{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:52:54Z","timestamp":1791334374533,"version":"4.3.1"},"reference-count":108,"publisher":"National Athletic Trainers' Association","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Exercise has been demonstrated to positively affect the prevention and treatment of anxiety and depression; however, athletes face an increased risk of mental health issues.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the prevalence and incidence of anxiety and depression among athletes and explore potential factors influencing these outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>PubMed, Embase, and Web of Science databases were searched between inception and August 18, 2025, for studies in which anxiety and depression in athletes were investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Selection<\/jats:title>\n                    <jats:p>Studies were included according to the following criteria: (1) athletes of any level including high school or collegiate level, amateur, and elite and (2) prevalence or incidence of moderate to severe anxiety or depressive symptoms or diagnosis of anxiety or depressive disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Extraction<\/jats:title>\n                    <jats:p>Study characteristics, type of modality, anxiety or depressive symptoms tools with cutoffs for moderate to severe symptoms, and participant characteristics were extracted. Two reviewers assessed risk of bias of the included studies using the Newcastle-Ottawa Scale. Meta-analysis was performed using random-effects models. We calculated incidence and prevalence estimates with 95% CIs for each study, then pooled the data for symptom groups. Subanalyses by level of sport and type of sport were conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Synthesis<\/jats:title>\n                    <jats:p>We included 64 studies (n = 131\u2009840 athletes) in the systematic review and 64 studies (97 events) in the meta-analysis. The prevalence of diagnosed disorders was 21% for anxiety (95% CI = 0.14, 0.29; 3 studies, 106\u2009403 athletes), 6% for depression (95% CI = 0.04, 0.10; 1 study, 290 athletes), and 14% for combined anxiety and depression (95% CI = 0.12, 0.15; 1 study, 3719 athletes). However, the prevalence of moderate to severe anxiety symptoms was 16% (95% CI = 0.13, 0.21; 33 studies, 12\u2009893 athletes), 18% for moderate to severe depressive symptoms (95% CI = 0.14, 0.22; 46 studies, 19\u2009290 athletes), and 35% for moderate to severe anxiety and depressive symptoms (95% CI = 0.29, 0.43; 11 studies, 4069 athletes). The 12-month incidence for moderate to severe anxiety and depressive symptoms was 40% (95% CI = 0.24, 0.58; 3 studies, 611 athletes).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The prevalence rates for moderate to severe anxiety, depressive, or anxiety and depressive symptoms are relatively different when diagnosed by specialists or assessed using validated screening tools. These findings underscore the importance of early identification and focused attention on athletes\u2019 mental health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4085\/1062-6050-0581.25","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T01:16:17Z","timestamp":1770858977000},"page":"700-715","source":"Crossref","is-referenced-by-count":0,"title":["Anxiety and Depression in Athletes of Different Levels Without Current Injury: A Systematic Review With Meta-Analyses"],"prefix":"10.4085","volume":"61","author":[{"given":"Lucas","family":"Melo Neves","sequence":"first","affiliation":[{"name":"Physical Activity, Sport and Mental Health Laboratory (LAFESAM), Rio Claro, Brazil"},{"name":"Bipolar Disorder Program (PROMAN), University of S\u00e3o Paulo Medical School, Brazil"},{"name":"Postgraduate Program in Human Development and Technologies (DHT UNESP), Rio Claro, Brazil"},{"name":"Postgraduate Program in Movement Sciences (Interunidades UNESP), S\u00e3o Paulo State University (UNESP), Rio Claro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matheus","family":"Mesquita Vieira","sequence":"additional","affiliation":[{"name":"Sports and Strength Training Research Group, Presidente Prudente, Brazil"},{"name":"Graduate Program in Movement Science\u2014Interunits, S\u00e3o Paulo State University (UNESP), Presidente Prudente, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liris Naomi","family":"Noguchi","sequence":"additional","affiliation":[{"name":"Physical Activity, Sport and Mental Health Laboratory (LAFESAM), Rio Claro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Victor","family":"Felisberto da Silva","sequence":"additional","affiliation":[{"name":"Sports and Strength Training Research Group, Presidente Prudente, Brazil"},{"name":"Graduate Program in Movement Science\u2014Interunits, S\u00e3o Paulo State University (UNESP), Presidente Prudente, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee","family":"Smith","sequence":"additional","affiliation":[{"name":"Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souheil","family":"Hallit","sequence":"additional","affiliation":[{"name":"School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon"},{"name":"Psychology Department, College of Humanities, Effat University, Jeddah, Saudi Arabia"},{"name":"Applied Science Research Center, Applied Science Private University, Amman, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liye","family":"Zou","sequence":"additional","affiliation":[{"name":"Body-Brain-Mind Laboratory, Shenzhen University, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davy","family":"Vancampfort","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, University of Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe","family":"Barreto Schuch","sequence":"additional","affiliation":[{"name":"Institute for Mental and Physical Health and Clinical Translation (IMPACT) and Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia; Faculty of Health\/School of Medicine, Deakin University, Australia"},{"name":"Department of Sports Methods and Techniques, Federal University of Santa Maria (UFSM), Brazil"},{"name":"Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Brazil"},{"name":"Faculty of Health Sciences, Universidad Aut\u00f3noma de Chile, Provid\u00eancia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabricio Eduardo","family":"Rossi","sequence":"additional","affiliation":[{"name":"Sports and Strength Training Research Group, Presidente Prudente, Brazil"},{"name":"Graduate Program in Movement Science\u2014Interunits, S\u00e3o Paulo State University (UNESP), Presidente Prudente, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2557","reference":[{"issue":"6","key":"i1938-162X-61-10-700-b01","series-title":"JAMA Psychiatry","first-page":"550","article-title":"Association between physical activity and risk of depression: a systematic review and meta-analysis","volume":"79","author":"Pearce","year":"2022","unstructured":"Pearce M,\nGarcia L,\nAbbas A, et al. 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Sports (Basel). 2024;12(4):106. doi:10.3390\/sports12040106"},{"issue":"2","key":"i1938-162X-61-10-700-b60","series-title":"J Clin Med","first-page":"479","article-title":"Relationship between poor sleep and depressive symptoms in Korean elite youth athletes","volume":"14","author":"Choi","year":"2025","unstructured":"Choi Y,\nKim S,\nPark SH, et al. Relationship between poor sleep and depressive symptoms in Korean elite youth athletes. J Clin Med. 2025;14(2):479. doi:10.3390\/jcm14020479"},{"issue":"7","key":"i1938-162X-61-10-700-b61","series-title":"J Sci Med Sport","first-page":"338","article-title":"Compulsive exercise and its relationship with mental health and psychosocial wellbeing in recreational exercisers and athletes","volume":"26","author":"Cosh","year":"2023","unstructured":"Cosh SM,\nMcNeil DG,\nTully PJ. Compulsive exercise and its relationship with mental health and psychosocial wellbeing in recreational exercisers and athletes. 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Clin J Sport Med. 2023;33(1):5\u201312. doi:10.1097\/JSM.0000000000001077"},{"issue":"4","key":"i1938-162X-61-10-700-b87","series-title":"Br J Sports Med","first-page":"226","article-title":"Expanding the screening toolbox to promote athlete health: how the US Olympic & Paralympic Committee screened for health problems in 940 elite athletes","volume":"55","author":"Nabhan","year":"2021","unstructured":"Nabhan D,\nLewis M,\nTaylor D,\nBahr R. Expanding the screening toolbox to promote athlete health: how the US Olympic & Paralympic Committee screened for health problems in 940 elite athletes. 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