Depressive symptoms in high-performance athletes and non-athletes: a comparative meta-analysis update

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Abstract
Objective: Provide an updated comparison of the prevalence of mild or more severe depressive symptoms between high-performance athletes and non-athletes. Design: Comparative OR meta-analysis. Data sources: PubMed (Medline), PsycINFO (Ebsco), Scopus (Elsevier) and SportDiscus (Ebsco). We conducted hand searches of reference lists of relevant papers. Eligibility: Studies were included that were published in full in English; compared high-performance athletes and non-athletes; used a validated measure of depressive symptoms; and provided the prevalence of individuals who indicated at least mild depressive symptoms. Results: 1834 records were screened, 58 reviewed for eligibility, and five studies were included and added to five studies from our previous meta-analysis. Collectively, 10 studies reporting data on 2430 high-performance athletes and 2725 non-athletes were evaluated. A risk of bias in prevalence studies assessment demonstrated an agreement between the two evaluating authors that was considered substantial or strong with a kappa statistic of 0.75. There was no significant difference in depressive symptom prevalence between high-performance athletes and non-athletes (OR=1.016, 95% CI=0.815 to 1.267, p=0.888). Male high-performance athletes (n=1708) were no more likely than male non-athletes (n=1556) to report mild or more severe depressive symptoms (OR=0.936, 95% CI=0.710 to 1.235, p=0.641). Female high-performance athletes (n=722) were no more likely than female non-athletes (n=1157) to report mild or more severe depressive symptoms (OR=1.031, 95% CI=0.818 to 1.299, p=0.796). Male high-performance athletes (n=1019) were 47% less likely to report mild or more severe depressive symptoms than female high-performance athletes (n=722) (OR=0.527, 95% CI=0.418 to 0.664, p<0.001). Male non-athletes (n=955) were 33% less likely to report mild or more severe depressive symptoms than female non-athletes (n=1157) (OR=0.666, 95% CI=0.447 to 0.992, p=0.045). Conclusion: This meta-analysis found no significant difference in depressive symptom prevalence between high-performance athletes and non-athletes. However, both female high-performance athletes and non-athletes report a greater prevalence of depressive symptoms than their male counterparts.

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