Osteoarthritis is associated with symptoms of common mental disorders among former elite athletes

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Abstract
Purpose The primary aim was to establish the association between osteoarthritis (OA) and the occurrence and comorbidity of symptoms of common mental disorders (CMD: distress, anxiety/depression, sleep disturbance, adverse alcohol use) in a group of former elite athletes (rugby, football, ice hockey, Gaelic sports and cricket). A secondary aim was to explore this association in the subgroups of sports. Methods Cross-sectional analysis was performed on the baseline questionnaires from five prospective cohort studies conducted between April 2014 and January 2016 in former elite athletes of rugby, football, ice hockey, Gaelic sports and cricket. The presence of OA (diagnosed by a medical professional) was examined with a single question, and symptoms of CMD were evaluated through multiple validated questionnaires (4DSQ, GHQ-12, PROMIS, AUDIT-C). Results There was a significant association between OA and symptoms of distress (OR 1.7, 95 % CI 1.2–2.6), sleep disturbance (OR 1.6, 95 % CI 1.1–2.3), adverse alcohol use (OR 1.8, 95 % CI 1.2–2.6) and a comorbidity of symptoms of CMD (OR 1.5, 95 % CI 1.0–2.1) in former elite athletes. Conclusion OA might be a risk factor for developing symptoms of CMD in former elite athletes. The clinical relevance of this study is that an interdisciplinary approach to the clinical care and support of former elite athletes after their careers is advocated as the interaction between the physical and mental health issues occurring on the long term is complex. Monitoring OA among former elite athletes should be empowered while strategies to prevent symptoms worsening should be developed and implemented. The self-awareness, prevention and care of mental health problems that might occur after a professional sports career should also be addressed. Level of evidence Level III.

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