From the Guidelines
The PHQ result can significantly impact sports clearance decisions, and athletes with high scores indicating moderate to severe depression or other mental health issues may be delayed or receive conditional clearance until further evaluation and treatment are completed. This is because depression and anxiety can impair concentration, reaction time, and decision-making abilities, potentially increasing injury risk during sports participation, as noted in the context of assessing anxiety and depressive symptoms in adults with cancer 1. The sports clearance process typically involves a comprehensive assessment where PHQ results are considered alongside physical health factors, similar to the approach outlined for evaluating athletes with cardiovascular abnormalities 1.
Key Considerations
- The PHQ-9 screening score can help identify athletes who may require further evaluation or treatment for mental health concerns before being cleared for sports participation.
- Medical providers should consider the potential risks and benefits of sports participation for athletes with mental health conditions, taking into account factors such as the type of sport, competitive level, and individual athlete's circumstances.
- A decision-based model for return to play, as outlined in the context of the female athlete triad 1, can help guide the assessment and decision-making process for athletes with mental health concerns.
- The use of medications such as SSRIs (e.g., sertraline or fluoxetine) may be considered as part of the treatment plan, but their potential side effects and impact on athletic performance should be carefully evaluated.
Sports Clearance Process
- Athletes with positive PHQ screens may receive conditional clearance with specific monitoring requirements or activity modifications.
- Mental health treatment might include therapy, medication, or a combination approach, with regular follow-up to assess improvement before full clearance is granted.
- The sports clearance process should prioritize the athlete's safety and wellbeing, while also considering their individual circumstances and the potential benefits of sports participation.
From the Research
PHQ Result and Sports Clearance
- The Patient Health Questionnaire (PHQ-9) is a tool used to identify and grade depression symptoms 2, 3, 4.
- There is no direct evidence in the provided studies that links PHQ-9 results to sports clearance.
- However, the PHQ-9 can be used to detect major depressive disorder in primary care, which may have implications for an individual's ability to participate in sports 3.
- The severity of depression symptoms, as measured by the PHQ-9, can impact an individual's quality of life and healthcare resource utilization 2.
- In the context of sports clearance, a healthcare professional may use the PHQ-9 as part of a comprehensive evaluation to assess an individual's mental health and determine their suitability for participation in sports.
Implications for Sports Clearance
- The PHQ-9 can help identify individuals with depressive symptoms who may require further evaluation or treatment before participating in sports 5.
- The use of the PHQ-9 in practice can be influenced by interactions between patients and physicians, which may impact the accuracy of depression diagnosis and treatment recommendations 6.
- While the PHQ-9 is a useful tool for detecting depression, it should be used in conjunction with other evaluations and assessments to determine an individual's suitability for sports participation.
- Further research is needed to explore the relationship between PHQ-9 results and sports clearance, as well as the implications for individuals with depressive symptoms who wish to participate in sports.