Football does not improve mental health: a systematic review on football and mental health disorders
and | Feb 26, 2018
About this article
Published Online: Feb 26, 2018
Page range: 25 - 37
Received: Sep 14, 2017
Accepted: Dec 23, 2017
DOI: https://doi.org/10.2478/gp-2018-0001
Keywords
© 2018 Reinhard Heun, Alan Pringle, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
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| Authors | Year | Study design | Sample | Mean age, SD (years) | Country | Diagnostic instruments | Prevalence of mental health problems | Results | Potential bias |
|---|---|---|---|---|---|---|---|---|---|
| studies in professional players/referees | |||||||||
| Turner AP, Barlow J H, Heathcote-Elliott C. | 2000 | Cross-sectional survey | 284 former professional football players, 138 with osteoarthritis | 56.1 (11.8) | United Kingdom | Health-related Quality of life (EuroQuoL) | 19% of those without osteoarthritis and 37 % of those with osteoarthritis suffered current problems with anxlety/depresslon | Osteoarthritis Increases the prevalence of depression and anxiety In former professional football players | High non-reponse, selection bias |
| Gouttebarge, Aoki, Kerkhoffs | 2015 | Cross-sectional | 607 professional soccer players | 26.8 (4.4) | random sample from national players unions Belgium, Chile, Finland, France, Japan, Norway, Paraguay, Peru, Spain, Sweden and Switzerland | 12-item General Health Questionnaire, 2 or more points indicating caseness | 37.9 % suffering anxiety/depression | Significant associations were found for a higher number of severe Injuries and career dissatisfaction with distress, anxiety/depression | 37% response rate |
| Gouttebarge, Backx F, Aoki, Kerkhoffs | 2015 | Cross-sectional | 540 active professional players | 25 (Finland) to 28.2 (France) | Finland, France, Norway, Spain or Sweden | 12-item General Flealth Questionnaire, 2 or more points indicating caseness | Anxiety/depression between 25.0% (Spam) and 40.0% (Finland) | Life events and career dissatisfaction related to anxiety/depression In some but not In all countries. | 34% response rate |
| Gouttebarge, Ooms, Tummers, Inklaar | 2015 | Observational prospective study | active and recently retired football players | 30 years at death | world-wide (FIFA) | completed suicide between 2007-2013 | 214 deaths, 11.3% from suicide | suicide Is prevalent In active and recently retired players | Unknown reference sample |
| Gouttebarge, Frings-Dresen, Sluiter | 2015 | Cross-sectional assessment | 149 current professonals, 104 former football players | 27(5) current, 36 (5) former | members of World Footballers Union and national union members from Australia, Ireland, Netherlands, New Zealand, Scotland and United States | 12-item General Flealth Questionnaire, 2 or more points Indicating caseness | 26% of current and 39% of former player suffered anxiety/depression. | There Is considerable mental health morbidity In current and former players. Mental health problems were associated with low social support and recent life events. | Low response rate of only 29% |
| Gouttebarge, Aoki, Ekstrand, Verhagen | 2016 | Cross-sectional study | 540 professional footballers | 26.7 (4.4) | Finland, France, Norway, Spain or Sweden | 12-item General Health Questionnaire, 2 or more points indicating caseness | The number of severe injuries in a football career was positively correlated with distress and sleeping disturbance but not with anxiety/depression. | The number of injuries only slightly increases the risk of mental health problems. | See Gouttebarge, Backx F, Aoki, Kerkhoffs 2015 |
| Gouttebarge, Aoki, Kerkhoffs | 2016 | Cross-sectional | 219 retired male professional footballers | 35.0 (6.4) | 11 countries from three continents | 12-item General Health Questionnaire, 2 or more points indicating caseness | 35% one-month prevalence for anxiety/depression | Life events in the previous six months increased the risk of anxiety/depression (odds ratio 1.6, confidence interval 1.2-2.1) | Selection bias |
| Gouttebarge, Aoki, Verhagen, Kerkhoffs 2016 | 2016 | Cross sectional survey | 607 current and 219 retired football players | 27 versus 35 | 11 countries from 3 continents | 12-item General Health Questionnaire, 2 or more points indicating caseness | As above | Only amongst retired professional footballers, employment status as well as a higher number of working hours was weakly correlated to symptoms of distress and anxiety/depression. | Selection bias |
