Potential risk factors for suicide identified in the professional athlete population

A career in a top or elite sport is not in itself a risk factor for suicide, according to a judgement published in the Journal of Psychiatric Practice. But physicians, coaches and family members should be alert to supporting elite and professional athletes as they approach retirement, a potential athlete-specific risk factor for suicide.

George A. Wilson, MBBS, of the University of South Wales in Great Britain, and colleagues write: “The data we reviewed showed that former athletes were likely to be at greater risk of suicide compared to the global average. Compared to their peers, professional and elite athletes were likely to have an equal or lower risk of suicide.

“It is recommended that future research focus on developing and implementing resources to help athletes prepare for life after retirement, such as life skills training and educational groups to reduce the risk of suicide within this cohort.”

Participation in elite and professional sports does not increase the risk of suicide

The authors based their conclusions on a review of nine studies of suicide in elite or professional athletes who were at least 16 years old. Collectively, the studies involved 23,836 athletes: 2,407 women and 21,429 men.

In addition to finding no increased risk of suicide overall, Dr. Wilson and his colleagues found no trends in suicide risk related to specific sports. The exceptions were elite or professional sports where anabolic-androgenic steroid use was suspected to be high, and shooting sports, where athletes had access to firearms.

Several factors may contribute to a lower risk of suicide in athletes, the reviewers note. It is well known that regular exercise has a positive effect on mental health and wellbeing, and belonging to a sporting community or team can lead to reduced feelings of social isolation and loneliness.

“Athletes can also develop effective coping skills through sport, which can promote a sense of resilience and control that can be applied to other areas of life,” the researchers explain. The social circumstances and higher socioeconomic status of professional athletes may also help protect against suicide.

Elite and professional athletes have certain potential risk factors for suicide

The reviewers found evidence of potential risk factors for suicide among elite and professional athletes:

• Retirement from sport
• Anabolic androgenic steroid use
• Victimization of sexual abuse
• The use of self-blame or behavioral withdrawal as a coping strategy

“Retirement from an athletic career is often a stressful and challenging experience,” the authors point out. “Athletes may face loss of purpose, loss of identity, emotional distress, social isolation and financial challenges and difficulties in adapting to a new lifestyle outside of sport. The psychology of athlete retirement is complex and multifaceted. It is therefore important to ensure that support and resources are in place to help athletes deal with the emotional aspects of the process.”

Dr. Wilson and his colleagues emphasize that as the field of sports psychiatry continues to evolve, clinicians must consider other sports-related factors unique to elite and professional athletes. “A comprehensive understanding of these factors is needed to provide guidance to those working with athletes to improve care models, improve emotional well-being, and increase quality of life in this population.”