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 history.
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 if DSM-IV 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 depression.
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 team and ball-based sports (baseball, softball). Understanding how these emotional disorders and the demands of the sport are associated with 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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