Depression and anxiety-related disorders and suicide among Swedish male elite football players: a nationwide cohort study.

Manzur Kader, Bj��rn Pasternak, Carl-Emil Lim, Martin Neovius, Magnus Forssblad, Henrik Svanstr��m, Jonas F Ludvigsson, Peter Ueda
Author Information
  1. Manzur Kader: Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
  2. Bj��rn Pasternak: Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
  3. Carl-Emil Lim: Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
  4. Martin Neovius: Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
  5. Magnus Forssblad: Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden.
  6. Henrik Svanstr��m: Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
  7. Jonas F Ludvigsson: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
  8. Peter Ueda: Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden peter.ueda@ki.se. ORCID

Abstract

OBJECTIVE: To assess whether male elite football players, during and after their active career, were at increased risk of depression and anxiety-related disorders and suicide, as compared with the general male population.
METHODS: We included male football players active in the Swedish top division 1924-2019 and general male population (matched to football players based on age and region of residence) aged <65 years in 1997. Using nationwide registers, we followed the football players from their first season in the top division (or the date of their first registered residency in Sweden) or 1 January 1997, and compared the risk of depression and anxiety-related disorders (captured through diagnoses from hospital admissions and outpatient visits, and use of prescription drugs) among football players versus controls. In a secondary analysis using data from death certificates, we compared the risk of suicide between football players and general population males who were alive in 1969 (when cause of death became available) .
RESULTS: During follow-up through 31 December 2020, 504 (13.6%) of 3719 football players and 7455 (22.3%) of 33���425 general population males had a depression or anxiety-related disorder. In analyses accounting for age, region of residence and calendar time, the risk of anxiety and depression-related disorders was lower among football players versus general population males (HR 0.61, 95%���CI 0.55 to 0.66). The protective association was attenuated with increasing age, and from around age 70 years the risk was similar in the two groups. The risk of suicide was lower among football players versus general population males (HR 0.48, 95%���CI 0.32 to 0.72).
CONCLUSIONS: In this nationwide cohort study in Sweden, elite male football players had a lower risk of depression and anxiety-related disorders and suicide as compared with the general population.

Keywords

References

  1. BMJ Open Sport Exerc Med. 2016 Jan 19;2(1):e000087 [PMID: 27900164]
  2. Br J Sports Med. 2019 Jun;53(11):700-706 [PMID: 31097451]
  3. Alzheimers Res Ther. 2014 Sep 24;6(5):68 [PMID: 25580160]
  4. J Hum Kinet. 2015 Dec 30;49:277-86 [PMID: 26925182]
  5. Epidemiol Rev. 2004;26:53-62 [PMID: 15234947]
  6. Eur J Epidemiol. 2022 Jul;37(7):767-777 [PMID: 35810240]
  7. Sports Med. 2021 Oct;51(10):2147-2163 [PMID: 34129222]
  8. Int Rev Sport Exerc Psychol. 2019;12(1):265-294 [PMID: 31217807]
  9. Lancet Public Health. 2023 Apr;8(4):e256-e265 [PMID: 36934741]
  10. Neurology. 2013 Sep 24;81(13):1122-9 [PMID: 23966253]
  11. Addiction. 2011 May;106(5):906-14 [PMID: 21382111]
  12. Br J Sports Med. 2019 Nov;53(21):1332 [PMID: 30760457]
  13. Am J Epidemiol. 2015 Nov 15;182(10):826-33 [PMID: 26507305]
  14. J Neurotrauma. 2021 Jan 15;38(2):169-188 [PMID: 32883162]
  15. Pharmacoepidemiol Drug Saf. 2017 May;26(5):554-560 [PMID: 28326633]
  16. BMC Public Health. 2016 Oct 19;16(1):1098 [PMID: 27760538]
  17. Br J Sports Med. 2021 Aug;55(16):900-905 [PMID: 33214139]
  18. JAMA Neurol. 2021 Sep 1;78(9):1057-1063 [PMID: 34338724]
  19. Scand J Med Sci Sports. 2021 Dec;31(12):2241-2248 [PMID: 34416791]
  20. BMJ Open Sport Exerc Med. 2022 Apr 22;8(2):e001196 [PMID: 35528132]
  21. Depress Anxiety. 2018 Sep;35(9):851-860 [PMID: 29999576]
  22. Acta Neuropathol. 2014 Jan;127(1):29-51 [PMID: 24366527]
  23. JAMA Psychiatry. 2022 Jun 1;79(6):550-559 [PMID: 35416941]
  24. Epidemiology. 2010 Jan;21(1):13-5 [PMID: 20010207]
  25. Br J Psychiatry. 2016 Oct;209(4):284-293 [PMID: 27445355]
  26. J Neurol Neurosurg Psychiatry. 2020 Dec;91(12):1256-1260 [PMID: 32694163]
  27. J Sports Med Phys Fitness. 2016 May;56(5):648-54 [PMID: 27285354]
  28. Nat Rev Neurol. 2013 Apr;9(4):211-21 [PMID: 23458973]
  29. BMJ. 2022 Dec 21;379:e074093 [PMID: 36543350]
  30. J Sports Sci Med. 2015 Nov 24;14(4):811-8 [PMID: 26664278]
  31. Scand J Public Health. 2022 May;50(3):395-403 [PMID: 33620003]
  32. N Engl J Med. 2019 Nov 7;381(19):1801-1808 [PMID: 31633894]
  33. Lancet Neurol. 2017 Dec;16(12):987-1048 [PMID: 29122524]
  34. Scand J Med Sci Sports. 2010 Oct;20 Suppl 2:88-94 [PMID: 20840566]
  35. Nat Rev Neurol. 2019 Mar;15(3):179-183 [PMID: 30664683]
  36. Scand J Med Sci Sports. 2021 Apr;31(4):875-883 [PMID: 33280186]

MeSH Term

Humans
Male
Football
Cohort Studies
Depression
Sweden
Suicide
Anxiety

Word Cloud

Created with Highcharts 10.0.0footballplayersriskgeneralpopulationmale0anxiety-relateddisorderssuicidedepressioncomparedageamongmaleselitenationwideversusloweractiveSwedishtopdivisionregionresidenceyears1997firstSwedendeathHR95%���CIcohortstudyDepressionOBJECTIVE:assesswhethercareerincreasedMETHODS:included1924-2019matchedbasedaged<65Usingregistersfollowedseasondateregisteredresidency1Januarycaptureddiagnoseshospitaladmissionsoutpatientvisitsuseprescriptiondrugscontrolssecondaryanalysisusingdatacertificatesalive1969causebecameavailableRESULTS:follow-up31December2020504136%37197455223%33���425disorderanalysesaccountingcalendartimeanxietydepression-related615566protectiveassociationattenuatedincreasingaround70similartwogroups483272CONCLUSIONS:players:Anxiety

Similar Articles

Cited By (1)