The prevalence of depressive symptoms in high-performance athletes: a systematic review

ABSTRACT

Objective: To provide an up-to-date overview of the prevalence of depressive symptoms in high-performance athletes and describe the tools used to assess for these in order to identify knowledge gaps and potential future research priorities.

Data sources: PubMed, EMBASE, SPORTDiscus, PsychINFO, and Cochrane were systematically searched from December 1993 to December 2018. Peer-reviewed original research articles reporting the prevalence of depression among high-performance athletes aged ≥ 17 years were included.

Study selection: Sixteen studies satisfied the inclusion criteria, and seven had a low risk of bias.

Data extraction: The Center for Epidemiologic Studies Depression Scale (CES-D) was the most commonly used tool to assess for depressive symptoms. The prevalence of those with high depression symptom cutoff scores ranged from 6.7% to 34.0%.

Data synthesis: Higher levels of competition, injuries, > 3 concussions, and female sex were identified as potential risk factors for depression. Female athletes and athletes playing individual sports had high risk of having elevated depression symptom scores.

Conclusions: Prevention of mental illness in high-performance sports is a novel and emerging field of research interest. This review highlights the prevalence of high depression symptom scores among high-performance athletes. The data collection methods, sample size, sport and athlete population, and tools used to assess depression vary across studies; thus, findings cannot be generalized. This review establishes the need for data collection enhancements with robust longitudinal study designs and standardized depression assessment tools to guide the development of evidence-based mental wellbeing interventions.

KEYWORDS:

• Athlete wellbeing
• mental health
• high-performance sports
• mood disorders
• elite players

Acknowledgments

No external support was provided for preparation of this manuscript, financial or otherwise.

Declaration

This article has not been submitted for consideration of publication elsewhere.

Declaration of interest

No potential conflict of interest was reported by the authors.

Additional information

Funding

No funding was received to conduct this study or prepare the manuscript. All authors contributed to all items in the ICMJE contributorship guidelines.