Abstract
AIM: This study aimed to examine the mental health of Japanese youth athletes during the second year of the COVID-19 pandemic and explore its associations with demographic and sport-related factors. METHODS: Three cross-sectional online surveys were conducted at a public high school in Japan in Spring 2021 (baseline; n = 1022), Fall 2021 (n = 1104), and Spring 2022 (n = 1066). Mental health was assessed using the Kessler-6 (K6), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) scales. Participants were categorized as youth athletes (national-level competitors [NC] and local-level competitors [LC]) or nonathlete students (NAS). Logistic regression was used to identify the mental health risk factors. RESULTS: Compared to the baseline, youth athletes showed higher rates of poor mental health indicators in the second and third surveys. Among them, female athletes showed higher risks of depression and anxiety in both later surveys, whereas upper grade athletes had an increased risk of depression in the second survey. No consistent association was found between COVID-19 infection history and mental health. CONCLUSION: Japanese youth athletes showed poorer mental health indicators at later points in the second year of the pandemic. Female and upper grade athletes may require targeted mental health support. Continuous monitoring is essential during extended public health emergencies.