Mental health problems in elite sport: the difference in the distribution of mental distress and mental disorders among a sample of Norwegian elite athletes

Tom Henning Oevreboe; Andreas Ivarsson; Jorunn Sundgot-Borgen; Ann Kristin Skrindo Knudsen; Anne Reneflot; Anne Marte Pensgaard

doi:10.1136/bmjsem-2023-001538

Mental health problems in elite sport: the difference in the distribution of mental distress and mental disorders among a sample of Norwegian elite athletes

BMJ Open Sport Exerc Med. 2023 Jul 19;9(3):e001538. doi: 10.1136/bmjsem-2023-001538. eCollection 2023.

Authors

Tom Henning Oevreboe¹, Andreas Ivarsson^{2

3}, Jorunn Sundgot-Borgen⁴, Ann Kristin Skrindo Knudsen⁵, Anne Reneflot⁶, Anne Marte Pensgaard¹

Affiliations

¹ Department of Sport and Social Sciences, Norwegian School of Sports Sciences, Oslo, Norway.
² School of Health and Welfare, Halmstad University, Halmstad, Sweden.
³ Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway.
⁴ Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway.
⁵ Department of Disease Burden, Norwegian Institute of Public Health, Oslo, Norway.
⁶ Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway.

Abstract

Objectives: To, based on diagnostic interviews, investigate the distribution of mental disorders among a sample of Norwegian elite athletes with 'at-risk scores' on a self-report questionnaire measuring symptoms of mental health problems. Then, to investigate the relationship between 'at-risk scores' and diagnosed mental disorders.

Methods: A two-phase, cross-sectional design was used. In phase 1, 378 elite athletes completed a questionnaire, including validated self-report psychiatric instruments assessing symptoms of mental disorders. In phase 2, we assessed the 30-day presence of the same disorders through diagnostic interviews with the athletes with 'at-risk scores' using the fifth version of the Composite International Diagnostic Interview.

Results: Two hundred and eighty athletes (74.1%) had an 'at-risk score,' and 106 of these athletes (37.9%) completed diagnostic interviews. Forty-seven athletes (44.3%) were diagnosed with a mental disorder. Sleep problems (24.5%) and obsessive-compulsive disorder (OCD) and OCD-related disorders (18.9%), mainly represented by body dysmorphic disorder (BDD), were most common. Anxiety disorders (6.6%), eating disorders (5.7%) and alcohol use disorder (≤4.7%) were less frequent. Affective disorders, gambling and drug use disorder were not present. Results from self-report questionnaires did not, in most cases, adequately mirror the number of mental disorders identified using diagnostic interviews.

Conclusions: Using self-report questionnaires to map mental distress among elite athletes can be beneficial. If the aim, however, is to investigate mental disorders, one should move beyond self-report questionnaires and use diagnostic interviews and diagnostic instruments. In our study, sleep problems and BDD were the most prevalent. Longitudinal studies are needed to investigate these findings further.

Keywords: athlete; mental; psychiatry; psychology; sports medicine.