
                bmjsem-2015-000087
                10.1136/bmjsem-2015-000087
                5117057
                81c82aa8-f82f-4167-ac31-c578ea8ce6df
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 7 November 2015
                : 17 November 2015
                Categories
                Research
                1506

                soccer,sport,mental
                soccer, sport, mental

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