Mental Health Matters: A Cross-Sectional Survey on Depression and Anxiety Symptoms and the Female and Male Athlete Triad

Abstract

Objective: To determine the relationship between the female and male athlete triad with depression and anxiety symptoms. Design: Cross-sectional survey. Setting: Survey distributed online through social media to participants. Participants: Male and female high school, collegiate, and postcollegiate athletes. Interventions: Participants completed a survey assessing components of the female athlete triad and the Patient-Reported Outcomes Measurement Information System depression and anxiety short-form questionnaires. Main Outcome Measures: Participants were classified into those with no, mild, moderate, or severe depression symptoms or anxiety symptoms. A female athlete triad (Triad) cumulative risk score was calculated. Multinomial logistic regressions were used to assess the relationship between triad score and depression/anxiety. Results: Two hundred fifty-four men and 780 women completed the survey; 66.6% of women and 41.3% of men reported at least mild anxiety symptoms; 54.2% of women and 38.7% of men reported at least mild depression symptoms. Triad risk score was significantly related to moderate and severe depression symptoms (P < 0 .0001) and moderate (P = 0.003) and severe (P < 0 .0001) anxiety symptoms in women. We found no significant associations between Triad risk score and depression or anxiety symptoms in men. Conclusions: We found a correlation between the female athlete triad and moderate and severe depression and anxiety symptoms in women. Depression and anxiety symptoms were most strongly related to the low energy availability component of the Triad risk score and to the presence of eating disorders/disordered eating. This suggests that mental health illness is most tied to the behavioral aspects of the Triad. Clinical Relevance: This study demonstrates the importance of screening for and treating mental health illness in those diagnosed with low energy availability, disordered eating, and/or the female athlete triad in addition to focusing on a nutrition intervention.