Which athletes are more vulnerable to mental health symptoms during the COVID-19 crisis? A cross-sectional study

The team behind the team: prevalence and correlates of mental health problems among professional football team medical and allied staff?

This study aimed to evaluate depression, anxiety, and stress prevalence and correlates among professional football team medical and allied health staff (MAHS) in Turkey. An online survey was sent to all MAHS (n = 865) attending the professional development accreditation course organized at the end of the 2021-2022 football season in Turkey. Three standardized scales assessed depression, anxiety, and stress. A total of 573 staff participated (response rate = 66.2%). 36.7% of MAHS reported at least moderate severity depression, 25% anxiety, and 80.5% stress. Younger (26-33 years) and less experienced (6-10 years) MAHS reported higher stress scores than their older (50-57 years) and more experienced (>15 years) counterparts (p = 0.02 and p = 0.03, respectively). Masseurs (compared to team doctors) and staff without a second job (compared to those with a second job) reported higher depression and anxiety scores (p = 0.02, p = 0.03, p = 0.03, p = 0.02, respectively). Depression, anxiety, and stress scores of MAHS whose monthly income was less than $519 were higher than those whose income was more than $1036 (all p < 0.01). Findings demonstrated that professional football team MAHS suffer from symptoms of mental-ill-health at substantial rates. In light of these results, organizational policies should be implemented to proactively support the mental health of MAHS working in professional football.

Mental health correlates of athletic shame and guilt among elite-level youth athletes in Turkey

OBJECTIVES

This study evaluated the mental health correlates of athletic shame and guilt among elite-level youth athletes and provided psychometric data on the Turkish version of the Athletic Perceptions of Performance Scale.

DESIGN

Cross-sectional.

METHODS

An online survey was sent to 645 Turkish elite-level youth athletes incorporating standardized scales assessing athletic shame, guilt, and symptoms of high prevalence mental disorders. A subset of participants (n = 45) provided test-retest data at 30 days.

RESULTS

A total of 301 elite youth athletes participated (M = 16.42 ± 0.49 years; 48.7 % response rate) equally representing team and individual sports. Confirmatory factor analysis validated the Turkish version of the Athletic Perceptions of Performance Scale and test-retest data supported temporal stability. Female athletes (compared to male athletes) and athletes participating in an individual sport (compared to participating in a team sport) reported higher athletic shame-proneness scores (p < 0.01 and p = 0.04; respectively). The Turkish version of the Athletic Perceptions of Performance Scale shame-proneness and no-concern scores were associated with athlete-specific stress, anxiety, and depression scores. The Turkish version of the Athletic Perceptions of Performance Scale guilt-proneness was associated with athlete-specific stress and anxiety scores.

CONCLUSIONS

Findings provide cross-cultural validation of the Athletic Perceptions of Performance Scale assessing athletic shame and guilt, demonstrating that female athletes and athletes participating in an individual sport were more likely to experience athletic shame-proneness. Results suggest that athletes experiencing shame-proneness and performance concerns may benefit from supportive coaching and/or mental health supports.

Mental health symptoms and correlates among amateur football players: a cross-sectional study

The objective of this study was to evaluate mental health problems reported by Turkish amateur football players. A total of 4516 Turkish amateur football players were invited to complete an anonymous online survey including demographic and COVID-19 pandemic related questions, the Patient Health Questionnaire-9, General Anxiety Disorder-7 scale, and Athlete Psychological Strain Questionnaire. A total of 1263 players participated in the study (27.9% response rate). Single players reported higher depression and anxiety scores than married players. Higher depression, anxiety, and athletes-specific stress scores were reported by players with an annual income <$5,000 and those reporting an income loss >75% during the COVID-19 pandemic. Players with a sports injury history, psychiatric illness, sleep problems, and perceived inadequate social and/or organizational support reported poorer indices relative to their counterparts. Implementation of mental health screening among amateur football players may assist in detecting vulnerabilities and initiating appropriate timely intervention.

Comparative Study of the Long-Term Impact of the COVID-19 Pandemic on Mental Health and Nutritional Practices Among International Elite and Sub-Elite Athletes: A Sample of 1420 Participants from 14 Countries

BACKGROUND

Although several studies have shown that the Coronavirus Disease 2019 (COVID-19) lockdown has had negative impacts on mental health and eating behaviors among the general population and athletes, few studies have examined the long-term effects on elite and sub-elite athletes. The present study aimed to investigate the long-term impact of COVID-19 lockdown on mental health and eating behaviors in elite versus sub-elite athletes two years into the pandemic. A cross-sectional comparative study was conducted between March and April 2022, involving athletes from 14 countries, using a convenient non-probabilistic and snowball sampling method. A total of 1420 athletes (24.5 ± 7.9 years old, 569 elites, 35% women, and 851 sub-elites, 45% women) completed an online survey-based questionnaire. The questionnaire included a sociodemographic survey, information about the COVID-19 pandemic, the Depression, Anxiety and Stress Scale-21 Items (DASS-21) for mental health assessment, and the Rapid Eating Assessment for Participants (REAP-S) for assessing eating behavior.

RESULTS

The results showed that compared to sub-elite athletes, elite athletes had lower scores on the DASS-21 (p = .001) and its subscales of depression (p = .003), anxiety (p = .007), and stress (p < .001), as well as a lower REAP-S score indicating lower diet quality (p = .013).

CONCLUSION

In conclusion, two years into the pandemic, elite athletes were likelier to have better mental health profiles than sub-elite athletes but surprisingly had lower diet quality.

