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The prevalence of Mental Health Problems in elite athletes
Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.ORCID iD: 0000-0002-2952-0347
Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.ORCID iD: 0000-0002-9921-6586
Karolinska Institutet.
Karolinska Institutet.
2020 (English)In: Journal of Science and Medicine in Sport, ISSN 1440-2440, E-ISSN 1878-1861, no 4, p. 329-335Article in journal (Refereed) Published
Abstract [en]

Objectives

The first aim was to examine mental health problems (MHP) in elite athletes addressing prevalence, sex-differences, onset, recurrent episodes, help-seeking, symptoms of specific disorders and previous psychiatric diagnoses. The second aim was to investigate if sport-specific instruments could indicate clinical levels of psychiatric symptoms.

Design

Cross-sectional survey.

Methods

Elite athletes (representing different Swedish national teams and applying for a university scholarship (n = 333) answered a web-based survey. Females represented 58.9%. Mean age was 24.6(±3.1) years and 77.2% were individual-and 22.8% team-sport athletes.

Results

Lifetime prevalence of MHP was 51.7% (females 58.2%, males 42.3%). Point prevalence was 11.7% (females 13.8%, males 8.8%). Onset of first MHP episode peaked at age 19 with 50% of onsets between ages 17–21. Recurrent episodes were common, and females sought help more than males (females 37.8%, males 16.8%). Overall 19.5% reached the clinical cut-offs for symptoms of anxiety and/or depression (females 26.0%, males 10.2%). Previous psychiatric diagnoses existed among 8.1% (females 10.7%, males 4.4%). A depressive disorder, an eating disorder or a trauma and stress related disorder (self-reported as burnout) were most common. Finally, most sport-specific instruments (80%) demonstrated a fair diagnostic accuracy compared to clinically validated instruments.

Conclusions

Lifetime prevalence of MHP was reported by more than half of the athletes. Symptoms manifested in young age and recurrent episodes were common. Sport-specific instruments indicating when symptoms reach clinical levels are potentially useful for data summary purposes on a group level, but without sufficiently high sensitivity and specificity to be recommend for applied work with athletes.

Place, publisher, year, edition, pages
Elsevier, 2020. no 4, p. 329-335
Keywords [en]
Psychiatric disorders, Help seeking, Onset, Measurement
National Category
Sport and Fitness Sciences Psychology
Research subject
Social Sciences/Humanities
Identifiers
URN: urn:nbn:se:gih:diva-5910DOI: 10.1016/j.jsams.2019.10.022ISI: 000521119900003OAI: oai:DiVA.org:gih-5910DiVA, id: diva2:1369187
Conference
Vol. 23 Issue 4, p329
Available from: 2019-11-11 Created: 2019-11-11 Last updated: 2023-01-04Bibliographically approved
In thesis
1. Psychiatric disorders in Swedish elite athletes: Prevalence, comorbidity and life stories
Open this publication in new window or tab >>Psychiatric disorders in Swedish elite athletes: Prevalence, comorbidity and life stories
2023 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis is to explore psychiatric disorders in Swedish elite athletes.

The first study investigates a) the prevalence of symptoms of psychiatric disorders, b) the prevalence of mental health problems, defined by psychological suffering and impairment>2 weeks, c) the usefulness of sport-specific instruments in indicating clinical levels of psychiatric symptoms, and d) the life history of psychiatric disorders.

The second study describes psychiatric disorders and comorbidities in a clinical cohort of treatment-seeking elite athletes and high-performance coaches at two publicly funded outpatient psychiatric clinics in Stockholm and Malmö, Sweden.

The third study uses a narrative approach to understand the reasons why elite athletes with established psychiatric disorders choose to seek support and treatment outside – rather than within – their own sport environment.

The fourth study presents a poetic representation of one female elite athlete’s experiences of living with, and seeking treatment for, an eating disorder.

In sum, 19.5% of Swedish elite athletes had symptoms of anxiety and/or depression, and 8.1% had previously received a psychiatric diagnosis. The lifetime prevalence of mental health problems was 51.7%, with 50% of onsets between ages 17 and 21. Sport-specific instruments generally reported fair diagnostic accuracy, but without sufficient sensitivity or specificity for practical use. Among elite athletes in psychiatric treatment, anxiety disorders were the most common (69%), followed by affective disorders (51%) and eating disorders (26%). Comorbidity was generally common between disorders.

Regarding help-seeking, the performance narrative – defined as a single-minded focus on performance that justifies, and even demands, the exclusion of any form of psychological weakness – forced elite athletes to adopt various impression management strategies to hide their psychological suffering. In closing, being invited to witness the em-bodied experiences of a female elite athlete struggling with and seeking treatment for an eating disorder reminds us that behind every prevalence number there is a person.

Place, publisher, year, edition, pages
Stockholm: Gymnastik- och idrottshögskolan, GIH, 2023. p. 114
Series
Avhandlingsserie för Gymnastik- och idrottshögskolan ; 28
National Category
Applied Psychology Sport and Fitness Sciences
Research subject
Social Sciences/Humanities
Identifiers
urn:nbn:se:gih:diva-7460 (URN)978-91-988127-0-1 (ISBN)
Public defence
2023-02-03, Aulan, Lidingövägen 1, Stockholm, 15:30 (English)
Opponent
Supervisors
Available from: 2023-01-04 Created: 2023-01-04 Last updated: 2023-01-13Bibliographically approved

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Åkesdotter, CeciliaKenttä, Göran

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