Prevalence of mental health symptoms among male and female Australian professional footballers

Abstract

ObjectiveDetermining the prevalence of mental health symptoms (MHS) among Australian professional footballers compared with former players. A secondary aim was to assess whether MHS were associated with recent injury and psychological resilience.MethodsThis cross-sectional study included 149 male (mean age: 24 years) and 132 female (mean age: 23 years) Australian A-League and W-League professional footballers (study group) and 81 former male footballers (control group, mean age: 39 years) for analysis. MHS and psychological resilience were assessed through validated questionnaires. Severe injuries were assessed through a single question. The adjusted Wald method was used to assess the primary aim. Logistic regression analyses was used to assess the secondary aim.ResultsThe most prevalent MHS among active footballers and former footballers was sport-related psychological distress (63%) and alcohol misuse (69%), respectively. Global psychological distress, sleep disturbance, alcohol misuse and substance misuse were significantly lower among active male footballers than among former players. Increased psychological resilience among active male footballers was associated with a decrease in symptoms of sport-related and global psychological distress, anxiety and depression of 9%, 14%, 23% and 20%, respectively. Increased psychological resilience among female players was associated with 10% decrease in symptoms of depression. Problem gambling and sleep disturbance was associated with injury in the previous 6 months among active male and female footballers, respectively.ConclusionsMHS are prevalent among active and former professional footballers. Higher level of psychological resilience is associated with decreased reporting of MHS. Severe injury is associated with problem gambling and sleep disturbance.

Mental health difficulties among professional footballers

“…Two additional international cross-sectional studies using the same assessment method identified adverse nutritional behaviours in 47.4–74.3% of male players [15, 16]. Within the recent Australian cross-sectional study [23], 35.1% of current male players, 43.8% of current female players and 40.0% of former male players reported disordered eating behaviours via the Brief Eating Disorder in Athletes Questionnaire (BEDA-Q) [47].…”

“…The majority of studies were cross-sectional in design (n=9), but two case-control studies, an observational prospective cohort study and a retrospective cohort study were also reviewed. The studies sampled male (n=7), female (n=4) and mixed-sex (n=2) populations, examining mood (11 studies) [14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24], anxiety (10 studies) [14, 15, 16, 17, 18, 19, 21, 22, 23, 25], distress/burnout (6 studies) [14, 15, 16, 17, 18, 23], disordered eating (5 studies) [14, 15, 16, 17, 23], sleep disturbance (6 studies) [15, 16, 17, 18, 23, 26], alcohol use (6 studies) [14, 15, 17, 18, 23, 24], substance misuse (1 study) [23] and gambling (1 study) [23]. Full details of the studies are reported in Table 1…”

“…Using the PROMIS, a 12-month prospective cohort study of 135 male European footballers reported a sleep disturbance incidence rate of 18.5% [18]. Among male footballers in Australia, higher rates of sleep disturbance (assessed by the ASSQ) were seen in former versus current players, with prevalence rates of 32.5% and 12.2% respectively (p<0.01) [23]. The rate of sleep disturbance observed among current female players (32.6%) was similar to that in retired male players.…”

“…Substance misuse was examined in only one publication, the Australian cross-sectional study of 281 male and female current players and 81 male former players [23]. The CAGE Adapted to Include Drugs (CAGE-AID) Questionnaire [57] was used, with a score of !2 (from a maximum possible score of 4) deemed indicative of the presence of substance misuse.…”

“…The Australian study was also the sole publication to examine footballers' gambling behaviours [23]. The NORC (National Organisation for Research, University of Chicago) Diagnostic Screen for Gambling Problems [58] was used to identify problem gambling, with a reported prevalence of 23.6% (95% CI 17.5 to 31.1) in male current players, 2.3% (95% CI 0.5 to 6.9) in female current players and 32.5% (95% CI 23.0 to 42.2) in male former players.…”