| Gouttebarge, Aoki, Verhagen, Kerkhoffs | 2016 | 12 months follow-up | 384 male footballers | 27 (5) | Finland, France, Norway, Spain and Sweden | 12-item General Health Questionnaire, 3 or more points indicating caseness | 12 months incidence of 37% for anxiety/depression. | No significant association between adverse life events, conflict with trainer or career satisfaction with anxiety/depression. | Selection bias, loss to follow up. |
| Gouttebarge, Johnson, Rochcongar, Rosier, Kerkhoffs | 2016 | Cross-sectional, one season incidence | 391 European professional football referees | 33 (7) | Belgium, Finland, France, Germany, Norway, Russia, Scotland and Sweden | 12-item General Health Questionnaire, 3 or more points indicating caseness | 4-week prevalence rate of 12% for anxiety/depression, one season incidence of 16% for anxiety/depression | Mental health in referees needs adressing | 45.2% response and completion rate, selection bias |
| Junge and Feddermann-Dermont | 2016 | Cross-sectional | 289 male and 182 female football players | 18.4 to 24.8 | Switzerland | CES-D (above 16, GAD-7 (above 10) | 7.6% mild to moderate depression, 3.0% major depression, 1.4% suffered anxiety disorders | Swiss FL football players had the same prevalence of depression as the general population, whilst male U-21 players had a higher prevalence; anxiety disorders were less prevalent than the general population. Players characteristics and playing positions influenced prevalences. | High response rate (above 92%), possible minor selection bias, |
| Prinz, Dvořák, Junge | 2016 | Cross-sectional | 157 female players | 33 (6.3) | Germany | Centre for epidemiological studies depression scale (CES-D) above 16 | 32% career time prevalence of depression. | The depression score varied significantly by playing positions and levels of play. Important reason for low mood were conflicts with coach/management (49.7%), low performance/injury (48.4%), too little support/acknowledgement by the coach (40.0%). | 64% response rate |
| Kiliç, Aoki, Goedhart, HäggLund, Kerkhoffs, Kuijer, Wälder, Gouttebarge | 2017 | 12 months follow-up | 384 professional footballers | 27(5) | Finland, France, Norway, Spain or Sweden | 12-item General Health Questionnaire, 3 or more points indicating caseness | See Gouttebarge, Aoki, Verhagen, Kerkhoffs 2016 | Anxiety/depression was not significantly related to musculoskeletal time-loss injuries during 12-month follow-up. | Selection bias, follow-up only completed in 68% |
| van Ramele, Aoki, Kerhoffs, Gouttebarge | 2017 | 12 months follow-up incidence | 194 retired male football players | 35 (6) | Members of World and national players’ unions | 12-item General Health Questionnaire, 3 or more points indicating caseness | 29% 12 months’ incidence for anxiety/depression | Life events increased the risk to develop anxiety/depression. | 54 % response rate, unclear nationalities |
| Studies in amateurs | |||||||||
| Richards, Foster, Townsend, Bauman | 2014 | Randomised case-control | 1,462 adolescents, 74 in the male intervention group | 11-14 | Uganda | Acholi Psychosocial Assessment Instrument for local depressionlike and anxietylike syndromes | Depression-like syndroms and anxiety-like syndromes higher in boys’ intervention group compared to wait-listed and non-reglstered group | The study challenges the blanket statements that physical activity improves mental health in young people. | Open intervention, use of local concept of mental health |
| Studies in spectators/general population | |||||||||
| Lau, Tsui, Mo, Mak, Griffiths | 2015 | 2 cross sectional surceys before and after 2006 World Cup Finals | 500/530 male members of the general population | 65% between 18 and 44 years, 35% between 45 and 60 years | Hong Kong | Telephone interviews, GHQ-12, caseness above 74 percentile in first phase of interview, above 11 points | 27% versus 20% had a high GFIQ score (above 11) | The subjective mental health of men slightly improved after the 2006 World Cup. | 51% reponse rates |
| Hassanian-Moghaddam, Ghorbani, Rahimi, Farahani, Sani, Lewin, Carter | 2017 | Time-series analysis | 2,930 cases hospital-treated deliberate self-poisoning before, during and after 2014 World Cup. | Not provided | Iran | Hospital admission for overdose | Increased hospital admissions for deliberate self-poisoning during world Cup | The increase was only prominent in 12- to 20-year old subjects | Uncrlear population age |