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Adolescent Sport Participation and Symptoms of Anxiety and Depression: A Systematic Review and Meta-Analysis
Open accessAbstract
Sport may protect against symptoms of mental disorders that are increasingly prevalent among adolescents. This systematic review explores the relationship between adolescent organized sport participation and self-reported symptoms of anxiety and depression. From 9,955 records screened, 29 unique articles were selected that included 61 effect sizes and 122,056 participants. Effects were clustered into four categories based on the operationalization of sport involvement: absence or presence of involvement, frequency of involvement, volume of involvement, and duration of participation. Results from the random-effects meta-analyses indicated that symptoms of anxiety and depression were significantly lower among sport-involved adolescents than in those not involved in sport, although this effect size was small in magnitude. Meta-regression was used to identify how age and sex explained heterogeneity in effects. Although these results do not signify a causal effect, they do support theorizing that sport participation during adolescence may be a protective environment against anxiety and depressive symptoms.
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“We found evidence that children and adolescents who participated more frequently, who participated with higher intensity or who participated with longer duration (e.g. started at an early age or participated for a long period), had better mental health compared to their peers (Eime et al., 2013, Evans et al., 2017, Panza et al., 2020).”
From Impact of organized activities on mental health in children and adolescents: An umbrella review (2022) · cites this paper as Panza et al., 2020
In the citing paper
“However, the magnitude of the effect sizes were negligible (Eime et al., 2013, Evans et al., 2017, Panza et al., 2020).”
From Impact of organized activities on mental health in children and adolescents: An umbrella review (2022) · cites this paper as Panza et al., 2020
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Thornton, E., Petersen, K. J., Marquez, J., & Humphrey, N. (2024) · Journal of Youth and Adolescence · doi:10.1007/s10964-024-01950-7 · Cited by 17
“Importantly, such activity can promote mental health in addition to the more obvious physical health ben-e fi ts (Panza et al., 2020).”
BackgroundHogue, C. M. (2026) · International Journal of Sport and Exercise Psychology · doi:10.1080/1612197x.2024.2437481 · Cited by 14
“A recent meta-analysis that included over 100,000 participants revealed that adolescent athletes have lower symptoms of anxiety and depression than non-athletes (Panza et al., 2020).”
The Role of Psychologists in Sport Medicine Practice
Jasser, J., Patel, D. R., & Beenen, K. T. (2022) · Pediatric Clinics of North America · doi:10.1016/j.pcl.2022.05.010 · Cited by 13
Zhu, Y., Li, X., & Du, Z. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1626831 · Cited by 14
Ljungmann, C. K., Christensen, J. H., Johnsen, H. R., Klinker, C. D., & Pawlowski, C. S. (2023) · Sport in Society · doi:10.1080/17430437.2023.2286013 · Cited by 17
“Organized sports participation can make contributions to adolescents reaching the recommended amount of daily PA (Silva et al. 2013) as well as promoting psychosocial health (Panza et al. 2020; Doré et al. 2019).”
BackgroundMcGinley, J. J., Stapleton, E. J., Worrall, H. M., Ellis, H. B., Wilson, P. L., & Ulman, S. M. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.906300 · Cited by 12
“Sports may confer strong benefits to the participant in the avenues of physical health, teamwork development, and mental improvement (Panza et al., 2020).”
BackgroundBewegung, körperliche Aktivität und Sport bei depressiven Erkrankungen
Bendau, A., Petzold, M. B., & Ströhle, A. (2022) · NeuroTransmitter · doi:10.1007/s15016-021-9343-y · Cited by 12
“Körperliche Aktivität in der Prävention Zahlreiche korrelative Beobachtungsstudien, Reviews und Meta analysen haben den Zusammenhang körperlicher Akti vität mit der kategorialen Prävalenz sowie dem dimensionalen Schweregrad depressiver Erkrankungen untersucht [2, 4, 6, 7, 8].”
