Study: mental health symptoms among kickboxers call for more attention

Kickboxers who compete or have competed at the highest level frequently experience mental health symptoms. That is the conclusion of researchers at Amsterdam University Medical Center (Amsterdam Universitair Medisch Centrum). Dozens of A-class and B-class kickboxers took part in the study.

How often do mental health symptoms occur among current and former elite kickboxers, and is there a link between these symptoms and severe injuries or concussions? That was the research question posed by Sharaisha Bilgoe, Gino Kerkhoffs and Vincent Gouttebarge.

The study involved 45 current and 29 former kickboxers in the A-class or B-class, the highest international levels. The data were collected through an anonymous digital questionnaire, available in Dutch and English. The Nederlandse Vechtsportautoriteit (Dutch Combat Sports Authority) provided the researchers with practical support, as the VA endorses the importance of research of this kind.

To measure mental health symptoms, the researchers used questionnaires that are internationally recognised. In scientific terms: they used validated screening instruments from the International Olympic Committee Sport Mental Health Assessment Tool 1 (SMHAT-1).

The athletes completed questionnaires on psychological distress, anxiety, depression, sleep disturbance, alcohol and drug use and possible eating disorders. Information was also collected on severe injuries and concussions.

Results

The results show that mental health symptoms are common among competitive kickboxers at the top level. Among current elite kickboxers, more than half experience psychological distress and disordered eating. Almost one in five has sleep disturbance. One in six competitive fighters has problems with alcohol misuse. Symptoms of anxiety, depression and drug use were also reported.

Among former elite kickboxers, more than four in ten report problems with alcohol misuse. More than one in three experiences sleep disturbance and a quarter experiences psychological distress even after their competitive career. An equally large share continues to experience disordered eating after ending their competitive career.

Conclusions

The researchers conclude that mental health problems are frequently present among elite kickboxers. The high levels of psychological distress and disordered eating among active athletes, and the frequent alcohol use among former competitive athletes, are particularly striking. Nevertheless, no links were found between mental health symptoms and severe injuries or concussions. This is notable, because such links have previously been established in other sports. The researchers suggest this may be explained by the under-reporting of symptoms, cultural factors within combat sports and the limited size of the study.

The authors stress the need for more attention to mental health within the kickboxing world. They recommend the structural involvement of sports physicians and psychologists, better information about concussions, and efforts to counter the stigma surrounding mental health problems. They also emphasise the importance of follow-up research, preferably with more participants.

The Nederlandse Vechtsportautoriteit encourages athletes and former athletes who are approached for research of this kind to take part. It is in the interest of young athletes in particular that we gain more insight into possible problems, so that targeted efforts can be made to prevent them.

A preliminary study on the prevalence of mental health symptoms in current and former elite kickboxers and their possible association with severe musculoskeletal injuries and concussions

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