Prevalence and Factors Associated with Mental Health Complaints in Japanese Collegiate Athletes
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
4.1. Total Prevalence of Mental Health Complaints
4.2. Prevalence of Specific Mental Health Complaints
4.2.1. Anxiety and Depression
4.2.2. Sleep Disorders
4.2.3. Eating Disorders
4.2.4. Developmental Disorders
4.2.5. Alcohol and Substance Misuse
4.3. Mental Health Complaints in Female versus Male Athletes
4.4. Mental Complaints in Different Sports Groups
4.5. Athlete’s Characteristics Associated with Mental Health Complaints
4.6. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Castaldelli-Maia, J.M.; Gallinaro, J.G.d.M.E.; Falcão, R.S.; Gouttebarge, V.; Hitchcock, M.E.; Hainline, B.; Reardon, C.L.; Stull, T. Mental health symptoms and disorders in elite athletes: A systematic review on cultural influencers and barriers to athletes seeking treatment. Br. J. Sports Med. 2019, 53, 707–721. [Google Scholar] [CrossRef] [PubMed]
- Kessler, R.C.; Berglund, P.; Demler, O.; Jin, R.; Merikangas, K.R.; Walters, E.E. Lifetime Prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch. Gen. Psychiatry 2005, 62, 593–602. [Google Scholar] [CrossRef]
- Allen, S.V.; Hopkins, W.G. Age of peak competitive performance of elite athletes: A systematic review. Sports Med. 2015, 45, 1431–1441. [Google Scholar] [CrossRef] [PubMed]
- Gouttebarge, V.; Castaldelli-Maia, J.M.; Gorczynski, P.; Hainline, B.; E Hitchcock, M.; Kerkhoffs, G.M.; Rice, S.M.; Reardon, C.L. Occurrence of mental health symptoms and disorders in current and former elite athletes: A systematic review and meta-analysis. Br. J. Sports Med. 2019, 53, 700–706. [Google Scholar] [CrossRef] [PubMed]
- Walton, C.C.; Rice, S.; Gao, C.X.; Butterworth, M.; Clements, M.; Purcell, R. Gender differences in mental health symptoms and risk factors in Australian elite athletes. BMJ Open Sport Exerc. Med. 2021, 7, e000984. [Google Scholar] [CrossRef]
- Rice, S.M.; Purcell, R.; De Silva, S.; Mawren, D.; McGorry, P.D.; Parker, A.G. The mental health of elite athletes: A narrative systematic review. Sports Med. 2016, 46, 1333–1353. [Google Scholar] [CrossRef]
- Keaney, L.C.; Kilding, A.E.; Merien, F.; Dulson, D.K. The impact of sport related stressors on immunity and illness risk in team-sport athletes. J. Sci. Med. Sport 2018, 21, 1192–1199. [Google Scholar] [CrossRef]
- Gulliver, A.; Griffiths, K.M.; Mackinnon, A.; Batterham, P.J.; Stanimirovic, R. The mental health of Australian elite athletes. J. Sci. Med. Sport 2015, 18, 255–261. [Google Scholar] [CrossRef]
- Nixdorf, I.; Frank, R.; Hautzinger, M.; Beckmann, J. Prevalence of depressive symptoms and correlating variables among german elite athletes. J. Clin. Sport Psychol. 2013, 7, 313–326. [Google Scholar] [CrossRef]
- Torstveit, M.K.; Sundgot-Borgen, J. The female athlete triad: Are elite athletes at increased risk? Med. Sci. Sports Exerc. 2005, 37, 184–193. [Google Scholar] [CrossRef]
- Reardon, C.L.; Hainline, B.; Aron, C.M.; Baron, D.; Baum, A.L.; Bindra, A.; Budgett, R.; Campriani, N.; Castaldelli-Maia, J.M.; Currie, A.; et al. Mental health in elite athletes: International Olympic Committee consensus statement (2019). Br. J. Sports Med. 2019, 53, 667–699. [Google Scholar] [CrossRef] [PubMed]
