Former professional footballers actually have lower risk of mental health disorders. This is perhaps a surprising outcome following recent concerns that the risk of mental health disorder and suicide in former athletes is linked to a specific degenerative brain pathology.
The concern was that mental health was linked to exposure to brain injury (known as chronic traumatic encephalopathy or CTE). This pathology has been described in a high proportion of former contact sports athletes, including former footballers and has previously been linked to psychiatric presentations including depression and suicidality.
It is already well documented that football also gives rise to a higher incidence of injuries than many other sports. As lead sports doctor, Ralph Rogers explains, "footballing injuries usually involve the pelvis, groin, hip, thigh, knee, calf, ankle or foot and most are caused by trauma". However brain injury and mental health have been the more recent focus of research.
The FIELD study is currently funded by the Football Association (FA) and the Professional Footballers’ Association (PFA). It is the first and largest study to investigate the association between elite level contact sport and risk of common mental health disorders.
FIELD is an acronym for ‘Football’s InfluencE on Lifelong health and Dementia risk.’ The study began in March 2018 and runs to February 2021. Two thirds of the footballers included in this study were born after 1952.
To put the mental health results in context, this is the fourth output from the FIELD study, the previous 3 outcomes included:
- The landmark FIELD study on former professional footballers neurodegenerative disease risk, published in the New England Journal of Medicine, which found that found that former professional footballers had an approximately three and a half times higher rate of death due to neurodegenerative disease than expected,
- The FIELD study protocol, published in BMJOpen, and
- A manuscript detailing brain pathology in former footballers and rugby players with dementia in Acta Neuropatholgica
Footballers at no greater risk
The new fourth set of findings show that former professional football players have lower risk of hospitalization for the most common mental health disorders, including anxiety and depression, and are at no greater risk of suicide.
The study found that former footballers were approximately half as likely to be admitted for:
- anxiety and stress related disorders,
- depressive disorder,
- alcohol use disorders,
- drug use disorders, and
- bipolar and affective mood disorders
Led by consultant neuropathologist Dr Willie Stewart, honorary clinical associate Professor at the University of Glasgow, this latest research looking at mental health outcomes in over 7,500 former professional footballers and approximately 23,000 general population controls and is published in the Journal of Neurology, Neurosurgery and Psychiatry.
Nevertheless, despite former professional footballers in the FIELD study having high rates of dementia, they were at lower risk of hospital admission for the most common mental health disorders, when compared to matched counterparts in the general population. Specifically, former footballer players were approximately half as likely to be admitted for anxiety and stress related disorders, depressive disorder, alcohol use disorders, drug use disorders, and bipolar and affective mood disorders.
Dr Willie Stewart said: “This is the first and largest study to date to investigate the association between elite level contact sport and risk of common mental health disorders after retirement in this way.
“Our findings show that, despite former professional footballers having higher death from neurodegenerative disease, they are in fact approximately half as likely to be admitted to hospital with common mental health disorders.”
“This is important, because in recent decades there have been suggestions that common mental health disorders and suicide are features of neurodegenerative disease in contact sports athletes. The results from FIELD would suggest this is not the case after all.