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. 2024 Dec 18;10(4):e001867.
doi: 10.1136/bmjsem-2023-001867. eCollection 2024.

Prevalence of anxiety and depression in former elite athletes: a systematic review and meta-analysis

Adam Runacres  1 , Zoe A Marshall  2
Affiliations

Prevalence of anxiety and depression in former elite athletes: a systematic review and meta-analysis

Adam Runacres et al. BMJ Open Sport Exerc Med. .

Abstract

Objectives: To summarise the evidence regarding the prevalence of anxiety and depression in former elite athletes compared with the general population.

Design: Systematic review and meta-analysis.CRD42022347359.

Data sources: Five electronic databases (Web of Science, PubMed, MEDLINE, Scopus and SPORTDiscus) were searched from 1970 to 2023.

Eligibility criteria: Studies were included in the meta-analysis if they: (1) were written in English; (2) included male or female elite athletes that had been retired ≥1 year; (3) included a control group or population reference values; (4) reported the time-point prevalence of anxiety and/or depression; and (5) were of a retrospective, longitudinal or prospective, methodological design. A modified version of the Downs and Black tool was used to determine risk of bias.

Results: 37 unique studies including 24 732 former athletes (2% female) were included in the meta-analysis. The time-point prevalence of anxiety (prevalence ratio (PR): 2.08 (95% CI 1.57 to 2.60)) and depression (PR: 2.58 (95% CI 2.04 to 3.12)) in former athletes was over twice that of the general population. Subgroup analyses revealed former American football players and jockeys had the highest time-point prevalence of both anxiety and depression (PR: 2.24-2.88), whereas the time-point prevalence of depression and anxiety was not significantly different to the general population for former rugby players (PR: 1.13-1.30).

Conclusion: Our meta-analyses demonstrated the time-point prevalence of anxiety and depression in former elite athletes could be over twice that of the general population, with sport-specific differences evident.

Prospero registration number: CRD42022347359.

Keywords: Anxiety; Athlete; Depression; Meta-analysis.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1. Schematic flow diagram of the systematic review and meta-Analysis process.
Figure 2
Figure 2. Overall depression forest plot. HK, Hartung-Knapp adjustment; PR, prevalance ratio.
Figure 3
Figure 3. Overall anxiety forest plot. HK, Hartung-Knapp adjustment; PR, prevalance ratio.
Figure 4
Figure 4. Combined anxiety and depression measures forest plot. HK, Hartung-Knapp adjustment; PR, prevalance ratio.
See this image and copyright information in PMC

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