BackgroundLatina, D., Jaf, D., Alberti, R., & Tilton‐Weaver, L. C. (2022) · Psychology of sport and exercise · doi:10.1016/j.psychsport.2022.102133 · Cited by 15
Khan, A., Werner‐Seidler, A., Hidajat, T. J., Feng, J., Huang, Y., & Rosenbaum, S. (2023) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2023.07.011 · Cited by 15
Beyond the scoreboard: school-based sport experiences and high school student-athlete well-being
Bates, S. M., Mack, S., & Nothnagle, E. A. (2024) · Sport Education and Society · doi:10.1080/13573322.2024.2338402 · Cited by 17
“Researchers have theorized that student-athlete experiences in sport influence their stress levels, overall well-being, and risks for burnout (Eime et al., 2013; Larson et al., 2020; Panza et al., 2020).”
Liu, X., Yan, N., Wang, L., He, K., Zhang, W., Zhang, X., Lan, T., Wang, J., & Zhou, Y. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-06184-2 · Cited by 14
“Previous studies have shown that physical exercise can effectively reduce MPA [49], boost self-esteem [50] and lower levels of depression [51].”
BackgroundLin, S.-T., Hung, Y.-H., & Yang, M.-H. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20010251 · Cited by 11
“[26] employed a systematic review and meta-analysis related to 29 adolescents’ organized sport participation and self-reported symptoms of depression.”
MethodMental Health in Youth Elite Athletes
Walton, C. C., Rice, S., & Purcell, R. (2022) · Springer eBooks · doi:10.1007/978-3-031-08364-8_22 · Cited by 11
ÖZKAN, R., Yılmaz, C., Uzun, R. N., Bayrakdaroğlu, S., Akar, Ö. O., Öz, F., Çiçekli, A., Çiçekli, A., Dal, S., Ursu, V. E., et al. (2026) · BMC Psychology · doi:10.1186/s40359-026-03962-3 · Cited by 10
“Regarding sport anxiety, reductions in both cognitive and somatic components are consistent with studies demonstrating that participation in organized sports is linked to lower anxiety and depressive symptoms among youth [40].”
Hagum, C. N., Tønnessen, E., & Shalfawi, S. A. I. (2022) · PLoS ONE · doi:10.1371/journal.pone.0263575 · Cited by 10
“However, additional research is needed to test different variables that explain potential gender differences and mental health relationships in sports [76].”
BackgroundPasquerella, L., Aychman, M. M., Tasnim, N., Piccirillo, A., Holmes, V., & Basso, J. C. (2025) · Scientific Reports · doi:10.1038/s41598-025-88427-0 · Cited by 10
de Oliveira, L. M. F. T., da Silva, A. O., Farah, B. Q., Leão, I. C. S., de Souza, F. T. C., Santiago, F. L., Machado, L., & Diniz, P. R. B. (2023) · Salud Mental · doi:10.17711/sm.0185-3325.2023.022 · Cited by 12
“Thus, it is still unclear how group and individual sports relate to mental health and suicidal ideation (Panza et al., 2020).”
Andersson, M. J., Kenttä, G., Moesch, K., Borg, E., Claesdotter‐Knutsson, E., & Håkansson, A. (2023) · Journal of Sports Sciences · doi:10.1080/02640414.2023.2241783 · Cited by 11
“…social connection, and social support are important protective factors mediating the relationship between high school sports participation and the onset of internalizing symptoms such as depression and anxiety in adolescents (Armstrong et al., 2015; Harvey et al., 2018; Panza et al., 2020).”
BackgroundWang, K., & Qian, J. (2024) · Behavioral Science · doi:10.3390/bs14060512 · Cited by 12
“…the World Health Organi-Behav zation (WHO) [10], sports participation, as a non-invasive and easily accessible method, effectively alleviates anxiety by aiding individuals in managing and coping with their anxious emotions [11,12], including test anxiety [13,14], enhancing their well-being [15,16].”
BackgroundKaja, S. M., Gower, A. L., Parchem, B., Adler, S. J., McGuire, J. K., Rider, G. N., & Eisenberg, M. E. (2025) · Research Quarterly for Exercise and Sport · doi:10.1080/02701367.2025.2465702 · Cited by 9
“It could also be that the factors that cause sport to be related to lower depressive symptoms (i.e., social connection) do less to alleviate anxiety (Babiss & Gangwisch, 2009; Panza et al., 2020).”
