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Uusitalo, A L.T.1; Valkonen-Korhonen, M1; Koskelo, J1; Länsimies, E1; Vanninen, E1

Medicine & Science in Sports & Exercise: May 2003 - Volume 35 - Issue 5 - p S39
A-15Q Free Communication/Poster Performance of Athletes

1Kuopio University Hospital, Dept. of Clinical Physiology and Nuclear Medicine, Dept. of Neurophysiology and Psychiatry, Kuopio, Finland

(Sponsor: Rainer Rauramaa, FACSM)

Depressive disorders and changes in autonomic function are presented as results of overtraining. However, no studies using clinically validated depression scales on overtrained athletes, and no studies of cardiac autonomic connections of depression in athletes exist.

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We investigated the prevalence of depression in severely overtrained athletes, and its correlation with heart rate variability (HRV).

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Twelve severely overtrained (age 25 ± 2 yr; 7 women, 5 men) and nine control (27 ± 2 yr; 6 women, 3 men) athletes were examined. Overtraining was diagnosed using the following criteria: an athlete 1) had suffered from unexplained decrement in physical performance and fatigue even after recovery time of at least three weeks, 2) was examined to be otherwise healthy, and 3) had suitable training history for overtraining. Depression was studied by using standardized scales, HDRS and MADRS (Hamilton and Montgomery-Åsberg Depression Rating Scales). HRV was measured using 24-hour ECG-recording, of which ten 10-minute standard periods were averaged representing daytime HRV, and four 10-minute standard periods were averaged representing nocturnal HRV. HRV parameters were: mean RR interval, square root of the mean of the sum of the squares of differences between adjacent RR intervals, approximate entropy (ApEn) and sample entropy (SampEn).

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According to HDRS and MADRS, nine (75 %) and seven (58 %) overtrained athletes had depression, two and three of them had major depression, respectively. None of the control athletes was depressive, and significant differences in the total scores of HDRS and MADRS between the groups (p < 0.05) were found. The total score of MADRS correlated significantly with daytime ApEn and SampEn (r = .46, p < 0.05) and with nocturnal SampEn (r = .55, p < 0.01).

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Depression, even major depression, seems to be evident in severely overtrained athletes, which should be noticed in the treatment protocol. Interestingly, non-linear dynamics of HRV were related to depressive disorders of athletes. Supported by Finnish Ministry of Education.

©2003The American College of Sports Medicine