Sharaisha Chanita Bilgoe

We explored the epidemiological evidence on the prevalence of mental health symptoms among current and former elite athletes as well as among their entourage members. Methods: A systematic review and meta-analysis were conducted in PubMed, PsycINFO, SportDiscus and Scopus to retrieve original quantitative studies that (i) were written in English, (ii) were conducted exclusively among current or former elite athletes and/or their entourage members, and (iii) presented prevalence rates of mental health symptoms. Results: In total, 72 studies were included, focusing on self-reported mental health symptoms (not on clinically diagnosed mental health disorders). Meta-analyses comprising 2596 to 10,927 current elite athletes showed that the prevalence of mental health symptoms ranged from 4% for drug misuse to 33% for distress. Meta-analyses comprising 2070 to 3405 former elite athletes showed that the prevalence of mental health symptoms ranged from 12% for depression to 28% for alcohol misuse. Because of the considerable heterogeneity among the included studies, the pooled prevalence estimates from these meta-analyses should be interpreted cautiously, as they summarize highly heterogeneous populations. Mental health symptoms were found to also be common among entourage members, with prevalence rates ranging from 5% for depression or anxiety to 53% for alcohol misuse in high-performance staff (including coaches) and reaching up to 36–58% for burnout in healthcare professionals working during the Paralympic games. Conclusions: Showing considerable heterogeneity across included studies, our systematic review and meta-analysis established that mental health symptoms are commonly reported by current and former elite athletes, as well as by their high-performance staff (including coaches) and medical staff. This warrants the implementation of various tailored resources, such as mental health literacy, screening programs and the availability of interdisciplinary medical and psychological support.

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.

Aim(s) This study aimed to explore the prevalence of mental health symptoms in current and former elite kickboxers and to establish whether these mental health symptoms were associated with severe musculoskeletal injuries and/or concussions. Methods A cross-sectional study was conducted by utilizing an electronic questionnaire among current and former elite kickboxers from the highest and second highest international level. Validated screening questionnaires from the International Olympic Committee Sport Mental Health Assessment Tool 1 (SMHAT-1) were used to asses mental health symptoms. Results The most prevalent mental health symptoms among current elite kickboxers (N = 45) were psychological distress (57%) and disordered eating (63%). Among former elite kickboxers (N = 29), the most prevalent mental health symptoms were 36% for psychological distress and 43% for alcohol misuse. Additionally, no statistically significant associations were found between mental health symptoms and severe musculoskeletal injuries and/or concussions among current and former elite kickboxers. Conclusions The substantial prevalence rates of mental health symptoms among current and former elite kickboxers emphasize the need for increased attention in this area. No associations were found between the potential contributing factors and mental health symptoms among current and former elite kickboxers. While further research is needed, raising awareness as well as developing preventive and supportive measures to assist elite kickboxers with personal and career development should be prioritized, both inside and outside the ring.

Background: Elite athletes encounter various situations and conditions that may disrupt their sleep, a crucial factor for optimal performance and well-being. Objectives: The aim of this study was to synthesise existing research on the effect of sleep interventions on sleep quantity and quality in elite sports and to provide evidence-based guidance for athletes, coaches, and other stakeholders in elite sports who seek to enhance sleep quantity and quality. Methods: This review followed the PRISMA guidelines, whereas the search was executed in September 2023 utilising the electronic databases SCOPUS, PubMed and Web of Science. Studies were included if they met the inclusion criteria. Results: A total of 1014 studies were retrieved from the databases, and data extraction was performed on 32 studies. The included studies evaluated sleep hygiene education/strategies, acute cold exposure, light therapies, supplementation, neurostimulation/neurofeedback, and other (mindfulness and massage therapy) strategies. Sleep hygiene education was the most effective intervention to improve sleep quantity. Supplementation and light therapy interventions showed improved sleep quality and quantity. Additionally, cold water immersion and mindfulness showed improved sleep quality, but further studies are required for confirmation. Conclusion: Future research should use reliable and valid methods to improve the quality of evidence and ensure conclusive findings.

Objective: To establish the prevalence of mental health symptoms (MHSs) among Dutch elite athletes and their coaches, to examine the association between potential contributing factors and MHS among Dutch elite athletes and their coaches and to explore the view and needs of Dutch elite athletes and their coaches regarding mental health resources and support. Methods: A cross-sectional study was conducted by distributing an electronic questionnaire based on validated screening questionnaires for the assessment of MHS. Results: In total, 156 athletes (55% female) and 95 coaches (79% male) across various sports participated in this study. The most prevalent MHS among athletes and coaches were distress (73% and 41%) and alcohol misuse (52% and 53%). Adverse life events showed an association with anxiety, depression, sleep disturbance, alcohol misuse and disordered eating while severe injuries showed an association with distress and sleep disturbance in elite athletes. Among coaches, no significant associations were found between potential contributing factors and MHS. 60% of the athletes and 60% of the coaches (totally) agreed that they could openly address their mental health issues within their sport while 53% of the athletes and 41% of the coaches (totally) agreed a need for increased attention regarding mental health/guidance in their sport. Conclusions: MHSs are prevalent among Dutch elite athletes and coaches. Recent adverse life events and severe injuries have a potential intersection with MHS in elite athletes. There is a need for increased attention regarding mental health/guidance among Dutch elite athletes and coaches within their sport so that subsequent treatment/support can be provided.

Objective To calculate the prevalence rates of mental health symptoms among female professional football players over a 12-month period and to explore the associations of severe injury and related surgery with mental health symptoms among female professional footballers. Methods An observational prospective cohort study was conducted over a 12-month follow-up period by distributing an electronic questionnaire three times. The questionnaire was based on validated screening tools for assessing mental health symptoms. Results A total of 74 female professional football players participated in this study. Mental health symptoms ranged from 1% for substance misuse to 65% for sport-psychological distress at baseline, from 6% for anxiety to 53% for sport-psychological distress 6 months postbaseline and from 3% for substance misuse to 55% for sport-psychological distress 12 months postbaseline. The prevalence of disordered eating remained between 15% and 20% over the 12-month period. Only one of the associations was statistically significant. Female professional football players were nearly twice as likely to report sport-related psychological distress following every surgery. Conclusions The substantial prevalence of mental health symptoms among female professional football players emphasises the need for increased attention, awareness and interventions. Additionally, female professional football players are nearly twice as likely to report sport-related psychological distress after each surgery. Sports medicine physicians and mental health professionals working in female football should provide standard care, which involves identifying, monitoring and implementing tailored interventions for mental health symptoms.