Mental Health in Ultra-Endurance Runners: A Systematic Review

Mabliny Thuany; Carel Viljoen; Thayse Natacha Gomes; Beat Knechtle; Volker Scheer

doi:10.1007/s40279-023-01890-5

Mental Health in Ultra-Endurance Runners: A Systematic Review

Sports Med. 2023 Oct;53(10):1891-1904. doi: 10.1007/s40279-023-01890-5. Epub 2023 Aug 3.

Authors

Mabliny Thuany¹, Carel Viljoen², Thayse Natacha Gomes^{3

4

5}, Beat Knechtle^{6

7}, Volker Scheer⁸

Affiliations

¹ Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal. mablinysantos@gmail.com.
² Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
³ Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland.
⁴ Physical Activity for Health Cluster, Health Research Institute, University of Limerick, Limerick, Ireland.
⁵ Department of Physical Education, Federal University of Sergipe, São Cristóvão, Brazil.
⁶ Medbase St. Gallen am Vadianplatz, St. Gallen, Switzerland.
⁷ Institute of Primary Care, University of Zurich, Zurich, Switzerland.
⁸ Ultra Sports Science Foundation, Pierre-Bénite, France.

PMID: 37535248
DOI: 10.1007/s40279-023-01890-5

Abstract

Background: Among ultra-endurance runners (UER), the mental, behavioral, and physical demands of training/competition can result in maladaptive outcomes. Mental health issues are common in athletes and can impact psychology, physical health, and performance.

Objective: To synthesize information regarding the incidence/prevalence and factors associated with mental health issues among UER.

Methods: Systematic searches were performed in PubMed, SPORTDiscus, Scopus, Cochrane databases, CINAHL, Web of Science, and Medline Ovid using key terms related to UER (e.g., trail running, road running) and psychological issues (e.g., exercise addiction, depression). Inclusion criteria included original articles published in peer-reviewed journals in English, using qualitative or quantitative approaches. We considered papers reporting incidence/prevalence and associated factors with mental health outcomes in UER of both sexes, all ages, and levels of competition (e.g., elite, nonprofessional runners). The Joanna Briggs Institute Analytical Cross-Sectional Studies critical appraisal tool was used for quality assessment.

Results: A total of 282 studies were identified, and 11 studies were included in the final selection. A total of 3670 UER were included in the studies. The prevalence of mental health issues among UER ranged between 32.0% and 62.5% for eating disorders, from 11.5% to 18.2% for exercise addiction, 18.6% for depressive symptoms, and 24.5% for sleep disturbance. Exercise addiction was not related to weekly volume, but a strong relationship with exercise in an unstructured space, age, and body mass index was shown.

Conclusion: Mental health issues among UER are common, especially eating disorders, exercise addiction, sleep disturbances, and depressive symptoms. Further high-quality studies are needed to examine underlying factors and find preventative strategies to protect UER.

Registration: The protocol of this systematic review was registered at the PROSPERO-CRD42022338743.

Publication types

Systematic Review
Review

MeSH terms

Cross-Sectional Studies
Exercise
Female
Humans
Male
Mental Health
Nutritional Status
Running*
Sleep Wake Disorders*