- Ito, T.; Fetters, M.D.; Kipps, C.; Kumar, B. Depressive symptoms among male professional soccer players in Japan. Asian J. Sport Exerc. Psychol. 2023, 3, 154–160. [Google Scholar] [CrossRef]
- Oguro, S.; Ojio, Y.; Matsunaga, A.; Shiozawa, T.; Kawamura, S.; Yoshitani, G.; Horiguchi, M.; Fujii, C. Mental health help-seeking preferences and behaviour in elite male rugby players. BMJ Open Sport Exerc. Med. 2023, 9, e001586. [Google Scholar] [CrossRef] [PubMed]
- Ojio, Y.; Matsunaga, A.; Hatakeyama, K.; Kawamura, S.; Horiguchi, M.; Yoshitani, G.; Kanie, A.; Horikoshi, M.; Fujii, C. Anxiety and depression symptoms and suicidal ideation in japan rugby top league players. Int. J. Environ. Res. Public Health 2021, 18, 1205. [Google Scholar] [CrossRef]
- Mahoney, M.J. Psychological predictors of elite and non-elite performance in Olympic weightlifting. Int. J. Sport Psychol. 1989, 20, 1–12. [Google Scholar]
- Finnish Institute for Health and Welfare. Finnish Environment Institute Helsinki Declaration to Protect Human and Planetary Health for 2020s. Available online: http://www.julkari.fi/handle/10024/139144 (accessed on 2 October 2020).
- International Olympic Committee Injury; Illness Epidemiology Consensus Group; Bahr, R.; Clarsen, B.; Derman, W.; Dvorak, J.; Emery, C.A.; Finch, C.F.; Hägglund, M.; Junge, A.; et al. International Olympic Committee Consensus Statement: Methods for Recording and Reporting of Epidemiological Data on Injury and Illness in Sports 2020 (Including the STROBE Extension for Sports Injury and Illness Surveillance (STROBE-SIIS)). Orthop. J. Sports Med. 2020, 8, 2325967120902908. [Google Scholar] [CrossRef]
- Sunagawa, N. Recommended Methods for Sports Injury and Illness Surveillance: Japanese Society of Clinical Sports Medicine and Japanese Society for Athletic Training Consensus Document. Jpn. J. Clin. Sports Med. 2022, 30, 319–331. (In Japanese) [Google Scholar]
- Aithal, A.; Aithal, P.S. Development and validation of survey questionnaire & experimental data—A systematical review-based statistical approach. Int. J. Manag. Technol. Soc. Sci. 2020, 5, 233–251. [Google Scholar] [CrossRef]
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed.; DSM-5; American Psychiatric Association: Arlington, VA, USA, 2013. [Google Scholar]
- American Academy of Sleep Medicine. International Classification of Sleep Disorders, 3rd ed.; Text Revision; American Academy of Sleep Medicine: Darien, IL, USA, 2023. [Google Scholar]
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed.; Text Revision (DSM-5-TR); American Psychiatric Association: Arlington, VA, USA, 2022. [Google Scholar]
- World Health Organization. International Classification of Diseases for Mortality and Morbidity Statistics; Eleventh Revision (ICD-11); World Health Organization: Geneva, Switzerland, 2022. [Google Scholar]
- NIH. National Institute on Alcohol Abuse and Alcoholism. Understanding Alcohol Use Disorder. Available online: https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder#:~:text=Alcohol%20use%20disorder%20(AUD)%20is,%2C%20occupational%2C%20or%20health%20consequences (accessed on 25 August 2024).
