Anxiety, insomnia, and depression during COVID-19 lockdown in elite individual and team sport athletes

Abstract

Purpose: Pandemic-induced lockdowns disrupted sport training and competition. We aimed to identify the impact on the mental health of high-level athletes and clarify whether the effects differ for team-based and individual athletes. Methods: This cross-sectional survey, stratified by sex and sport type, collected demographic data and mental health measurements from 274 Brazilian high-performance athletes (142 from team sports and 132 from individual sports) involved with the Brazilian Olympic Committee program for the Tokyo Olympics 2021. Depression, disturbed sleep, and anxiety were assessed by the 9-Item Patient Health Questionnaire, 7-Item Insomnia Severity Index, and 7-Item Generalized Anxiety Disorder scale respectively. Responses were analyzed dichotomously according to published threshold values, characterizing the relative frequency distribution of prevalence (PCRS) or non-prevalence of clinically relevant symptoms (NPCRS). Results: Out of all participants, 47 [17.1%], Z(274) = 15.38, p =.001, 32 [11.7%], Z(274) = 17.94, p =.001, and 49 [17.9%], Z(274) = 15.04, p =.001 had PCRS of anxiety, insomnia, and depression, respectively. There were no significant differences in the PCRS among genders. Compared with individual sport athletes, team sport athletes were more likely to report PCRS of insomnia (12 [37.5%] vs 20 [62.5%], Z(274) = −2.00, p =.046), and depression (18 [36.7%] vs 31 [63.3%], Z(274) = −2.63, p =.009) but not for anxiety. Conclusion: Athletes reported high levels of mental health problems during the lockdown. Team sport athletes reported worse symptoms of insomnia and depression than individual sport athletes, possibly due to the impact of unaccustomed social isolation and lack of social team activity. Therefore, it becomes relevant to consider psychological support to team sport athletes who for some reason, such as a pandemic, enduring crisis even injury rehabilitation needs to be isolated.