Effect of Sleep Duration on Blood Pressure in Patients with SARS-CoV-2 Infection and Hypertensive Urgencies in Shanghai Fangcang Shelter Hospital

Objective

To evaluate the effect of sleep duration on blood pressure in patients with hypertension urgencies combined with SARS-CoV-2 infection in a Fangcang shelter hospital.

Methods

From April 10, 2020 to May 20, 2022, we statistically analyzed the blood pressure and sleep conditions of 52 patients with combined hypertension urgencies and SARS-CoV-2 infection admitted in Shanghai National Convention and Exhibition Center Fangcang shelter hospital. They were divided into the short-term (daily sleep duration: <7 h) and normal sleep group (7-9 h). We performed a comparison of the control effects of basic antihypertensive drugs. Additionally, patients in the short-term sleep group underwent drug therapy for sleep regulation and continuous monitoring of blood pressure.

Results

Among these patients, the blood pressure was higher in the short-term sleep group than that of the normal sleep group, and also more difficult to control (p <0.05). Furthermore, the blood pressure of the patients in the short-term sleep group was more easily controlled after treatment with drugs for sleep regulation and basic antihypertensive drugs (p <0.05).

Conclusion

The blood pressure level in patients with combined SARS-CoV-2 infection and hypertension urgencies was higher in those with a shorter duration of daily sleep, and also more difficult to control in Fangcang shelter hospital. Drug therapy for sleep regulation should be administered early to obtain sufficient blood pressure control effects.

Psychological changes in athletes infected with Omicron after return to training: fatigue, sleep, and mood

Background

This study aims to analyze the changes of approximately 1 month in fatigue, sleep, and mood in athletes after returning to training following infection with the COVID-19 Omicron strain and provide recommendations for returning to training after infection.

Methods

Two hundred and thirty professional athletes who had returned to training after being infected with COVID-19 in December 2022 were recruited to participate in three tests conducted from early January 2023. The second test was completed approximately 1 week after the first, and the third was completed about 2 weeks after the second. Each test consisted of completing scales and the exercise-induced fatigue measure. The scales included a visual analog scale, the Athens Insomnia Scale for non-clinical application, and the Depression-Anxiety-Stress scale. The exercise task was a six-minute stair climb test, and athletes evaluated subjective fatigue levels before and after exercise using another Visual Analog Scale and the Karolinska Sleepiness Scale.

Results

After returning to training, athletes' physical fatigue decreased initially but increased as training progressed. Cognitive fatigue did not change significantly. The exercise task led to elevated levels of physical fatigue after a longer duration of training. Sleep quality problems decreased rapidly after the start of training but remained stable with prolonged training. Depression levels continued to decline, while anxiety levels only reduced after a longer duration of training. Stress levels decreased rapidly after the start of training but did not change with prolonged training.

Conclusion

Athletes who return to training after recovering from COVID-19 experience positive effects on their fatigue, sleep, and mood. It is important to prioritize anxiety assessment and interventions during the short period after returning and to continue monitoring fatigue levels and implementing recovery interventions over a longer period of time.

Psychological and Mental Sequelae in Elite Athletes with Previous SARS-CoV-2 Infection: A Systematic Review

During the COVID-19 pandemic, many athletes from several sporting disciplines were infected with the SARS-CoV-2. The aim of this systematic review is to summarize the current scientific evidence on the psychological sequelae and mental health of elite athletes who have been infected by the virus. The review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement; three databases were searched: PubMed, ISI Web of Knowledge, and Scopus. The initial search resulted in 2420 studies; after duplicate removal and screening by title and abstract, 41 articles were screened by full-text. A total of four eligible articles were included in the review. All included articles measured depression and anxiety in athletes who had suffered from COVID-19, while in three papers levels of stress were measured. Overall, the only two questionnaires used in more than one study were the DASS-21 and the APSQ. In our systematic review, we highlighted that mental and psychological health in elite athletes has the same importance as physical health. This statement suggests that these examinations should be introduced and performed during the competitive sports' medical examinations conducted at the start of the sporting season, which currently consists only of the examination of physical parameters. Due to lack of studies on the topic, the results of our review show that mental health in athletes with a history of SARS-CoV-2 infection is an issue that requires more investigation, considering the evidence of clinical consequences. The importance of post-infection psychological sequelae is significant in assessing possible repercussions on the athletes' sporting performance.

Mental Health Symptoms of Amateur Association Football Referees: A Cross-Sectional Study

Although referees who officiate in the amateur football leagues are exposed to various stressors that can negatively affect their mental health (MH), little is known about their MH symptoms. The purpose of the study was to evaluate MH symptoms of referees who officiate in the Turkish amateur football leagues. An online survey was sent to all referees in the Turkish amateur football leagues (n = 4,900) incorporating standardized scales assessing depression, anxiety, and stress. A total of 1,279 referees participated in the study. Female referees reported higher depression (p < .01) and anxiety (p = .02) scores than males. Younger referees (23–27 years) reported higher depression (p = .01) and anxiety (p < .01) scores than older (>38 years) referees. Results showed that symptoms of depression, anxiety, and stress scores were associated with marital status (being single), lower incomes, severe sports injury history, and inadequate social support. In light of these results, MH assessments should be undertaken to detect which referees are at greater risk of MH problems and facilitate appropriate and timely MH interventions. Further study is needed to inform MH risk reduction strategies and/or programming.