- Kovacs, R.; Baggish, A.L. Cardiovascular adaptation in athletes. Trends Cardiovasc. Med. 2015, 26, 46–52. [Google Scholar] [CrossRef]
- Maron, B.J.; Pelliccia, A. The heart of trained athletes: Cardiac remodeling and the risks of sports, including sudden death. Circulation 2006, 114, 1633–1644. [Google Scholar] [CrossRef]
- Pelliccia, A.; Caselli, S.; Sharma, S.; Basso, C.; Bax, J.J.; Corrado, D.; D’andrea, A.; D’ascenzi, F.; Di Paolo, F.M.; Edvardsen, T.; et al. European Association of Preventive Cardiology (EAPC) and European Association of Cardiovascular Imaging (EACVI) joint position statement: Recommendations for the indication and interpretation of cardiovascular imaging in the evaluation of the athlete’s heart. Eur. Heart J. 2018, 39, 1949–1969. [Google Scholar] [CrossRef] [PubMed]
- Schaal, K.; Tafflet, M.; Nassif, H.; Thibault, V.; Pichard, C.; Alcotte, M.; Guillet, T.; El Helou, N.; Berthelot, G.; Simon, S.; et al. Psychological balance in high level athletes: Gender-based differences and sport-specific patterns. PLoS ONE 2011, 6, e19007. [Google Scholar] [CrossRef] [PubMed]
- Yamaguchi, S.; Kawata, Y.; Murofushi, Y.; Ota, T. The influence of vulnerability on depression among Japanese university athletes. Front. Sports Act. Living 2023, 4, 1003342. [Google Scholar] [CrossRef]
- Howarth, H.; Evans, G.; Kruger, P.; Dilkes, E.; Bell, G.; Kipps, C. The prevalence of common mental health problems and associated psychosocial issues in elite swimmers. Sports Psychiatry 2023, 2, 83–88. [Google Scholar] [CrossRef]
- Knowles, O.E.; Drinkwater, E.J.; Urwin, C.S.; Lamon, S.; Aisbett, B. Inadequate sleep and muscle strength: Implications for resistance training. J. Sci. Med. Sport 2018, 21, 959–968. [Google Scholar] [CrossRef] [PubMed]
- Mah, C.D.; Mah, K.E.; Kezirian, E.J.; Dement, W.C. The effects of sleep extension on the athletic performance of collegiate basketball players. Sleep 2011, 34, 943–950. [Google Scholar] [CrossRef]
- Milewski, M.D.; Skaggs, D.L.M.; Bishop, G.A.; Pace, J.L.; Ibrahim, D.A.; Wren, T.A.; Barzdukas, A.M. Chronic lack of sleep is associated with increased sports injuries in adolescent athletes. J. Pediatr. Orthop. 2014, 34, 129–133. [Google Scholar] [CrossRef]
- Picavet, H.S.J.; Berentzen, N.; Scheuer, N.; Ostelo, R.W.; Brunekreef, B.; Smit, H.A.; Wijga, A. Musculoskeletal complaints while growing up from age 11 to age 14: The PIAMA birth cohort study. Pain 2016, 157, 2826–2833. [Google Scholar] [CrossRef]
- Von Rosen, P.; Frohm, A.; Kottorp, A.; Fridén, C.; Heijne, A. Too little sleep and an unhealthy diet could increase the risk of sustaining a new injury in adolescent elite athletes. Scand. J. Med. Sci. Sports 2016, 27, 1364–1371. [Google Scholar] [CrossRef]
- Sundgot-Borgen, J.; Larsen, S. Pathogenic weight-control methods and self-reported eating disorders in female elite athletes and controls. Scand. J. Med. Sci. Sports 1993, 3, 150–155. [Google Scholar] [CrossRef]
