title: Depression, Anxiety, and Alcohol Use in Elite Rugby League Players Over a Competitive Season.
abstract: OBJECTIVE
  To assess the prevalence of symptoms of depression, anxiety, and rates of alcohol misuse in elite rugby league players in Australasia.
  
  
  METHODS
  A cross-sectional, epidemiological study with repeated measures.
  
  
  METHODS
  Surveys were conducted during the 2015 preseason and in-season.
  
  
  METHODS
  Four hundred four elite rugby league players participated preseason and 278 players in-season.
  
  
  METHODS
  Symptoms of depression were measured using the Patient Health Questionnaire-9 scale, symptoms of generalized anxiety disorder (GAD) with the GAD-7 scale, and the Alcohol Use Disorders Identification Test Consumption scale was used to assess hazardous alcohol use.
  
  
  RESULTS
  The overall prevalence of depression was 12.6% preseason and 10.1% in-season. Generalized anxiety disorder had a prevalence of 14.6% and 10.1% for these 2 periods. Overall, 68.6% of players had hazardous levels of alcohol use preseason, and 62.8% in-season. There was no significant difference for any of the main outcomes between the periods. Players with a history of mental illnesses had 5.62 greater odds (95% confidence interval [CI], 2.62-12.04) of depression than those without during preseason, and 22.08 greater odds (95% CI, 7.77-62.71) in-season. Players reporting ≥3 previous concussions had 2.02 greater odds (95% CI, 1.07-3.82) of depression than those reporting ≤2 in the preseason sample.
  
  
  CONCLUSIONS
  Rugby league players have a lower prevalence of depression compared with studies of the general population and other athletes, but a higher prevalence of GAD, and high rates of alcohol misuse. Clubs may consider implementing regular screening for these conditions. Further prospective research to determine causality of independent factors is required.
authors.affiliation: *Australasian College of Sport and Exercise Physicians, Sydney, Australia; †Applied Research Program, New South Wales Institute of Sport, Sydney, Australia; ‡Narrabeen Sports Medicine Centre, Sydney, Australia; §Southern Cross Orthopaedic and Sports Clinic, Sydney, Australia; ¶Sports Clinic NQ, North Ward, Australia; and ‖Sydney Sports Medicine Centre, New South Wales Institute of Sport, Sydney, Australia.
authors.forename: Etienne J
authors.initials: EJ
authors.lastname: Du Preez
authors.forename: Kenneth S
authors.initials: KS
authors.lastname: Graham
authors.forename: Thomas Y
authors.initials: TY
authors.lastname: Gan
authors.forename: Bassam
authors.initials: B
authors.lastname: Moses
authors.forename: Chris
authors.initials: C
authors.lastname: Ball
authors.forename: Donald E
authors.initials: DE
authors.lastname: Kuah
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D001007:Anxiety / Q000453:epidemiology*; D056352:Athletes; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005538:Football; D006801:Humans; D008297:Male; D015995:Prevalence; D011795:Surveys and Questionnaires; D055815:Young Adult