Ooms, L., van Stam, W., Sevdalis, V., Overbye, M., Algurén, B., Heck, S., & Hoye, A. V. (2025) · BMC Public Health · doi:10.1186/s12889-025-25916-x · Cited by 13
“This need applies to sports participation in general, across different stages of development, and particularly among children and adolescents [20, 21, 24, 36, 37].”
School belonging and depressive symptoms: the mediating roles of social inclusion and loneliness
Barzoki, M. H. (2024) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2024.2304067 · Cited by 10
“…in adolescence largely predict major depression in adulthood [3], which is associated with many consequences, including, but not limited to, anxiety [4,5], maladaptive outcomes [6], psychosocial outcomes such as failure to complete secondary school, unemployment [7], and suicidal behaviors [4,8].”
BackgroundAssociations between organised leisure-time activities and mental health problems in children
Boelens, M., Smit, M. S., Windhorst, D. A., Jonkman, H., Hosman, C. M. H., Raat, H., & Jansen, W. (2022) · European Journal of Pediatrics · doi:10.1007/s00431-022-04591-9 · Cited by 12
“However, most did not adjust for physical activity [16, 42, 43].”
BackgroundJovanović, G. K., & Čulina, T. (2024) · Frontiers in Nutrition · doi:10.3389/fnut.2024.1398464 · Cited by 8
Carter, J. S., McNair, G., Bushnell, A., Saldana, L., & Grant, K. E. (2023) · Mental health and physical activity · doi:10.1016/j.mhpa.2023.100562 · Cited by 7
Wiggins, L. D., Daniels, J. L., Overwyk, K. J., Croen, L., DiGuiseppi, C. G., Bradley, C., Powell, P. S., Dichter, G. S., Moody, E. J., & Pazol, K. (2024) · Disability and health journal · doi:10.1016/j.dhjo.2024.101633 · Cited by 7
Zhao, Z., Che, X., Wang, H., Zheng, Y., Ma, N., Gao, L., & Shui, Y. (2025) · Behavioral Sciences · doi:10.3390/bs15020155 · Cited by 7
“Furthermore, it has been shown that anxiety and depression symptoms are significantly lower among adolescents participating in sports than among those who do not participate in sports (Panza et al., 2020).”
Liu, B., You, J., Fan, Y., Xia, Y., Wang, H., Zhang, X., & Zhang, Y. (2025) · Frontiers in Pediatrics · doi:10.3389/fped.2025.1552597 · Cited by 9
Chow, A. R. W., Zaneva, M., Rashid, L., Wheatley, C., Coussios, C. C., Hepach, R., & Bowes, L. (2026) · Sports Medicine · doi:10.1007/s40279-025-02379-z · Cited by 13
Murphy, J. M., Coulter, M., Sweeney, M. R., & McGrane, B. (2022) · Advances in Physical Education · doi:10.4236/ape.2022.122008 · Cited by 10
Veliz, P. T., & Mutumba, M. (2023) · Journal of Physical Activity and Health · doi:10.1123/jpah.2022-0635 · Cited by 8
Zeller, A. M., Lear, A., Post, E. G., McNulty, S., & Bentley, B. C. (2024) · Sports Health A Multidisciplinary Approach · doi:10.1177/19417381241228539 · Cited by 10
Stornæs, A. V., Sundgot-Borgen, J. K., Pettersen, G., Rosenvinge, J. H., & Nordin‐Bates, S. M. (2023) · Psychology of sport and exercise · doi:10.1016/j.psychsport.2023.102474 · Cited by 7
Janković, M., Boxtel, G. J. M. V., & Bogaerts, S. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1234910 · Cited by 10
Farello, A., Trajkovski, M., & Massey, W. V. (2025) · Journal of Applied Sport Psychology · doi:10.1080/10413200.2024.2413999 · Cited by 6
“While no one is completely immune to experiencing mental health struggles, there is a growing body of literature supporting the positive relationship between sport participation and mental health benefits from childhood to later adulthood (Massey et al., 2024; Panza et al., 2020).”