- Poysophon, P.; Rao, A.L. Neurocognitive Deficits associated with ADHD in athletes: A systematic review. Sports Health A Multidiscip. Approach 2018, 10, 317–326. [Google Scholar] [CrossRef] [PubMed]
- Hoare, E.; Reyes, J.; Olive, L.; Willmott, C.; Steer, E.; Berk, M.; Hall, K. Neurodiversity in elite sport: A systematic scoping review. BMJ Open Sport Exerc. Med. 2023, 9, e001575. [Google Scholar] [CrossRef]
- Bonke, E.M.; Bonfert, M.V.; Hilmann, S.M.; Sandmo, S.B.; Wiegand, T.L.; Yhang, E.; Degeilh, F.; Gaubert, M.; Kaufmann, D.; Schwarz-Moertl, B.; et al. Prevalence of signs of minor neurological dysfunction and its association with higher cognitive functions in youth athletes. Other: Free Paper Session, 4 March 2022. [Google Scholar]
- McDuff, D.; Stull, T.; Castaldelli-Maia, J.M.; E Hitchcock, M.; Hainline, B.; Reardon, C.L. Recreational and ergogenic substance use and substance use disorders in elite athletes: A narrative review. Br. J. Sports Med. 2019, 53, 754–760. [Google Scholar] [CrossRef] [PubMed]
- De Souza, N.L.; Esopenko, C.; Conway, F.N.; Todaro, S.M.; Buckman, J.F. Patterns of health behaviors affecting mental health in collegiate athletes. J. Am. Coll. Health 2019, 69, 495–502. [Google Scholar] [CrossRef] [PubMed]
- Pitts, M.; Chow, G.M.; Donohue, B. Relationship between general and sport-related drinking motives and athlete alcohol use and problems. Subst. Use Misuse 2018, 54, 146–155. [Google Scholar] [CrossRef] [PubMed]
- Dietze, P.M.; Fitzgerald, J.L.; A Jenkinson, R. Drinking by professional Australian Football League (AFL) players: Prevalence and correlates of risk. Med. J. Aust. 2008, 189, 479–483. [Google Scholar] [CrossRef] [PubMed]
- Gil, F.; de Andrade, A.G.; Castaldelli-Maia, J.M. Discussing prevalence, impacts, and treatment of substance use disorders in athletes. Int. Rev. Psychiatry 2016, 28, 572–578. [Google Scholar] [CrossRef]
- Ghaedi, L.; Mohd Kosnin, A.; Mislan, N. Comparison of the degree of depression between athletic and non-athletic undergraduate students. Open Sci. J. Educ. 2014, 2, 1–6. [Google Scholar]
- Sundgot-Borgen, J.; Torstveit, M.K. Prevalence of eating disorders in elite athletes is higher than in the general population. Am. J. Ther. 2004, 14, 25–32. [Google Scholar] [CrossRef]
Characteristic | Athletes with Mental Health Complaints n = 269 | Athletes with No Complaints n = 10,730 | p-Value (Mann–Whitney or χ2) |
---|---|---|---|
Age, years; mean ± SD | 19.9 ± 1.4 | 19.9 ± 1.3 | 0.650 |
Year at university; mean ± SD | 2.2 ± 1.1 | 2.3 ± 1.2 | 0.440 |
Sex: female; n (%) | 149 (3.6%/4096) | 3947 (96.4%/4096) | <0.001 |
Sex: male; n (%) | 116 (1.7%/6848) | 6732 (98.3%/6848) | |
Height, cm; mean ± SD | 165.6 ± 9.0 | 168.3 ± 8.6 | <0.001 |
Weight, kg; mean ± SD | 61.6 ± 13.7 | 66.3 ± 14.1 | <0.001 |
BMI; mean ± SD | 22.3 ± 3.5 | 23.2 ± 3.6 | <0.001 |
Sports experience, years; mean ± SD | 8.0 ± 4.9 | 7.1 ± 5.1 | 0.003 |
Sports level in the past: national; n (%) | 97 (36.1%) | 4275 (39.8%) | 0.554 |
