What is the clinical evidence from this study?

Study design: Cohort. Population: Symptoms of common mental disorders (CMD) (n=384). Intervention: Professional football career. Primary outcome: 12-month incidence of symptoms of anxiety/depression (95% CI 29.4-45.4).

September 13, 2016Open Access

A 12-Month Prospective Cohort Study of Symptoms of Common Mental Disorders Among European Professional Footballers

VGVincent GouttebargeWorld Health Organization - Pakistan HAHaruhito AokiSt. Marianna University School of Medicine EVEvert VerhagenUniversidade Federal de Minas Gerais

Key Result

Among European professional footballers, the 12-month incidence of symptoms of common mental disorders was substantial, ranging from 12% for distress to 37% for anxiety/depression.

Study Design

Type

Cohort (n=384)

Multicenter

Yes

Structured PICO

Population

384 male professional footballers from 5 European countries, aged 18 years or older, were followed for 12 months to determine the incidence of symptoms of common mental disorders.

Outcome

Incidence of symptoms of common mental disorders (distress, anxiety/depression, sleep disturbance, and adverse alcohol use) over 12 monthspatient reported

Symptoms of common mental disorders are highly incident among European professional footballers, with anxiety/depression affecting up to 37% over a 12-month period.

Limitations

Missing values led to a smaller sample size for the calculation of incidence and regression analyses.
Scales used to measure symptoms of CMD were not administered in the native language of participants from Finland, Norway, and Sweden.
Self-reported questionnaires with potential for false positives and false negatives due to screening instrument measurement quality.
Recall bias may be present due to the 6-month recall period at follow-up.

Abstract

OBJECTIVE: To determine the 12-month incidence and comorbidity of symptoms of common mental disorders (CMD) among European professional footballers and to explore the association of potential stressors with the health conditions under study among those European professional footballers. DESIGN: Observational prospective cohort study with a follow-up period of 12 months. PARTICIPANTS: Male professional footballers from 5 European countries (n = 384 at baseline). ASSESSMENT OF RISK FACTORS: Adverse life events, conflicts with trainer/coach, and career dissatisfaction were explored by using validated questionnaires. MAIN OUTCOME MEASURES: Symptoms of distress, anxiety/depression, sleep disturbance, and adverse alcohol use were assessed using validated questionnaires. RESULTS: A total of 384 players (mean age of 27 years old; mean career duration of 8 years) were enrolled, of which 262 completed the follow-up period. The incidence of symptoms of CMD were 12% for distress, 37% for anxiety/depression, 19% for sleep disturbance, and 14% for adverse alcohol use. Over the follow-up period of 12 months, approximately 13% of the participants reported 2 symptoms, 5% three symptoms, and 3% four symptoms. Professional footballers reporting recent adverse life events, a conflict with trainer/coach, or career dissatisfaction were more likely to report symptoms of CMD, but statistically significant associations were not found. CONCLUSIONS: The 12-month incidence of symptoms of CMD among European professional footballers ranged from 12% for symptoms of distress to 37% for symptoms of anxiety/depression. A professional football team typically drawn from a squad of 25 players can expect symptoms of CMD to occur among at least 3 players in one season.

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