Risk Factors For Mental Health And Quality Of Life In Elite Adolescent Athletes

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PURPOSE: The factors influencing mental health and quality of life (QOL) in elite youth athletes are not well-defined. The purpose of this study is to identify independent risk factors for anxiety, depression, and QOL in elite adolescent soccer athletes. METHODS: 668 youth soccer athletes (13-18 years old) completed a survey on sleep, athletic identity (AI), prior injury, anxiety (GAD-7), depression (PHQ-9), and QOL (PedsQL). Wilcoxon Rank Sum tests compared outcomes between males and females. Multivariable regression models determined independent predictors of mental health and QOL, with age, gender, prior week sleep, injury, AI, and racial minority group as covariates. RESULTS: Compared to males, female youth athletes, on average had significantly worse symptoms of anxiety (4.1 [3.6-4.7] v 6.2 [5.7-6.6], p < 0.001) and depression (3.8 [3.3-4.4] v 5.6 [5.1-6.1], p < 0.001), and significantly lower overall QOL (81 [79-83] v 79 [77-80], p = 0.02), respectively. Independent predictors of anxiety were greater age (estimate (b) = 0.28 +/-0.072, p < 0.001), female gender (b = -1.7+/-0.40, p < 0.001), less sleep (b = -0.88+/-0.16, p < 0.001), lower AI (b = 0.11+/-0.034, p = 0.002), and prior injury (b = 1.2+/-0.37, p = 0.001), but not racial minority group (b = 0.35+/-0.39, p = 0.37). Independent predictors of depression included greater age (b = 0.29+/-0.070, p < 0.001), female gender (b = -1.4+/-0.41, p < 0.001), less sleep (b = -1.2+/-0.16, p < 0.001), prior injury (b = 0.88+/-0.37, p = 0.019), and identifying as part of a racial minority group (b = 0.81+/-0.40, p = 0.004), but not AI (b = 0.049+/-0.035, p = 0.16). Independent predictors of QOL were age (b = -0.60+/-0.19, p = 0.001), sleep (b = 2.6+/-0.43, p < 0.001), prior injury (b = -3.7+/-0.98, p < 0.001), and AI (b = -0.22+/-0.092, p = 0.016), but not gender (b = 1.8+/-1.1, p = 0.10), and not racial minority group (b = -1.5+/-1.0, p = 0.16). Of the included covariates, sleep had the greatest relative importance (38-56%) in all models. CONCLUSION: Among elite youth soccer athletes, greater age, female gender, prior injury, and less sleep were independently associated with greater symptoms of anxiety and depression. Similarly, older age, prior injury, reduced sleep, and higher AI were associated with reduced total QOL. Prior week sleep had the greatest influence on mental health and QOL.

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