Depression in Collegiate Runners and Soccer Players: Relationships with Serum 25-Hydroxyvitamin D, Ferritin, and Fractures.

The main purpose of this study was to evaluate relationships between depression versus serum 25-hydroxyvitamin D (vitamin D), serum ferritin (ferritin), and fractures across a competitive season. The authors conducted a prospective observational study (both pre- and post-season testing) on 51 collegiate soccer and cross-country athletes from a Midwest University. Our main outcome measure was depression, measured using the Center for Epidemiological Studies Depression Scale (CES-D). A CES-D score ≥ 16 represented the threshold value for clinical depression. Secondary outcome variables included vitamin D, ferritin, and fractures. Two athletes (3.9%; one female) pre-season while seven athletes (13.7%; five females) post-season demonstrated clinically relevant depression (CES-D score ≥ 16). Depression scores increased from pre- to post-season (6.0 to 8.9; p = 0.009; effect size = 0.53; n = 51). A medium effect noted for depressed athletes vs. non-depressed athletes (n = 7; post-season) to have lower pre-season serum vitamin D (38.4 vs. 50.2 ng/ml; p = 0.15; effect size = 0.68) with a small overall correlation effect (r = -0.08; p = 0.58). A medium correlation effect was noted between post-season ferritin vs. depression scores (r = -0.45; p = 0.01) in the female cohort only. Six athletes (11.8%) sustained fractures and had lower depression scores vs. non-injured athletes (4 vs. 10; p = 0.04; effect size = 1.08) post-season. Depression scores increased over a competitive season, especially in females. Small correlation effects were observed between depression and vitamin D. A medium correlation effect was noted between depression and low ferritin levels, in female athletes only. A large effect was noted between athletes sustaining fractures during the season and depression, post-season, with injured athletes being less depressed than non-injured athletes.