Sports level in the past: international; n (%) | 9 (3.3%) | 322 (3.0%) | |
Practice days per week; mean ± SD | 4.8 ± 1.6 | 5.2 ± 1.3 | <0.001 |
Reported at least one injury; n (%) | 149 (55.6%/268) | 5351 (49.9%/10,729) | 0.064 |
Reported at least one illness; n (%) | 45 (16.7%/269) | 737 (6.9%/10,730) | <0.001 |
Support of athletic trainer; n (%) | 138 (51.4%/269) | 5811 (54.1%/10,730) | 0.353 |
Skill Sports | Power Sports | Mixed Sports | Endurance Sports | Aesthetic Sports | |||||
---|---|---|---|---|---|---|---|---|---|
n = 592 | n = 717 | n = 8530 | n = 958 | n = 202 | |||||
5.4% | 6.5% | 77.6% | 8.7% | 1.8% | |||||
Males n = 324 | Males n = 478 | Males n = 5332 | Males n = 662 | Males n = 52 | |||||
Females n = 262 | Females n = 233 | Females n = 3159 | Females n = 293 | Females n = 149 | |||||
Undisclosed n = 6 | Undisclosed n = 6 | Undisclosed n = 39 | Undisclosed n = 3 | Undisclosed n = 1 | |||||
Kendo | 144 | Judo | 564 | Lacrosse | 1689 | Athletics | 531 | Cheerleading | 84 |
Aviation | 84 | Wrestling | 49 | Softball | 1242 | Rowing | 195 | Dance | 35 |
Table tennis | 83 | Taekwondo | 40 | Baseball | 1212 | Swimming | 123 | Artistic swimming | 17 |
Archery | 58 | Alpine skiing | 22 | American football | 895 | Orienteering | 60 | Figure skating | 15 |
Kyudo | 40 | Shorinji kempo ※ | 15 | Soccer | 883 | Canoeing | 18 | Gymnastics | 12 |
Other (24 sports) | 191 | Other (6 sports) | 27 | Other (17 sports) | 2609 | Other (8 sports) | 31 | Other (5 sports) | 39 |
Complaint | Skill Sports | Power Sports | Mixed Sports | Endurance Sports | Aesthetic Sports | p-Value χ2 | Total |
---|---|---|---|---|---|---|---|
Anxiety | 11 (1.9) | 3 (0.4) | 77 (0.9) | 10 (1.0) | 1 (0.5) | 0.015 | 102 (0.99) |
Depression | 10 (1.7) | 5 (0.7) | 65 (0.8) | 9 (0.9) | 5 (2.5) | 0.084 | 94 (0.85) |
Sleep disorders | 9 (1.5) | 5 (0.7) | 57 (0.7) | 5 (0.5) | 4 (2.0) | 0.032 | 80 (0.73) |
Eating disorders | 3 (0.5) | 2 (0.3) | 24 (0.3) | 3 (0.5) | 1 (0.5) | 0.875 | 33 (0.30) |
Developmental disorders | 4 (0.7) | 3 (0.4) | 21 (0.2) | 5 (0.5) | 0 (0.0) | 0.189 | 21 (0.19) |
Alcohol misuse | 0 (0.0) | 0 (0.0) | 3 (0.04) | 0 (0.0) | 1 (0.5) | 0.014 | 4 (0.04) |
Substance misuse | 1 (0.2) | 0 (0.0) | 1 (0.01) | 1 (0.1) | 0 (0.0) | 0.114 | 3 (0.03) |
Total prevalence | 24/592 (4.1) | 11/717 (1.5) | 198/8332 (2.3) | 29/958 (3.0) | 7/202 (3.5) | 0.020 | 269/10,999 (2.4) |
Complaint * | Females n = 4096 | Males n = 6806 | χ2 Pearson p-Value | Sex Unspecified |
---|---|---|---|---|
Anxiety | 60 (1.5) | 40 (0.6) | 21 <0.001 | 2 |
Depression | 51 (1.2) | 42 (0.6) | 12.142 <0.001 | 1 |
Sleep disorders | 43 (1.0) | 35 (0.5) | 10.511 0.001 | 2 |
Eating disorders | 27 (0.7) | 5 (0.1) | 30.206 <0.001 | 1 |
Developmental disorders | 11 (0.3) | 22 (0.3) | 0.237 0.626 | 0 |
Alcohol misuse | 1 (0.0) | 3 (0.0) | 0.264 0.607 | 1 |
Substance misuse | 0 (0.0) | 2 (0.0) | 1.196 0.274 | 1 |
Total prevalence | 149 (3.6) | 116 (1.7) | 40.984 <0.001 | 4 |
