Don't forget to mind the mind: a prospective cohort study over 12 months on mental health symptoms in active professional male footballers.

Aims: We examined the prevalence and incidence of mental health symptoms (MHS) in active professional male footballers over a 12-month period and investigated if MHS was associated with severe injuries or surgeries.

Participants And Methods: Football Players Worldwide (FIFPRO) affiliated national unions invited active professional male football players to participate in the study. MHS was operationalised in symptoms of anxiety, disordered eating, depression, distress, sleep disturbance, alcohol misuse and drug misuse, all being assessed with validated questionnaires.

Results: Of the 101 participants enrolled, the prevalence of distress was 53% and MHS was between 6% for drug misuse and 48% for alcohol misuse. The incidence of distress was 29% and MHS ranged from 1% for anxiety to 11% for sleep disturbance. At baseline, players suffering from injury/surgery were more likely to report depression (OR 1.35; 95%CI 1.10-1.70) and disordered eating (OR 1.22; 95%CI 1.02-1.47). At follow-up, players who suffered injury or surgery were inclined to report distress (OR 2.15; 95%CI 1.26-4.31) and drug misuse (OR 2.05; 95%CI 1.01-4.04).

Conclusion: There seems to be a greater prevalence of MHS in active professional male footballers than in the global population and other sports. After severe injury/surgery, the risk of developing MHS is increased, confirming that healthcare professionals should be aware of the mental health of injured players.