A History of Concussions Is Associated With Symptoms of Common Mental Disorders in Former Male Professional Athletes Across a Range of Sports

Abstract

BackgroundRecent reports suggest that exposure to repetitive concussions in sports is associated with an increased risk of symptoms of Common Mental Disorders (CMD) and of later development of neurodegenerative diseases, in particular chronic traumatic encephalopathy (CTE).ObjectiveTo explore the relationship between sports career-related concussions and the subsequent occurrence of symptoms of CMD among former male professional athletes.DesignCross-sectional analyses performed on baseline electronic questionnaires from three prospective cohort studies.SettingNational unions or players' associations in professional football, ice hockey and rugby.Patients (or Participants)A total of 576 former male professional athletes were enrolled. Mean age at recruitment was 37 years; mean duration of sports career was 10 years.Interventions (or Assessment of Risk Factors)The total number of confirmed concussion incidents during an athlete's career and diagnosed by a medical professional was examined.Main Outcome MeasurementsSeveral Patient Reported Outcome Measures (PROMs) were included and assessed with validated scales, namely symptoms of distress, anxiety/depression, sleep disturbance, adverse alcohol use.ResultsThe number of sports career-related concussions was a predictor for all outcome measures (β=0.072–0.100; P≤0.035). Specifically, former professional athletes who reported a history of four or five concussions were approximately 1.5 times more likely to report symptoms of CMD, rising to a two- to four-fold increase in those reporting a history of six or more sports career-related concussions.ConclusionsThese data demonstrate a direct relationship between exposure to sports concussion and subsequent risk of symptoms of CMD in former professional athletes across a range of contact sports. Further work to explore the association between sports concussion and symptoms of CMD is required; in meantime strategies for effective risk reduction and improved management appear indicated.

Functional Limitations Mediate the Relationship Between Pain and Depressive Symptoms in Former NFL Athletes

“…In the case of NFL football players, injury emerges as an occupational hazard that exposes healthy young men to increased risk of functional limitations as they age. This is similar to the cases of many other collision sport athletes (e.g., boxing, roller derby, ice hockey, soccer, lacrosse, rodeo, full-contact martial arts; Segen’s Medical Dictionary , 2011) who may equally be at risk for premature functional decline and potentially elevated depressive symptoms (Gouttebarge, Aoki, Lambert, Stewart, & Kerkhoffs, 2017; Hume et al, 2017; Manley et al, 2017; Marshall et al, 2015). Improved understanding of risks for depressive symptoms in former NFL athletes may serve as a potential model for pain, functional status, and aging to support efforts in depression treatment and intervention.…”

Concussion in American Versus European Professional Soccer: A Decade-Long Comparative Analysis of Incidence, Return to Play, Performance, and Longevity

“…However, long-term effects of SRCs in soccer warrant further long-term exploration, with nearly 27% of all injuries attributed to head trauma and concussion. 1 Gouttebarge et al 11 found that soccer players were 50% more likely to subsequently develop mental disorders, including anxiety, depression, sleep disturbance, and substance abuse. Even more concerning, Beghi et al shared preliminary results at the 71st American Academy of Neurology 4 meeting and reported that approximately double the expected number of professional Italian soccer players were diagnosed with amyotrophic lateral sclerosis (33 cases vs 17 expected) at a median age of 43 years.…”

“…4,[12][13][14] In a recent study, professional athletes who had 4 or 5 SRCs over a career were 1.5 times more likely to report symptoms of a variety of common mental disorders, including anxiety, depression, sleep disturbance, and substance abuse. 11 Furthermore, evaluation has been conducted regarding the mechanism of injury leading to SRC and the effect of recent gameplay-related rule changes. For example, the institution of a red card for intentional elbow-head contact in a German professional soccer league in 2006 was found to decrease concussion incidence by 29%.…”

The association between COMT rs4680 and 5-HTTLPR genotypes and concussion history in South African rugby union players

“…The long-term effects of numerous concussion injuries are currently unknown (Raftery, 2014). However, a history of multiple concussions was associated with increased risk of permanent neurological dysfunctions (Baugh et al, 2012;Mckee et al, 2009), common mental disorders (Gouttebarge, Aoki, Lambert, Stewart, & Kerkhoffs, 2017), and mental health disturbances, including increased aggression and impulsivity (Kerr et al, 2014), in retired athletes. The relative frequency and the potential long-term effects of concussion, underline the need to identify factors that may modulate the risk of concussion in rugby.…”