Are endurance runners at higher risk of depression? Screening for depression and risk factors

Depression is an important public health issue. In the general adult population about 6.7% are affected. Little data are available in endurance runners. We conducted a prospective survey study screening for depression using the Patient Health Questionnaire (PHQ-9) and investigating potential associated risk factors in endurance runners (21.1km to 42.2km) and ultra-endurance runners (42.2km). Statistical analysis included descriptive, predictive techniques, and regression analysis. A total of n=601 runners participated (female n=222; male n=379; mean age (SD) 42.8 years (± 10.1)). Overall, 11.3% screened positive for major depression, particularly female runners compared to male (p=0.002) and endurance runners compared to ultra-endurance runners (p=0.023). No significant differences were observed among performance levels (elite vs non-elite). Mild depression was observed in 21.6% of runners. Factors associated with a higher risk for screening for major depression included age (p<0.001), particularly runners under the ages of 28 years, previous self-reported history of depression (p<0.001), more frequent weekly workouts (4-5 per week) (p=0.021), weeks lost to injury (p=0.022), and female sex (p=0.025). A third of endurance and ultra-endurance runners screened positive for depression, highlighting the importance of creating awareness for mental health issues and potential screening for athletes, providing access to appropriate support services and education.