Characteristic | Female Athletes Who Reported Mental Health Complaints n = 149 | Female Athletes Who Did NOT Report Mental Health Complaints n = 3947 | Mean Difference (95% CI) * | p-Value t-Test | Cohen’s d |
---|---|---|---|---|---|
Age; years | 19.9 ± 1.3 | 19.8 ± 1.3 | 0.10 (−0.11–0.31) | 0.340 | 0.08 |
Height; cm | 160.2 ± 6.1 | 160.2 ± 5.8 | 0.00 (−0.19–0.19) | 0.988 | −0.01 |
Weight; kg | 54.2 ± 7.6 | 55.5 ± 7.1 | −0.06 (−1.07–0.94) | 0.031 | −0.18 |
BMI; m/kg2 | 21.1 ± 2.6 | 21.6 ± 2.3 | −0.47 (−0.85–0.10) | 0.013 | −0.21 |
Sports experience; years | 7.1 ± 5.4 | 7.9 ± 1.5 | −0.82 (−1.61–0.15) | 0.046 | −0.17 |
Practice; days/week | 4.8 ± 1.5 | 5.1 ± 1.3 | −0.29 (−0.53–0.44) | 0.021 | −0.22 |
Characteristic | Male Athletes Who Reported Mental Health Complaints n = 116 | Male Athletes Who Did NOT Report Mental Health Complaints n = 6732 | Mean Difference (95% CI) * | p-Value t-Test | Cohen’s d |
---|---|---|---|---|---|
Age; years | 19.9 ± 1.6 | 19.9 ± 1.4 | 0.08 (−0.17–0.33) | 0.541 | 0.06 |
Height; cm | 172.5 ± 7.1 | 173.1 ± 5.9 | −0.59 (−0.36–0.60) | 0.291 | −0.10 |
Weight; kg | 71.0 ± 14.1 | 72.7 ± 13.3 | −1.69 (−1.07–0.94) | 0.173 | −0.13 |
BMI; m/kg2 | 23.8 ± 3.9 | 24.2 ± 3.9 | −0.44 (−0.85–0.10) | 0.233 | 0.11 |
Sports experience; years | 7.3 ± 5.0 | 8.1 ± 5.0 | 0.85 (−1.61–0.15) | 0.078 | −0.17 |
Practice; days/week | 4.7 ± 1.7 | 5.2 ± 1.3 | −0.47 (−0.53–0.4) | <0.001 | −0.36 |
Characteristic | Anxiety | Depression | Sleep Disorders | Eating Disorders | Developmental Disorders | Alcohol Misuse | Substance Misuse |
---|---|---|---|---|---|---|---|
Age; years | NS * | NS * | NS * | NS * | NS * | NS * | NS * |
Height; cm | 3.15 (1.48–4.82) | 2.93 (1.19–4.67) | NS * | 5.13 (22.19–0.19) | NS * | NS * | NS * |
Weight; kg | 4.45 (1.71–7.20) | 4.27 (1.41–7.14) | NS * | 8.37 (3.55–13.19) | NS * | NS * | NS * |
BMI; m/kg2 | NS * | NS* | NS * | 1.70 (0.47–2.94) | NS * | NS * | NS * |
Sports experience; years | NS * | 1.02 (–0.05–2.05) | NS * | NS * | NS * | NS * | NS * |
Practice; days/week | 0.40 (0.15–0.65) | 0.32 (0.06–0.58) | 0.31 (0.03–0.60) | NS * | 0.64 (0.19–1.08) | NS * | 1.48 (0.02–2.95) |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Kimura, T.; Mącznik, A.; Kinoda, A.; Yamada, Y.; Muramoto, Y.; Katsumata, Y.; Sato, K. Prevalence and Factors Associated with Mental Health Complaints in Japanese Collegiate Athletes. Sports 2024, 12, 240. https://doi.org/10.3390/sports12090240
Kimura T, Mącznik A, Kinoda A, Yamada Y, Muramoto Y, Katsumata Y, Sato K. Prevalence and Factors Associated with Mental Health Complaints in Japanese Collegiate Athletes. Sports. 2024; 12(9):240. https://doi.org/10.3390/sports12090240
Chicago/Turabian StyleKimura, Takeshi, Aleksandra Mącznik, Akira Kinoda, Yuichi Yamada, Yuki Muramoto, Yoshinori Katsumata, and Kazuki Sato. 2024. "Prevalence and Factors Associated with Mental Health Complaints in Japanese Collegiate Athletes" Sports 12, no. 9: 240. https://doi.org/10.3390/sports12090240