Promotion of Para athlete well-being in South Africa (the PROPEL studies): Profiles and prevalence of psychological distress.

OBJECTIVES: There is a paucity of research investigating mental health in Para athletes. The aim of this study was to describe mental health concerns of a representative sample of South African Para athletes. DESIGN: A descriptive, cross-sectional survey was conducted at the 2019 National Championships for athletes with impairments. METHODS: Mental health was measured with the Trait component of the State/Trait Anxiety Inventory (STAI-T), and the Kessler Psychological Distress Scale (K-10). Between-group differences were analysed using the Mann-Whitney U test or one-way ANOVA. RESULTS: A total of 125 athletes were included. The average score for the STAI-T was 39 (±9) units, whilst a quarter (25%) of all athletes scored ≥45. The mean K-10 questionnaire score was 20 (±6) units. K-10 scores indicated that 12 % of athletes may meet formal definitions for anxiety and/or depressive disorders (score of ≥28), while 76 % of athletes have a high level of subclinical symptoms (score of ≥16). On average, females (36 ±â€¯9) had better STAI-T scores than males (40 ±â€¯9; p = 0.02) and married athletes (33 ±â€¯9) had better scores than unmarried athletes (40 ±â€¯9; p = 0.002). K-10 scores were also significantly better in married than in unmarried athletes (p = 0.002), but there was no difference between sexes. Neither the K-10 nor STAI-T was associated with level of competition, sport code or impairment type. CONCLUSIONS: The study identified a high prevalence of psychological distress and anxiety among South African Para athletes, compared to the general population. There is a need to further understand factors contributing to mental health in this population.

Elite athletes travelling to international destinations >5 time zone differences from their home country have a 2-3-fold increased risk of illness.

BACKGROUND: Illness accounts for a significant proportion of consultations with a team physician travelling with elite athletes. OBJECTIVE: To determine if international travel increases the incidence of illness in rugby union players participating in a 16-week tournament. SETTING: 2010 Super 14 Rugby Union tournament. PARTICIPANTS: 259 elite rugby players from eight teams were followed daily over the 16-week competition period (22 676 player-days). ASSESSMENT: Team physicians completed a logbook detailing the daily squad size and illness in any player (system affected, final diagnosis, type and onset of symptoms, training/match days lost and suspected cause) with 100% compliance. Time periods during the tournament were divided as follows: located and playing in the home country before travelling (baseline), located and playing abroad in countries >5 h time zone difference (travel) and located back in the home country following international travel (return). MAIN OUTCOME MEASUREMENT: Incidence of illness (illness per 1000 player-days) during baseline, travel and return. RESULTS: The overall incidence of illness in the cohort was 20.7 (95% CI 18.5 to 23.1). For all teams, the incidence of illness according to location and travelling was significantly higher in the time period following international travel (32.6; 95% CI 19.6 to 53.5) compared with the baseline (15.4; 95% CI 8.7 to 27.0) or after returning to their home country (10.6; 95% CI 6.1 to 18.2). CONCLUSIONS: There is a higher incidence of illness in athletes following international travel to a foreign country that is >5 h time difference and this returns to baseline on return to the home country.