Understanding depression and suicide in college athletes: emerging concepts and future directions

Rao, Ashwin L.; Hong, Eugene

doi:10.1136/bjsports-2015-095658

Cited by 62 publications

(53 citation statements)

References 13 publications

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“…It is now accepted that elite athletes are under specific internal and external emotional pressures, and that these stressors may lead to an increased prevalence of mental health problems. 3 However, sound epidemiological studies are still rare, and their results are inconclusive. 5 9 25 Most studies investigated depression, and some assessed anxiety, eating disorders, abuse of alcohol or unspecific mental health problems such as distress and burnout in active athletes (for an overview, see ref.…”

Section: Introductionmentioning

confidence: 99%

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

Prinz

Dvořák

Junge

2016

BMJ Open Sport Exerc Med

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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.

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Section: Introductionmentioning

confidence: 99%

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

Prinz

Dvořák

Junge

2016

BMJ Open Sport Exerc Med

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“…The association between stress and depression was empirically validated in previous research in athletes (Rice et al, ) and the general population (Hammen, ; McGonagle & Kessler, ), with chronic stressors often preceding depressive events (Beck, ; Slavich & Irwin, ). As athletes experience a variety of physical and mental stressors (Rice et al, ), such as pressure, failure to meet expectations, and in case of persistent pain, a possible termination of the career (Rao & Hong, ) stress seems to be an important factor in the maintenance of depression, especially when athletes suffer from LBP.…”

Section: Discussionmentioning

confidence: 99%

“…However, not much research has been carried out yet in athletes on habitual TS with regard to pain that occurs outside competition or performance. Furthermore, athletes are likely to experience a high number of exercise‐ and career‐related as well as everyday stressors (Heidari, Hasenbring, Kleinert, & Kellmann, ; Heidari et al, ; Rao & Hong, ; Rice et al, ). Thus, it is reasonable to assume TS can play a role in athletes with chronic pain as well, possibly representing a mechanism through which depression and suicidality develop and maintain.…”

Section: Introductionmentioning

confidence: 99%

Depression and suicidal ideation in high‐performance athletes suffering from low back pain: The role of stress and pain‐related thought suppression

Konietzny

Chehadi

Levenig

et al. 2019

European Journal of Pain

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Background Depression and suicidal ideation are important health problems in athletes suffering from pain. Dysfunctional pain cognitions, that is, pain‐related thought suppression (PTS), may play an important role in their aetiology. Thought suppression was shown to increase depressive mood, particularly in highly stressed individuals. This cross‐sectional study examines the relationship between PTS and stress on depression and suicidal ideation in athletes with pain. Methods A total of 159 athletes with non‐specific low back pain completed a set of questionnaires to measure PTS, depression and stress. Participants were split into groups with high and low stress, and high and low PTS. Two‐way ANOVA calculated main effects for PTS, stress and a PTS*stress interaction, with depressive symptoms as dependent. Subsequently, distribution tests were calculated, investigating if the presence of clinically relevant depression and suicidal ideation is dependent of conditions of high/low PTS and stress. Results A main effect of stress demonstrated higher depression scores in highly stressed athletes. Further, a significant PTS*stress interaction showed elevated depression scores in athletes with high PTS and high stress. Distribution analysis revealed positive associations between PTS, stress and depression, with depression being most frequent among athletes with high PTS and high stress. Suicidal ideation was not significantly associated with PTS and only weakly correlated with stress. Conclusions Our findings show that PTS is the most common pain response in athletes with pain. The results indicate a higher prevalence of depression and elevated depressive symptoms in athletes experiencing high stress, seemingly more pronounced when highly engaging in PTS. Significance This study contributes to the understanding of depression in athletes with pain, suggesting stress and pain‐related thought suppression to increase symptoms and prevalence of depression. As athletes often experience acute or chronic pain, understanding the impact of pain cognitions on health outcomes is an important step in the optimization of treatments.

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“…Introduction: Be aware that mental illness remains a major public health concern affecting broad segments of the population, including athletes of all ages. Due to the lack of mandatory or consistent reporting systemic it's likely that mental health concerns are under‐reported in the athletic population [24,25].…”

Section: Guidelinesmentioning

confidence: 99%

Musculoskeletal and Sports Medicine Physical Medicine and Rehabilitation Curriculum Guidelines

Zaremski

Diamond

Aagesen

et al. 2017

PM&R

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Understanding depression and suicide in college athletes: emerging concepts and future directions

Cited by 62 publications

References 13 publications

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

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

Depression and suicidal ideation in high‐performance athletes suffering from low back pain: The role of stress and pain‐related thought suppression

Musculoskeletal and Sports Medicine Physical Medicine and Rehabilitation Curriculum Guidelines

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