Epidemiology of mental health conditions in incoming division
I collegiate athletes
Sarac N, Sarac
B, Pedroza A, Borchers J. Phys Sports Med.
2017. [Epub Ahead of Print].
Take Home Message: Approximately 1 in 7 incoming collegiate athletes
reported mental health conditions. These conditions were associated with injury
Understanding the relationship between
mental health and injuries is important for health professionals to consider as
athletes with mental health conditions (e.g., anxiety, depression) may have an
increased risk of injury or suffer longer recovery periods. Much of the
research regarding mental health focuses on concussion; however, mental health
may also be associated with musculoskeletal injuries. Therefore, the authors reviewed
pre-participation exam questionnaires from 1,118 incoming students from 33
varsity athletic teams at one Division I collegiate institution. Each athlete
answered questions regarding history of mental health, sport played,
musculoskeletal injury and concussion history, post-concussion depression, and
if they have ever been diagnosed with attention deficit /hyperactive disorder,
eating disorders or emotional disturbance. The authors defined a mental health condition
criteria were met. The authors found that ~1 in 7 athletes had a history of any
mental health condition (14.2% males, 13.6% females). A history of emotional
disturbance was reported by 2.5%, eating disorders by 7%, and ADD/ADHD by 6% of
the athletes. Individual sport athletes reported greater prevalence (~17%) than
team athletes (~12%). Wresting (46%), women’s rowing (23%), and women’s
swimming (23) reported the highest prevalence of mental health conditions,
where cheerleading (5%), baseball (4%), and softball (4%) reported the lowest. The
authors found that upper extremity, lower extremity, axial skeleton, and
concussion injuries were all associated with mental health condition. Among the
251 athletes that reported history of concussion, 2% reported post-concussion
The authors found that the lifetime
prevalence of mental health conditions at this institution was low compared to
the general population where 1 in 4-5 adolescences may have a mental health
condition. This could be attributed to several factors such as athletic
participation mitigating depression symptoms, having a sense of belonging, or
due to underreporting of the mental condition. While the prevalence is lower
than the public it should still raise the attention of clinicians as almost 1
in 7 athletes had a history of a mental health condition. The authors also
found an association of reported mental health conditions and injury history; however,
further research is necessary to determine more information about this
relationship, such as, does mental health issues increase risk of injury. It
was interesting to see the difference in sports and reported mental health conditions.
Athletes in an individual, high aesthetic sports (wrestling, rowing, swimming)
seemed to report more mental health conditions compared with the team and ball-based
sports (baseball, softball). Understanding how these emotional disorders and
the demands of the sport are associated to injury history are important to move
forward with injury risk prevention and education plans. Furthermore, it would
be beneficial to see the lifetime prevalence and incidence of mental health
conditions at other colleges and high schools. Currently, medical professionals
should continue to screen and educate about mental health disorders.
Questions for Discussion: Do you see a relationship between injury
history and mental health? If so, how are you addressing it?
Written by: Jane McDevitt
Reviewed by: Jeffrey Driban
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