Mental Health in German Paralympic Athletes During the 1st Year of the COVID-19 Pandemic Compared to a General Population Sample

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Abstract

Introduction

The COVID-19 pandemic has huge influences on daily life and is not only associated with physical but also with major psychological impacts. Mental health problems and disorders are frequently present in elite paralympic athletes. Due to the pandemic situation, new stressors (e.g., loss of routine, financial insecurity) might act upon the athletes. Therefore, the assessment of mental health in athletes during the COVID-19 pandemic is important to identify prevalence of psychological problems and propose countermeasures.

Methods

The mental health of German paralympic athletes was longitudinally monitored (starting in May 2019). The athletes completed the Patient Health Questionnaire 4 (PHQ-4) on a weekly basis and reported a stress level, training hours, and training load. During the pandemic, 8 measurement time points (March 2020 to April 2021) were used to reflect the psychological health course of the athletes. In parallel, a convenience sample of the general population was questioned about their psychological distress, including the PHQ-4. To be included in the analysis, participants of both groups had to complete at least 4 measurement time points. Matching of the para-athletes and the general population sample was prioritized upon completion of the same measurement time points, gender, and age.

Results

Seventy-eight paralympic athletes (40 women, 38 men, age: 29.8 ± 11.4 years) met the inclusion criteria. Seventy-eight matched pairs of the general population (40 women; 38 men; age: 30.5 ± 10.9 years) were identified. The para-athletes had a significantly ( p <0.0001; 0.39 < r <0.48) lower PHQ-4 value at each measurement time point compared to the matched control group. No significant age or sex differences were evident regarding the symptom burden. In para-athletes, no significant and a weak positive correlation was found between decreased training load and PHQ-4 values and a stress level, respectively. Reduced physical activity was significantly ( p <0.0001) associated with higher PHQ-4 values in the general population sample.

Discussion

Lower PHQ-4 values were reported by the para-athletes compared to the general population sample. However, small sample sizes must be considered while interpreting the data. Nevertheless, adequate support for individuals suffering from severe psychopathological symptoms should be provided for para-athletes as well as for the general population.

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Most cited references 31

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User's guide to correlation coefficients

Haldun Akoglu (2018)

When writing a manuscript, we often use words such as perfect, strong, good or weak to name the strength of the relationship between variables. However, it is unclear where a good relationship turns into a strong one. The same strength of r is named differently by several researchers. Therefore, there is an absolute necessity to explicitly report the strength and direction of r while reporting correlation coefficients in manuscripts. This article aims to familiarize medical readers with several different correlation coefficients reported in medical manuscripts, clarify confounding aspects and summarize the naming practices for the strength of correlation coefficients.

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An ultra-brief screening scale for anxiety and depression: the PHQ-4.

Kurt Kroenke, Robert L Spitzer, Janet B W Williams … (2009)

The most common mental disorders in both outpatient settings and the general population are depression and anxiety, which frequently coexist. Both of these disorders are associated with considerable disability. When the disorders co-occur, the disability is even greater. Authors sought to test an ultra-brief screening tool for both. Validated two-item ultra-brief screeners for depression and anxiety were combined to constitute the Patient Health Questionnaire for Depression and Anxiety (the PHQ-4). Data were analyzed from 2,149 patients drawn from 15 primary-care clinics in the United States. Factor analysis confirmed two discrete factors (Depression and Anxiety) that explained 84% of the total variance. Increasing PHQ-4 scores were strongly associated with functional impairment, disability days, and healthcare use. Anxiety had a substantial effect on functional status that was independent of depression. The PHQ-4 is a valid ultra-brief tool for detecting both anxiety and depressive disorders.

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Prevalence of mental health problems during the COVID-19 pandemic: A systematic review and meta-analysis

Tianchen Wu, Xiaoqian Jia, Huifeng Shi … (2020)

Highlinghts • The COVID-19 pandemic increases the prevalence of depression, anxiety, distress, and insomnia. • Health care workers and COVID-19 patients are high-risk groups of mental health. • Urgent interventions are needed for preventing mental health problems.

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Author and article information

Contributors

Aglaja Busch: URI : http://loop.frontiersin.org/people/1464889/overview

Eva Johanna Kubosch: URI : http://loop.frontiersin.org/people/1710152/overview

Antonia Bendau: URI : http://loop.frontiersin.org/people/1391114/overview

Rainer Leonhart: URI : http://loop.frontiersin.org/people/555211/overview

Moritz Bruno Petzold: URI : http://loop.frontiersin.org/people/1046736/overview

Nina Wrobel: URI : http://loop.frontiersin.org/people/1692254/overview

Jens Plag: URI : http://loop.frontiersin.org/people/1233925/overview

Journal

Journal ID (nlm-ta): Front Sports Act Living

Journal ID (iso-abbrev): Front Sports Act Living

Journal ID (publisher-id): Front. Sports Act. Living

Title: Frontiers in Sports and Active Living

Publisher: Frontiers Media S.A.

ISSN (Electronic): 2624-9367

Publication date (Electronic): 14 April 2022

Publication date Collection: 2022

Publication date PMC-release: 14 April 2022

Volume: 4

Electronic Location Identifier: 870692

Affiliations

[1] ¹Outpatient Clinic, Sport Medicine and Sports Orthopedics, University of Potsdam , Potsdam, Germany

[2] ²Division Physiotherapy, Department of Health Professions, Bern University of Applied Sciences , Bern, Switzerland

[3] ³Department of Orthopedics and Trauma Surgery, Medical Center—Albert-Ludwigs-University of Freiburg , Freiburg, Germany

[4] ⁴Department of Psychiatry and Neurosciences CCM, Charité—Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt Universität zu Berlin , Berlin, Germany

[5] ⁵Department of Psychology, Albert-Ludwigs-University of Freiburg , Freiburg, Germany

[6] ⁶Department of General Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg , Heidelberg, Germany

[7] ⁷Department of Internal Medicine, Medical Center—Albert-Ludwigs-University of Freiburg , Freiburg, Germany

[8] ⁸ALTIUS Swiss Sportmed Center AG , Rheinfelden, Switzerland

Author notes

Edited by: Roy T. H. Cheung, Western Sydney University, Australia

Reviewed by: Kam Ming Mok, The Chinese University of Hong Kong, China; Morteza Taheri, Imam Khomeini International University, Iran

*Correspondence: Aglaja Busch agbusch@ 123456uni-potsdam.de

This article was submitted to Elite Sports and Performance Enhancement, a section of the journal Frontiers in Sports and Active Living

Article

DOI: 10.3389/fspor.2022.870692

PMC ID: 9047049

PubMed ID: 35498519

SO-VID: 9636154c-d45a-4486-8a8d-7edd4e635830

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

History

Date received : 07 February 2022

Date accepted : 16 March 2022

Page count

Figures: 2, Tables: 3, Equations: 0, References: 32, Pages: 9, Words: 6221

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Mental Health in German Paralympic Athletes During the 1st Year of the COVID-19 Pandemic Compared to a General Population Sample

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Abstract

Introduction

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Discussion

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Novel Coronavirus Disease COVID-19

Most cited references 31

User's guide to correlation coefficients

An ultra-brief screening scale for anxiety and depression: the PHQ-4.

Prevalence of mental health problems during the COVID-19 pandemic: A systematic review and meta-analysis

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Cited by 7