Differences in Mental Health Characteristics of Athletes in Japanese Outpatient Clinics Pre- and Post-covid-19: a Cross-sectional Observational Study

Background Mental health disorders and symptoms in athletes have received increasing attention in recent decades, with the COVID-19 pandemic intensifying the psychological distress of athletes. While there have been numerous studies on athletes’ visits to mental health clinics in other countries, no study has been conducted on this topic in Japan. Therefore, this study investigated the differences in characteristics between athletes who visited mental health outpatient clinics before and after the COVID-19 pandemic. Methods A cross-sectional observational survey was conducted using data used from Keio University General Hospital and three affiliated mental clinics. Our sample comprised 88 athletes who had visited various healthcare facilities between 2018 and 2022. The independent variable was the timing of their outpatient mental health clinic visits—either pre- or post-COVID-19. The primary outcome was the F classification based on the International Statistical Classification of Diseases and Related Health Problems 10th Revision. We collected data on clinical psychiatric diagnoses, age, sex, referral pathway, and sports-related details like the type, level of contact, whether individual or team sport, involvement duration, and athletic competition level. Results Overall, 86 athletes (37 before COVID-19 and 49 after COVID-19) were included in the study. No significant differences were found between the pre- and post-COVID-19 groups overall. However, subgroup analyses revealed a significant increase in anxiety-related disorders among female athletes and an increase in the participation of male athletes in individual sports in the post-COVID-19 group compared to the pre-COVID-19 group. Conclusion The increased anxiety among female athletes and the increased participation in individual sports among male athletes suggest that these groups should be a high-priority target for early intervention and prevention strategies. This study contributes to our understanding of how COVID-19 has affected the mental health of athletes seeking medical treatment in Japan, and it highlights which segments of the Japanese athlete population may be more vulnerable to mental health issues in the post-COVID-19 era. This study also provides valuable insights for practitioners on how to target specific segments of the athlete population for the implementation of interventions aimed at mitigating the development of mental health issues after COVID-19.