Mental health problems in elite sport: the difference in the distribution of mental distress and mental disorders among a sample of Norwegian elite athletes

Abstract

ObjectivesTo, based on diagnostic interviews, investigate the distribution of mental disorders among a sample of Norwegian elite athletes with ‘at-risk scores’ on a self-report questionnaire measuring symptoms of mental health problems. Then, to investigate the relationship between ‘at-risk scores’ and diagnosed mental disorders.MethodsA two-phase, cross-sectional design was used. In phase 1, 378 elite athletes completed a questionnaire, including validated self-report psychiatric instruments assessing symptoms of mental disorders. In phase 2, we assessed the 30-day presence of the same disorders through diagnostic interviews with the athletes with ‘at-risk scores’ using the fifth version of the Composite International Diagnostic Interview.ResultsTwo hundred and eighty athletes (74.1%) had an ‘at-risk score,’ and 106 of these athletes (37.9%) completed diagnostic interviews. Forty-seven athletes (44.3%) were diagnosed with a mental disorder. Sleep problems (24.5%) and obsessive-compulsive disorder (OCD) and OCD-related disorders (18.9%), mainly represented by body dysmorphic disorder (BDD), were most common. Anxiety disorders (6.6%), eating disorders (5.7%) and alcohol use disorder (≤4.7%) were less frequent. Affective disorders, gambling and drug use disorder were not present. Results from self-report questionnaires did not, in most cases, adequately mirror the number of mental disorders identified using diagnostic interviews.ConclusionsUsing self-report questionnaires to map mental distress among elite athletes can be beneficial. If the aim, however, is to investigate mental disorders, one should move beyond self-report questionnaires and use diagnostic interviews and diagnostic instruments. In our study, sleep problems and BDD were the most prevalent. Longitudinal studies are needed to investigate these findings further.

Comprehensive periodic health evaluations of 454 Norwegian Paralympic and Olympic athletes over 8 years: what did we learn?

“…A new Norwegian study investigated the relationship between ‘at-risk-scores’ for mental distress on a self-report questionnaire with mental disorders from diagnostic interviews among 378 elite and semi-elite athletes. 35 Three-quarters of them presented with ‘at-risk-scores’, and among the third, completing a diagnostic interview, 44% had a mental disorder. Sleep problems (25%) and obsessive–compulsive disorder (OCD) and OCD-related disorders (19%), were most common.…”

“…Sleep problems (25%) and obsessive–compulsive disorder (OCD) and OCD-related disorders (19%), were most common. 35 Based on other NOCs experiences, 36 37 we included single questions from multiple tools, authored by our team of professional psychologists and a psychiatrist, with the intention to both educate and optimise health in our population. These non-validated single questions served as entry questions for a more in-depth assessment when indicated.…”

“…The increased focus on mental health [35][36][37][38][39] and REDs is timely. 38 Recently, a Canadian study on collegiate athletes revealed an alarmingly high prevalence of anxiety (30%), depression (26%), sleep disturbances (39%), alcohol misuse (55%) and disordered eating (83%), 38 following screening with Sport Mental Health Assessment Tool-1 (SMHAT-1).…”