Independent Predictors of Mental Health and Quality of Life in Elite Youth Soccer Players.

Abstract

Objective: To identify the independent predictors of mental health and quality of life (QOL) among elite youth soccer athletes.

Design: Cross-sectional observational study.

Setting: Study materials were distributed to the Elite Clubs National League (ECNL) clubs through an online survey.

Participants: 668 adolescent athletes aged 13 to 18 years.

Assessment of risk factors: Independent variables included age, sex, previous week sleep duration, athletic identity (AI), previous injury, and racial/ethnic minority status.

Main outcome measures: Main outcome measures were anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), and QOL (PedsQL). Separate multivariable regression models evaluated independent predictors of each outcome.

Results: Independent predictors of anxiety were age (β = 0.28 ± 0.072, P < 0.001), female sex (β = -1.7±-0.40, P < 0.001), sleep (β = -0.88 ± 0.16, P < 0.001), AI (β = 0.11±-0.034, P = 0.002), and injury (β = 1.2±-0.37, P = 0.001), but not racial/ethnic minority status (β = 0.35 ± 0.39, P = 0.37). Independent predictors of depression included age (β = 0.29 ± 0.070, P < 0.001), female sex (β = -1.4 ± 0.41, P < 0.001), sleep (β = -1.2 ± 0.16, P < 0.001), injury (β = 0.88 ± 0.37, P = 0.019), and racial/ethnic minority status (β = 0.81 ± 0.40, P = 0.004), but not AI (β = 0.049 ± 0.035, P = 0.16). Independent predictors of QOL were age (β = -0.60 ± 0.19, P = 0.001), sleep (β = 2.6 ± 0.43, P < 0.001), injury (β = -3.7 ± 0.98, P < 0.001), and AI (β = -0.22 ± 0.092, P = 0.016), but not sex (β = 1.8 ± 1.1, P = 0.10) or racial/ethnic minority status (β = -1.5 ± 1.0, P = 0.16). In all models, sleep had the greatest relative importance (38%-56%).

Conclusions: Among youth soccer athletes, greater age, female sex, previous injury, and less sleep were independent predictors of anxiety and depression, whereas greater age, previous injury, less sleep, and higher AI predicted lower QOL. Sleep emerged as the strongest modifiable factor, highlighting its importance in psychosocial wellbeing, to the extent that sleep contributes to these outcomes.