Symptoms and risk factors of depression during and after the football career of elite female players

Abstract

BackgroundThe mental health of elite athletes has received increasing attention in recent years, but no study has evaluated the career–time prevalence of depression, and very few have analysed risk factors of mental health problems during or after the career.Methods157 (response rate 64.1%) female players who played in the German First League answered an anonymous online survey on details of their football career, stressful and helpful conditions, depression and need of psychotherapeutic support during and after the football career.ResultsThe career–time prevalence of depression symptoms was 32.3%. Significant differences in the average depression score were observed for playing positions (F=2.75; p<0.05) and levels of play (F=3.53; p<0.01). About half of the players (49.7%) stated ‘conflicts with coach/management’ as an important reason for their low in moods, followed by ‘low in performance/injury’ (48.4%) and ‘too little support/acknowledgement by the coach’ (40.0%). ‘Psychological strain/stress’ (46.5%) was (after injury) the second most important reason for lows in performance. During their career, almost 40% of players wanted or needed psychological support, but only 10% received it. After their career, the percentage of players wanting or needing psychological support decreased to 24%, of whom 90% received it.ConclusionsThe high prevalence of depression symptoms in combination with low use of psychotherapy during the career shows the need for de-stigmatisation of mental health issues in elite football. Furthermore, it seems very important to educate coaches, physicians, physiotherapists and club managers to recognise and prevent mental health problems of their players.

Depression and anxiety symptoms in 17 teams of female football players including 10 German first league teams

“…In contrast to Prinz et al 20 and Junge and Feddermann-Demont10 but in agreement with Gouttebarge et al ,34 no effect of playing position on the prevalence of depression symptoms was observed in the present study. In the present study injured and uninjured players had similar depression and generalised anxiety rates.…”

“…Players with the highest match experience had lower average depression and anxiety rates, and this extends previous reports by Prinz et al 20 for former elite female football players, and by Junge and Feddermann10 for active elite male and female football players. Multivariate regression analysis showed that match experience was a predictor for depression and generalised anxiety symptoms independent of level of play.…”

“…Prinz et al 20 reported that almost 40% of former elite female football players stated that they wanted or needed psychotherapeutic support during their career. In the present study a similar percentage of active players stated that they wanted or needed psychotherapeutic support previously or currently.…”

“…Based on the recommendation by Prinz et al ,20 ‘A suitable study population should regard the following criteria: (1) one type of sport because of the differences in depression between sports, (2) a popular sport because of the relevance of the result, and (3) a high level of play because of the associated level of stress’ 20. German female football players were selected as study population, since football is a popular sport worldwide,25 women are at higher risk for depression26 and generalised anxiety symptoms27 28 than men, and Germany is one of the top teams of the FIFA World Ranking list for women 29.…”

Occurrence of mental health symptoms and disorders in current and former elite athletes: a systematic review and meta-analysis

“…This might be explained because during their sport career, elite athletes are exposed to generic factors such as adverse life events but also to sport-specific stressors 6 45. For instance, a greater overall risk of mental health symptoms and disorders might be experienced by elite athletes with severe musculoskeletal injuries, multiple surgeries, decreased sport performance or maladaptive perfectionism 24 43 46–50. Prevalence of alcohol misuse calculated in our meta-analyses was similar among current and former elite athletes, namely 19% vs 21%, respectively.…”