Young men who play football in high school are not at increased risk of suicidal thoughts or depression in young adulthood, suggests a study in Clinical Journal of Sport Medicine. The journal is published in the Lippincott portfolio by Wolters Kluwer.
"In contrast, those who experienced mental health problems in high school were much more likely to experience suicidal ideation during their twenties," according to the new study, led by Grant L. Iverson, PhD, of Harvard Medical School. The researchers analyzed data from a nationally representative study that followed up US high school students from adolescence into adulthood.
Research questions link between high school football and suicide
Of 3,147 teens enrolled in the study at an average age of 15 years, 2,353 were re-evaluated at an average age of 29 years. As high schoolers, about 28 percent of participants reported that they played or intended to play football. Follow-up responses were analyzed to determine if playing high school football was associated with a higher risk of suicidal ideation (suicidal thoughts) later in life.
As young adults, about 10 percent of participants reported being diagnosed with depression sometime during their lives. Almost six percent had suicidal thoughts over the past year. Rates of suicidal thoughts and depression were not significantly different for men who did or did not play football as teens.
In contrast, mental health difficulties in adolescence were strongly related to suicidality in young adulthood. As teens, about 11 percent of boys said they had received psychological counseling. At age 29, men in this group were more than twice as likely to report being diagnosed with depression: about 20 percent versus nearly nine percent.
About 10 percent of participants reported suicidal thoughts as teens, while two percent said they had made a suicide attempt. At age 29, men who reported suicidality as adolescents were much more likely to report a depression diagnosis in their twenties, 21 percent versus 8.5 percent; and suicidal ideation over the past year, seven percent versus four percent. Both risks were even higher for men who reported a suicide attempt in their teens.
"There is societal concern that playing football might be associated with increased risk for later in life depression, suicidality, and suicide," Dr. Iverson and coauthors write. These concerns have been fueled by intense media coverage of some current and former National Football League players who have completed suicide in recent years. Some researchers have suggested that suicidality may be a clinical feature of chronic traumatic encephalopathy in football players, although the evidence to support this claim is controversial.
Of course, some former amateur and professional football players will experience depression and suicidality at some time during their lives. But as in nonathletes, these risks may be related to "life stressors" – such as chronic pain, financial and relationship problems, and substance abuse – rather than to football itself.
"The underlying causes for suicidality are usually complex and multifactorial," Dr. Iverson and coauthors add. "When these mental health problems arise in former athletes, it is important to provide them with high-quality evidence-informed mental health care." The researchers acknowledge some important limitations of their study. In particular, the study assessed whether the boys intended to play football in high school, but did not confirm that they actually did so.
The new findings are consistent with previous studies showing a lack of association between football participation and suicidality. Other research has suggested that teens who are physically active and participate in team sports have higher self-esteem and lower risk of mental health problems. Dr. Iverson and colleagues conclude: "It is overly simplistic, and inconsistent with the published literature, to link suicidality with playing high school football."
Read "Playing High School Football Is Not Associated With an Increased Risk for Suicidality in Early Adulthood"
DOI: 10.1097/JSM.0000000000000890
