Mental Health and the Youth Athlete: An Analysis of the HeartBytes Database

Author(s): Arthraj J Vyas, Mengyi Sun, Jason Farber, Sean J Dikdan, Max Ruge, Sondra Corgan, Drew Johnson, David Shipon

Objective: To examine the relationship between mental health and athletic performance in youth athletes, and how antidepressant use can alter symptoms.

Design: Data was collected by Simon’s Heart, a nonprofit organization that coordinates pre-participation examinations (PPE) for adolescents. Multivariable logistic regression was performed to assess the relationship between mental health disorders and each outcome.

Setting: There is a high rate of mental health conditions among adolescent athletes; however, there is limited information about its impact on their health and athletic performance.

Participants: Adolescent athletes participating in heart screenings performed by Simon’s Heart.

Independent Variables: Anxiety/Depression, ADHD, Antidepressant Use, Stimulant Use.

Main Outcome Measures: ECG Abnormalities, Chest Pain/Dyspnea, Syncope, Palpitations. Results: Screened participants without a diagnosis of ADHD or anxiety/ depression were significantly more likely to play sports compared to those with these conditions. Those with anxiety/depression not on an antidepressant, but not those on an antidepressant, were more likely to report chest pain or dyspnea with exercise. Those with ADHD not on a stimulant, but not those on a stimulant were more likely to report palpitations.

Conclusion: Young athletes with anxiety/depression were less likely to participate in sports than healthy individuals. This deterrence may be due to symptoms they experience during exercise. However, those taking antidepressants had fewer symptoms during exercise. Given that exercise has been shown to improve depression/anxiety, increasing the rate of antidepressant use may lead to less symptoms, more exercise, and an overall improvement in mental health.