PT - JOURNAL ARTICLE AU - Oevreboe, Tom Henning AU - Ivarsson, Andreas AU - Sundgot-Borgen, Jorunn AU - Knudsen, Ann Kristin Skrindo AU - Reneflot, Anne AU - Pensgaard, Anne Marte TI - Mental health problems in elite sport: the difference in the distribution of mental distress and mental disorders among a sample of Norwegian elite athletes AID - 10.1136/bmjsem-2023-001538 DP - 2023 Jul 01 TA - BMJ Open Sport & Exercise Medicine PG - e001538 VI - 9 IP - 3 4099 - http://bmjopensem.bmj.com/content/9/3/e001538.short 4100 - http://bmjopensem.bmj.com/content/9/3/e001538.full SO - BMJ OPEN SP EX MED2023 Jul 01; 9 AB - Objectives To, based on diagnostic interviews, investigate the distribution of mental disorders among a sample of Norwegian elite athletes with ‘at-risk scores’ on a self-report questionnaire measuring symptoms of mental health problems. Then, to investigate the relationship between ‘at-risk scores’ and diagnosed mental disorders.Methods A two-phase, cross-sectional design was used. In phase 1, 378 elite athletes completed a questionnaire, including validated self-report psychiatric instruments assessing symptoms of mental disorders. In phase 2, we assessed the 30-day presence of the same disorders through diagnostic interviews with the athletes with ‘at-risk scores’ using the fifth version of the Composite International Diagnostic Interview.Results Two hundred and eighty athletes (74.1%) had an ‘at-risk score,’ and 106 of these athletes (37.9%) completed diagnostic interviews. Forty-seven athletes (44.3%) were diagnosed with a mental disorder. Sleep problems (24.5%) and obsessive-compulsive disorder (OCD) and OCD-related disorders (18.9%), mainly represented by body dysmorphic disorder (BDD), were most common. Anxiety disorders (6.6%), eating disorders (5.7%) and alcohol use disorder (≤4.7%) were less frequent. Affective disorders, gambling and drug use disorder were not present. Results from self-report questionnaires did not, in most cases, adequately mirror the number of mental disorders identified using diagnostic interviews.Conclusions Using self-report questionnaires to map mental distress among elite athletes can be beneficial. If the aim, however, is to investigate mental disorders, one should move beyond self-report questionnaires and use diagnostic interviews and diagnostic instruments. In our study, sleep problems and BDD were the most prevalent. Longitudinal studies are needed to investigate these findings further.Data are available upon reasonable request. The data include highly profiled elite athletes and cannot be fully shared due to confidentiality and sensitivity.