Sports specialization in high schools may increase the risk of depression
The Association of Sports Specialization and Concussion History on self-reported depressive symptoms and quality of life among high school athletes.
Chou TY, Biese K, Leung W, Bell D, Kaminski T, McGuine T. [published online ahead of print, 2022 Nov 11]. Clin J Sport Med. 2022; doi:10.1097/JSM.0000000000001092
https://journals.lww.com/cjsportsmed/Abstract/9900/The_Association_of_Sport_Specialization_and.61.aspx
Take home message
Sports specialization in high school student-athletes may worsen depressive symptoms and decrease quality of life. History of concussions may not be related to mental health in this population.
Background
As sports participation increases, so do sports specialization and sports-related concussions. Adverse psychosocial outcomes associated with these factors include burnout, depression and reduced quality of life. Although published studies suggest that concussion and sport specialization may be associated with adverse mental health outcomes, no studies exist on student-athletes with either risk factor.
Study aim
The researchers wanted to determine whether sport specialization and concussion history are associated with depressive symptoms and quality of life in high school students.
Methods
The authors recruited student-athletes from 31 high schools in Wisconsin during the 2016-2018 school years. All participants met inclusion criteria by participating in interscholastic sports, enrolling in grades 9–12, and being medically eligible to participate in sports on the day of study recruitment. After meeting these criteria and consenting to participate, researchers collected participant demographic data, including concussion and sports history (participation in one or more sports). Athletic Trainers validate the information provided by the participant. Researchers used the Patient Health Questionnaire-9 to collect data regarding depressive symptoms and the Pediatric Quality of Life 4.0 Scale to assess the participants’ quality of life.
Results
Of the 2,453 athletes, 19% reported a previous concussion and 57% specialized in a sport. Athletes who participated in only one sport reported more depressive symptoms and lower quality of life than their counterparts who played multiple sports. Specifically, single-sport athletes were 50% more likely to report higher depression scores than athletes who played multiple sports in high school. The sports-related concussion was not related to depressive symptoms and quality of life.
Viewpoints
This research adds to the growing body of literature suggesting that sport specialization can lead to negative mental health outcomes for student-athletes. This relationship could explain increased concerns about athletes’ mental health in recent years. This study also adds to the literature that history of concussion is not associated with mental health problems in non-elite athletes. However, this is not intended to downplay the fact that some patients may experience depressive symptoms following a concussion and that we should carefully monitor all patients for mental well-being following an injury. This study is not without limitations. The authors relied on patients’ ability to recall a previous concussion history, raising concerns about the accuracy of one’s memory. The cross-sectional nature of this study also limits the authors’ ability to determine whether sport specialization (playing a single sport) has negative consequences for mental health and quality of life, or whether depressive symptoms make an athlete less often participates in multiple sports. .
Clinical implications
Sports medicine professionals must advocate for diverse sports experiences for youth, adolescent, and teen athletes while ensuring readiness to manage mental health issues in this population. Additionally, these professionals should avoid suggesting that sports-related concussions lead to mental health consequences, including depression.
Questions for discussion
What are your experiences with sports specialization athletics and mental health care? How do you deal with sports specialization in athletics? How does this study change your perspectives regarding sport specialization and concussions in athletics?
related posts
- We must break the stigma of seeking mental health care among student-athletes
- Mom and Dad say specialization is important
- Playing high school football should not lead to impaired cognition or depression
Written by: Cade Watts
Review by: Jeffrey Driban
