Gymnastik- och idrottshögskolan, GIH

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Prevalence and comorbidity of psychiatric disorders among treatment-seeking elite athletes and high-performance coaches
Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics. Karolinska Inst, Clin Neurosci, Stockholm, Sweden.ORCID iD: 0000-0002-2952-0347
Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics. Univ Ottawa, Sch Human Kinet, Ottawa, ON, Canada.ORCID iD: 0000-0002-9921-6586
Karolinska Inst, Dept Med Clin Epidemiol, Stockholm, Sweden.
Lund Univ, Fac Med, Dept Clin Sci Lund, Psychiat, Lund, Sweden; Clin Sports & Mental Hlth Unit, Malmö, Sweden.
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2022 (English)In: BMJ Open Sport & Exercise Medicine, ISSN 2398-9459, Vol. 8, no 1, article id e001264Article in journal (Refereed) Published
Abstract [en]

Objectives Few studies have evaluated the prevalence of psychiatric disorders among treatment-seeking elite athletes (EA) or high-performance coaches (HPC) in psychiatric outpatient settings. Methods Descriptive overview of EA and HPC with psychiatric disorders at two publicly funded psychiatric outpatient treatment clinics in Stockholm and Malmo, Sweden. Co-occurring psychiatric disorders were illustrated using Venn diagrams for EA and HPC, and male and female EA separately, among patients from the Stockholm clinic (SC) that used standardised diagnostic interviews. Results Overall, most patients were EA (n=221) compared with HPC (n=34). The mean age was 23.5 (+/- 5.9) years for EA and 42.8 (+/- 8.8) for HPC. Anxiety disorders were most common at the SC in EA and HPC (69% vs 91%, respectively). Stress-related disorders were found in 72% of HPC compared with 25% of EA. Affective disorders were found in 51% of EA and 52% of HPC. Eating disorders were common among EA (26%), especially females (37%). Substance use disorders were found in 17% of HPC. Comorbidity was generally common between affective and anxiety disorders. Conclusion Stress and adjustment disorders were found in nearly three of the four HPC compared with one in four EA. Eating disorders were prevalent in around one in four athletes and about one in six HPC had a substance use disorder.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2022. Vol. 8, no 1, article id e001264
Keywords [en]
anxiety, depression, eating disorders, psychiatry, stress, EATING-DISORDERS, MENTAL-HEALTH, SYMPTOMS, SPORT
National Category
Psychiatry Sport and Fitness Sciences
Research subject
Medicine/Technology
Identifiers
URN: urn:nbn:se:gih:diva-7032DOI: 10.1136/bmjsem-2021-001264ISI: 000776490400001PubMedID: 35444812OAI: oai:DiVA.org:gih-7032DiVA, id: diva2:1654127
Available from: 2022-04-26 Created: 2022-04-26 Last updated: 2025-02-11
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)
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Available from: 2023-01-04 Created: 2023-01-04 Last updated: 2025-02-11Bibliographically approved

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Åkesdotter, CeciliaKenttä, Göran

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