Osteoarthritis is Associated with Symptoms of Common Mental Disorders Among Former Elite Athletes
Shuring N., Aoki H., Gray J., Kerkhoffs GM., Lambert M., Gouttebarge V. Knee Surg Sports Traumatol Arthrosc 2016; ahead of print
Take Home Message: Former elite athletes with osteoarthritis are more likely to have symptoms of common mental disorders (distress, sleep problems, adverse alcohol use) compared to those without osteoarthritis.
Osteoarthritis (OA) is one of the most debilitating joint pathologies worldwide as it leads to physical pain and disability, which can also impact a patient’s mental health. Former elite athletes in certain sports are at risk for OA or report symptoms of mental health disorders. However, it is unclear the extent too which OA among elite athletes is associated with symptoms of common mental disorders. Therefore, the authors collected survey data from 602 (28% response rate) former elite athletes within 5 sports (rugby, football, ice hockey, cricket, and Gaelic players; ~37 years of age) to assess common mental disorders and history of a diagnosis of OA. The authors assessed patient-reported distress (4DSQ, anxiety/depression (GHQ-12 sleep disturbance (PROMIS short form), adverse alcohol use (AUDIT-C), and whether they were diagnosed by a doctor with OA. Overall, 33% of the former elite athletes reported having a diagnosis of OA. Authors identified that athletes reporting a diagnosis of OA were nearly 1.5 times more likely to report common mental disorders and comorbidity (having >2 symptoms of mental health) compared with athletes who were not diagnosed with OA. Overall, roughly 1 in 3 athletes who reported OA had symptoms of distress (29%), anxiety/depression (31%), sleep disturbance (33%), and adverse alcohol use (34%). In comparison, roughly 1 in 4 or 5 athletes who reported they do not have diagnosed OA had symptoms of distress (19%) anxiety/depression (25%), sleep disturbance (24%), and adverse alcohol use (23%). Hence, former elite athletes with OA are 50 to 70% more likely to have symptoms for common mental disorders than their peers without OA. The authors also noted that the relationship between OA and mental health disorder differed by sport. For example, data from former athletes in rugby and ice hockey supported these findings but data from former football/soccer athletes showed no association between OA and symptoms for common mental disorders.
This is an important study as it confirms that both OA and symptoms of common mental disorders are prevalent among former elite athletes. Additionally, OA may be associated to common mental disorders such as distress, sleep disturbance, and adverse alcohol use among former elite athletes. These findings illustrate the importance of looking at potential long-term consequences when making medical decisions that put athletes at risk for OA. The interaction between OA and mental health issues occurring is complex, and strategies to prevent symptoms should be discussed, developed, and implemented. Medical professionals should have discussions with athletes about the prevention and care of mental health problems that may occur after sports.
Questions for Discussion: Have you ever discussed the risks of OA or mental health problems that could arise following an injury or surgery with your patients? Do you implement patient reported outcome measures? If so, which ones do you find helpful?
Written by: Jane McDevitt, PhD
Reviewed by: Jeff Driban
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Schuring N, Aoki H, Gray J, Kerkhoffs GM, Lambert M, & Gouttebarge V (2016). Osteoarthritis is associated with symptoms of common mental disorders among former elite athletes. Knee Surgery, Sports Traumatology, Arthroscopy PMID: 27488101