Depressive symptoms and burnout linked to more concussions

Elite ice hockey players with a history of concussions report increased mental health symptoms, according to a new study from Lund University in Sweden. In addition, 1 in 5 female hockey players had symptoms of burnout, and both genders reported alcohol consumption to be at risk levels.

The researchers based their study on the two top men’s hockey divisions in Sweden: the SHL and Hockeyallsvenskan, and the women’s top league SDHL. A total of 648 players, including 180 women, completed the researchers’ online questionnaire. The focus of the questions was on alcohol use, mental health and concussion history.

Much research is being conducted in both Europe and the US into the effects of concussion on mental health and well-being.

“However, we want to investigate the long-term consequences for Swedish top players – six months or more after a concussion. The players’ responses have provided important insights into the link between concussion and mental health effects,” says Mitchell Andersson, PhD candidate. in psychiatry from Lund University.

He supports the investigation, which has now been conducted published in the news BMC Sports sciences, medicine and rehabilitationtogether with Anders Håkansson, consultant physician and professor of addiction medicine at Lund University.

When researchers from Lund University collected reported psychiatric symptoms among players, it was found that the male players had significantly fewer symptoms of depression/anxiety and burnout than other men – whether elite athletes in other sports or the wider Swedish male workforce . However, thirty percent of male hockey players reported risky alcohol use – much more than in the comparison groups.

The picture was slightly different for female hockey players. The prevalence of depression/anxiety symptoms was comparable to that of the average Swedish woman. However, burnout was much more common: more than 19% of women reported living with clinical symptoms of burnout – on average almost double the rate among Swedish women. The female hockey players also reported that they drank a lot of alcohol. The percentage of respondents who reported reaching the level of risky consumption was 36.4% – also well above average.

Regarding concussions, both female and male hockey players who reported more concussions were more likely to report increases in various psychiatric symptoms (e.g., depression and anxiety). The association was most pronounced in both sexes after three or more concussions: the risk of developing symptoms of depression doubled and the risk of burnout was three and a half times higher. More than 1 in 4 male and almost 1 in 5 female players reported having had at least three concussions.

“Other studies have shown that women experience more short-term symptoms than men after a concussion, but it was interesting that the link between concussion and an increased prevalence of symptoms of depression, anxiety and burnout was equally strong for both genders. This would indicate may indicate that the long-term neuropsychiatric recovery process is more similar in men and women than the short-term process,” says Andersson.

To meet the criteria for burnout, the individual must have lived under stress for at least six months and developed a number of physical and psychiatric symptoms. However, according to Andersson, it can sometimes be difficult to see what is what. The long-term symptoms after a concussion are often comparable to those of a burnout, such as cognitive impairment, irritability, concentration problems and sleep problems.

The results of the study suggest that there are several lines to follow, Andersson argues. One of these is investigating why alcohol consumption among elite players is so high.

“Hockey players are physically a little bigger and can perhaps drink a little more. Their own view of themselves, and that of others, may be that they are a bit tougher than others. There can be a sense of pride in being part of such a subculture, romanticizing alcohol can be part of it, for both men and women,” Andersson speculates. He himself played hockey at a non-elite level.

This same self-perceived toughness could contribute to male players actually under-reporting potential mental health issues. The fact that such a high proportion of women report burnout symptoms, even without concussions, could point to a recurring pattern within women’s sports at the highest level: their salaries are lower than men’s. They will often have to combine hockey with another job or study. Juggling their responsibilities with late-night games, often far from home, can be an impossible task.

“Top-level Swedish hockey players need to know where and how they can get help. Help is available aimed at this target group. Imagine being an elite athlete who trains regularly, eats healthy, makes good money doing the sport you love – and yet you’re still struggling. Can you imagine how scary and isolating that must feel? It is important not to feel alone in your state of mind,” concludes Andersson.