Participation in endurance sports has been increasing over the last few decades and our aim of our exploratory descriptive survey study is therefore to examine mental health issues in endurance athletes (marathon runners, ultra endurance runners, triathletes), employing the IOC assessment tool, to provide information on mental health issues in this population. Secondary objects are to evaluate risk factors for mental health issues in endurance athletes (like exercise behaviour, competition behaviour, age, gender, medical issues)

This study is an exploratory descriptive survey study.

The study protocol will be largely replicated from the IOC consensus paper and the questionnaires based according to SMHAT 1 with an athlete-specific screening tool (APSQ) and further eleven subsequent disorder-specific screening tools:

Eleven disorder specific screening tools:

1. General Anxiety Disorder-7 (GAD-7): assesses the presence of symptoms of anxiety.
2. Patient Health Questionnaire-9 (PHQ-9): assesses the presence of symptoms of depression.
3. Athlete Sleep Screening Questionnaire (ASSQ): assesses the presence of sleep disturbance.
4. Alcohol Use Disorders Identification Test Consumption (AUDIT-C): assesses the presence of alcohol misuse.
5. Cutting Down, Annoyance by Criticism, Guilty Feeling, and Eye-openers Adapted to Include Drugs (CAGE-AID): assesses the presence of substance misuse, being slightly adapted for the SMHAT (no focus on alcohol use as already explored with the AUDIT-C; additional question to explore which substance was used).
6. Brief Eating Disorder in Athletes Questionnaire (BEDA-Q): assesses the presence of disordered eating.
7. ADHD
8. Bipolar disorder
9. PTSD
10. Gambling
11. Psychosis

Additionally questions to assess exercise addiction will be used as it has been shown that exercise addiction may be particularly prevalent in endurance athletes.

Further questions about age, gender, country of origin, training data, past medical history and medication will be asked as well as a few specific questions about there thoughts on mental health issues as per IOC consensus paper

Inclusion Criteria:

• endurance athletes (marathon runners, ultramarathon runners and triathletes)
• over the age of 16
• all genders
• recreational athletes (non- elite)
• elite athletes (professional, international, college level)

Exclusion Criteria:

• athletes that that are not competing or have not competed in an official endurance race
• athletes that are younger than 16 years of age.

Particpants that have or are participating in endurance sports

anonymous