Do Exercisers With Musculoskeletal Injuries Report Symptoms of Depression and Stress?

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CONTEXT: Sports injuries in athletes can lead to negative emotional responses in terms of anger, anxiety, confusion, and sadness. Severe injuries can be understood as a stressful life event with increased levels of psychological distress, but injury assessment and rehabilitation typically focuses on somatic symptoms.

OBJECTIVE: The primary aim of this study was to estimate the prevalence of depression and emotional stress, and measure self-rated health in regular exercisers presenting to a sports medicine clinic with musculoskeletal injury. The secondary aim was to identify psychosocial factors associated with depression in injured exercisers and the potential need for psychological counselling.

DESIGN: A cross-sectional survey study.

SETTING: A sports medicine clinic for injuries of the foot, knee, or shoulder.

PARTICIPANTS: Regular exercisers with present injuries (n=694) and exercisers without injuries (n=494). Regular exercisers were defined as those undertaking moderate exercise at least once a week.

INTERVENTION: A questionnaire survey completed on paper by patients in a sports medicine clinic and a web-based version completed by online sports communities.

MAIN OUTCOME MEASURES: Participants completed the Major Depression Inventory (MDI), Perceived Stress Scale (PSS), health-related quality of life (EQ-5D-5L), and questions on sociodemographics, exercise habits, and injury history.

RESULTS: Symptoms of depression were reported by 12% of injured exercisers and 5% of non-injured controls (p<0.001). Clinical stress was found in 30% of injured exercisers and 22% of controls (p=0.002), and EQ-5D-5L VAS score was lower for injured (69±19) than non-injured exercisers (87±13, p<0.001). Injured exercisers with symptoms of depression reported high stress levels and impaired daily functioning, were younger, and more likely to have over 10 days injury-related work absence.

CONCLUSIONS: We recommend psychological assessment of exercisers attending a sports medicine clinic for musculoskeletal injury, and supplemental clinical psychological interview for suspected depression or stress-related psychopathology.

TidsskriftJournal of Sport Rehabilitation
StatusUdgivet - 2018