Differences in Mental Health Characteristics of Japanese Athletes in Outpatient Clinics Pre- and Post-Covid-19: A Repeated Cross-Sectional Observational Study

Tatsuya Yamaguchi,1– 3 Akari Kitahara,1,4 Kazuki Sato,1 Masaru Mimura3,5 1Institute for Integrated Sports Medicine, School of Medicine, Keio University, Tokyo, Japan; 2Department of Sports Medicine, Faculty of Medicine, Juntendo University, Tokyo, Japan; 3Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; 4Department of Psychiatry, Dokkyo Medical University, Tochigi, Japan; 5Center for Preventive Medicine, Keio University, Tokyo, JapanCorrespondence: Tatsuya Yamaguchi, Email [email protected]: To investigate the differences in characteristics between Japanese athletes who visited mental health outpatient clinics before and after the COVID-19 pandemic.Patients and Methods: Athletes who visited various healthcare facilities between 2018 and 2022 were considered. The independent variable was the timing of outpatient mental health clinic visits—either before or after COVID-19. The primary outcome was the F classification based on the International Statistical Classification of Diseases and Related Health Problems 10th Revision. We collected data on clinical psychiatric diagnoses, age, sex, referral pathway, and sports-related information such as the type of sport, level of contact, individual/team sport, involvement duration, and athletic competition level. Between-group comparisons were performed among the pre- and post-COVID-19 groups using the t-test, Mann–Whitney test, and chi-square test.Results: Eighty-six athletes (37 before COVID-19 and 49 after COVID-19) were deemed eligible for the study. No significant differences were detected between the pre- and post-COVID-19 groups. However, subgroup analyses revealed a significant increase in anxiety-related disorders among female athletes and in participation in individual sports among male athletes in the post-COVID-19 group compared with the pre-COVID-19 group.Conclusion: The increased anxiety among female athletes and the increased participation in individual sports among male athletes suggest that these groups should be a high-priority target for early intervention and prevention strategies. This study contributes to our understanding of how COVID-19 has affected the mental health of athletes seeking medical treatment in Japan, and it highlights which segments of the Japanese athlete population may be more vulnerable to mental health issues in the post-COVID-19 era. Although the sample size is small, this study also provides valuable insights for practitioners on how to target specific segments of the athlete population for the implementation of interventions aimed at mitigating the development of mental health issues after COVID-19.Keywords: Japanese athletes, mental health problems, medical facilities, individual sports, female athletes, anxiety