# Prevalence and Levels of Symptoms of Anxiety, Depression and Suicidal Ideation Amongst Elite Male Soccer Players: An Age- and Education-Matched Controlled Study

## TL;DR

Elite male soccer players experience similar rates of anxiety and depression as non-athletes, but have higher suicidal ideation, highlighting a need for mental health support in sports.

## Contribution

This study uses age- and education-matched controls to reveal mental health symptom levels in elite athletes with standardized assessments.

## Key findings

- Elite soccer players and controls had similar depression and anxiety prevalence, but athletes showed higher suicidal ideation.
- Neural network analysis found combined anxiety and depression symptoms modestly differentiate athletes from controls.
- Anxiety severity was lower among athletes compared to controls despite similar prevalence.

## Abstract

Public health relevance—How does this work relate to a public health issue?
Mental health symptoms, including anxiety and depression, are prevalent among elite male soccer players at similar levels compared to controls.The use of matched control groups with standardised assessment measures addresses a critical gap in population-based mental health research involving elite footballers (soccer players).

Mental health symptoms, including anxiety and depression, are prevalent among elite male soccer players at similar levels compared to controls.

The use of matched control groups with standardised assessment measures addresses a critical gap in population-based mental health research involving elite footballers (soccer players).

Public health significance—Why is this work of significance to public health?
Findings from this study challenge assumptions that elite sports are inherently protective against mental health difficulties, particularly suicidal ideation.Although anxiety and depression levels were comparable between groups, higher suicidal ideation among elite soccer players highlights ongoing public health concerns for athlete mental health.

Findings from this study challenge assumptions that elite sports are inherently protective against mental health difficulties, particularly suicidal ideation.

Although anxiety and depression levels were comparable between groups, higher suicidal ideation among elite soccer players highlights ongoing public health concerns for athlete mental health.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Mental health monitoring in elite sports should prioritise ongoing, validated multidimensional assessment tools rather than reliance on diagnostic thresholds alone.Public health strategies targeting athletes’ mental health support should explicitly include suicide prevention and tailored psychological interventions within high-performance football clubs and organisations.

Mental health monitoring in elite sports should prioritise ongoing, validated multidimensional assessment tools rather than reliance on diagnostic thresholds alone.

Public health strategies targeting athletes’ mental health support should explicitly include suicide prevention and tailored psychological interventions within high-performance football clubs and organisations.

Mental health among elite athletes has received increasing attention, yet evidence from studies including matched control groups remains limited. This study investigated the prevalence and levels of anxiety, depression, and suicidal ideation among elite male soccer players compared with age- and education-matched controls from the general population. A total of 324 participants were included, comprising 214 elite male soccer players and 110 controls. Participants completed the Beck Depression Inventory–II (BDI-II) and the Beck Anxiety Inventory (BAI). Suicidal ideation was assessed using item 9 of the BDI-II. Data were analysed using descriptive statistics, reliability analysis, and non-parametric inferential statistics. In addition, a neural network classification analysis was conducted to examine whether combined anxiety and depressive symptoms could differentiate elite athletes from controls. No significant differences were found in the prevalence of depression (40.19% in athletes vs. 37.27% in controls) or anxiety (87.38% in athletes vs. 90.00% in controls). Levels of depressive symptoms were similar between groups, whereas anxiety levels were higher among controls. Suicidal ideation was significantly less prevalent in controls (22.73%) compared with elite soccer players (46.73%). Neural network classification achieved above-chance accuracy (68.8%) in differentiating athletes based on combined anxiety and depressive symptoms, but low sensitivity reinforces prior results that athletes and matched controls have similar levels of mental health outcomes. Elite soccer players and controls show similar prevalence of depression and anxiety, although anxiety severity appears lower among athletes. The joint configuration of anxiety and depressive symptoms modestly differentiates group affiliation, while suicidal ideation remains more prevalent among elite players. These findings highlight the complex and distinctive mental health profile of elite athletes and suggest the need for continued psychological support and monitoring in high-performance sport contexts.