Impacts of the Early COVID-19 Pandemic on Depressive Symptoms and Mental Health Among Student-Athletes

Abstract

Christopher S Ahmad,1 Justin E Hellwinkel,1 Rifat Ahmed,1 Frank J Alexander,1 Alan W Reynolds,1 Dana P Piasecki,2,3 Thomas S Bottiglieri,1 T Sean Lynch,1 Charles A Popkin,1 Bryan M Saltzman,2,3 David P Trofa1 1Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, 10032, USA; 2Sports Medicine Center, OrthoCarolina, Charlotte, NC, 28207, USA; 3Musculoskeletal Institute, Atrium Health, Charlotte, NC, 28207, USACorrespondence: David P Trofa, Columbia University Irving Medical Center, 622 West 168 St, PH-11, New York, NY, 10032, Email [email protected]: Social distancing protocols due to the COVID-19 pandemic resulted in premature ending of athletic seasons and cancellation of upcoming seasons, placing significant stress on young athletes. Inability to play or forced early retirement has significant consequences on athlete’s mental health, as demonstrated by an extensive body of injury literature. We hypothesize that premature suspension and cancellation of athletic events due to the COVID-19 pandemic leads to higher incidence of depressive symptoms among high-school and collegiate athletes. Further, athletes who strongly derive their sense of self-worth centered around athletics would have higher rates of depressive symptoms.Methods: High school and collegiate athletes were evaluated for depressive symptoms, emotional health and athletic identity measures through validated assessment instruments from May 2020 through July 2020. The Patient-Reported Outcomes Measurement Information System Depression Computer Adaptive Test (PROMIS-10 Depression CAT), Veterans RAND-12 (VR-12), which comprises both a physical and mental health component, and Athletic Identity Measurement Scale (AIMS) were utilized.Results: Mental health assessments were completed by 515 athletes (52.4% male, 47.6% female; .84.5% collegiate, 15.5% high school). Female athletes scored significantly worse than males on VR-12 mental health assessments, as well as PROMIS-10 Depression scores; however, males scored significantly lower than females on VR-12 physical health assessments, irrespective of education level. Athletes who had strong associations with athletics as central to their personal identity exhibited worse psychologic impact on VR-12 mental health and PROMIS-10 Depression measures and female athletes in this cohort reported greater depressive symptoms than males.Conclusion: Social distancing protocols due to the COVID-19 pandemic have limited athlete’s ability to participate in sports at the training and competition level. Higher rates of depressive symptoms in high school and college athletes have resulted among female athletes and those who identify strongly as an athlete.Keywords: COVID-19, mental health, return to play, involuntary retirement, psychological impact, depression

Keywords

• covid-19
• mental health
• return to play
• involuntary retirement
• psychological impact
• depression.