目的:先前关于运动员心理健康的系统评价发现,与公众相比,运动员的心理健康诊断风险可能会增加。多项横断面研究检查了不同运动员人群的自杀行为,但是有必要进行全面审查,以综合和确定有关精英运动员人群自杀行为的风险因素和流行病学,尤其是与普通人群相比。
方法:在MEDLINE进行了系统的文献检索,EMBASE,Scopus,和WebofScience从1990年到2023年1月。纳入标准包括原始同行评审的研究文章,检查自杀意念,自杀未遂,或在精英运动员群体中完成自杀。排除标准包括参加高中或残奥会水平运动的运动员,没有单独报告关于精英运动员和非运动员的结果的研究,和非同行评审工作。所有研究均由两名独立评审者筛选纳入。从纳入的研究中提取的主要结果变量包括比率,危险因素,和自杀行为的保护因素。使用Joanna-Briggs研究所(JBI)关键评估工具对每项研究的研究质量和偏倚风险进行评估。
结果:在确定的875项独特研究中,22项研究,所有这些都是横截面的,符合纳入标准。七项研究评估了以前的运动员,13项研究评估了当前的运动员,两项研究包括以前和现在的运动员的组合。七项研究涉及大学运动员,九名涉及各种运动的专业运动员,六人专注于国际或奥林匹克级别的运动员。在四项研究中,职业运动员的自杀意念率为6.9%至18%,而在三项研究中,大学运动员的比率在3.7%至6.5%之间。十项研究将运动员与普通人群进行了比较,其中大多数发现运动员自杀意念的风险降低,自杀未遂,完成自杀。只有一项研究发现,与匹配的非运动员相比,运动员的自杀率增加。在多项研究中发现的自杀行为的危险因素包括男性,非白人种族,年龄较大,和抑郁症。玩家位置,运动水平,运动,伤害对自杀行为风险的影响有限。
结论:本综述表明,精英运动员的自杀意念风险普遍降低,自杀未遂,与一般人群相比,自杀完成。教练应该意识到具体的因素,比如男性,非白人种族,和更高的运动水平,以便更好地识别有风险的运动员。本综述的局限性包括纳入研究的方法和运动员人群的异质性。因此,未来的有针对性的研究对于比较体育运动之间的自杀行为和确定特定体育运动的自杀风险因素至关重要。
背景:PROSPERO注册:CRD42023395990。
OBJECTIVE: Previous systematic reviews on mental health in athletes have found athletes to be at a potentially increased risk for mental health diagnoses compared to the public. Multiple cross-sectional studies have examined suicide behaviour within different athlete populations, but there is a need for a comprehensive
review to synthesize and identify risk factors and epidemiology regarding suicide behaviour in the elite athlete population, especially as it compares to the general population.
METHODS: A systematic literature search was performed in MEDLINE, EMBASE, Scopus, and Web of Science from 1990 to January 2023. Inclusion criteria included original peer-reviewed research articles examining suicidal ideation, suicide attempt, or suicide completion within elite athlete populations. Exclusion criteria included athletes participating in high-school or Paralympic level sports, studies that did not report results regarding elite athletes and non-athletes separately, and non-peer reviewed work. All studies were screened for inclusion by two independent reviewers. The primary outcome variables extracted from included studies included rates, risk factors, and protective factors for suicide behaviour. The study quality and risk of bias was evaluated for each study using the Joanna-Briggs Institute (JBI) critical appraisal tools.
RESULTS: Of the 875 unique studies identified, 22 studies, all of which were cross-sectional in nature, met the inclusion criteria. Seven studies evaluated previous athletes, 13 studies evaluated current athletes, and two studies included a combination of previous and current athletes. Seven studies involved varsity college athletes, nine involved professional athletes of various sports, and six focused on international or Olympic level athletes. The rate of suicidal ideation in professional athletes ranged from 6.9 to 18% across four studies, while the rate in collegiate athletes ranged from 3.7 to 6.5% across three studies. Ten studies compared athletes to the general population, the majority of which found athletes to be at reduced risk of suicidal ideation, suicide attempt, and suicide completion. Only one study found athletes to have increased rates of suicide compared to matched non-athletes. Risk factors for suicide behaviour identified across multiple studies included male sex, non-white race, older age, and depression. Player position, athletic level, sport played, and injuries showed trends of having limited effect on suicide behaviour risk.
CONCLUSIONS: This
review suggests that elite athletes generally demonstrate reduced risk of suicidal ideation, suicide attempt, and suicide completion compared to the general population. Coaches should remain aware of specific factors, such as male sex, non-white race, and higher athletic level, in order to better identify at-risk athletes. Limitations of this
review include the heterogeneity in the methodology and athlete populations across the included studies. Therefore, future targeted research is essential to compare suicide behaviour between sports and identify sport-specific suicide risk factors.
BACKGROUND: PROSPERO Registration: CRD42023395990.