Dongoran, M. F., Setyawati, H., Kristiyanto, A., Raharjo, H. P., & Setiawan, C. (2025) · Frontiers in Sports and Active Living · doi:10.3389/fspor.2025.1515200 · Cited by 6
Gómez-Paniagua, S., Galán-Arroyo, C., Castillo-Paredes, A., & Rojo-Ramos, J. (2025) · Healthcare · doi:10.3390/healthcare13070809 · Cited by 9
“Panza and colleagues [2] identified a significant increase in the prevalence of adolescent anxiety disorders and depression in recent years.”
Associations of Sport Participation with Depression and Anxiety among Chinese Minority Adolescents
Xiao, Z., Doig, S. R., Wu, H., & Wang, L. (2022) · International Journal of Mental Health Promotion · doi:10.32604/ijmhp.2022.019395 · Cited by 7
Misztal, M. C., Tio, E. S., Mohan, A., & Felsky, D. (2023) · Psychiatry Research · doi:10.1016/j.psychres.2023.115550 · Cited by 8
“…further suggests that the benefits of sports participation in youth are dependent on the frequency and type of sport played (Dor ´ e et al., 2016; Panza et al., 2020; Sabiston et al., 2016; Vella et al., 2017); for example, Sabiston et al. found that young high school-aged adults who…”
BackgroundRodrigue, C., Bőthe, B., & Dion, J. (2024) · Child Maltreatment · doi:10.1177/10775595241267964 · Cited by 6
“In a recent meta-analysis, Panza et al. (2020) concluded that a negative relationship exists between sports participation and depressive and anxiety symptoms.”
Zimmerman, S. P., Nowland, L. A., Zhu, X., Haegele, J. A., & Ross, S. M. (2023) · Disability and health journal · doi:10.1016/j.dhjo.2023.101541 · Cited by 6
Halladay, J., Ogrodnik, M., Alla, J. F., Sunderland, M., Gardner, L. A., & Georgiades, K. (2023) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2023.111039 · Cited by 6
Pediatric Sports: The Mental Health and Psychological Impact of Sport and Injury
Xu, E., Greif, D. N., Castle, P., & Lander, S. T. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14124321 · Cited by 6
Cappetto, K. D., Ehrlich, B., Anderson, E. A., Huynh, A. T., Tran, J., & Hudon, K. D. (2024) · BMC Medical Education · doi:10.1186/s12909-024-05806-3 · Cited by 5
“Research has shown organized sport participation can be protective against symptoms of anxiety and depression [28].”
BackgroundImpact of structured physical activity on youth’s mental health: A review of umbrella reviews
Ciacchella, C., Collacchi, B., Fiorillo, A., Sampogna, G., & Cirulli, F. (2025) · International Journal of Social Psychiatry · doi:10.1177/00207640251342425 · Cited by 5
“…externalizing (conduct dysregulation, risky behavior, school truancy, and delinquency) problems in this target group (Ashdown-Franks et al., 2020; Boelens et al., 2022; Dale et al., 2019; Firth et al., 2020; Lynch et al., 2013; Nelson & Gordon-Larsen, 2006; Panza et al., 2020; Wegner et al., 2020).”
Pappagianopoulos, J. E., Rouch, E. F., & Mazurek, M. O. (2023) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-023-06158-5 · Cited by 7
“…Consistent with hypotheses and prior findings among TD youth and one study with a small sample of autistic adolescents (Bohnert et al., 2019; Eime et al., 2013; Panza et al., 2020), adolescents who participated in sports were significantly less likely to have a current depression diag - nosis.”
Spiegler, J., EL‐Awad, U., Baumann, N., Lemola, S., & Dieter Wolke, C. (2024) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-023-02365-8 · Cited by 5
“Investigations of the association between club sport participation (CSP) and mental health problems have been limited to cross-sectional and retrospective studies [11, 15, 27].”
BackgroundHu, Y., Son, K., Yang, Z., & Mao, Y. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1117186 · Cited by 6
Murphy, J. M., McGrane, B., & Sweeney, M. R. (2021) · Physical Activity and Health · doi:10.5334/paah.127 · Cited by 12
O’Leary, C., Rooney, B., Donohue, B. C., & Matthews, J. J. (2022) · Journal of Applied Sport Psychology · doi:10.1080/10413200.2022.2126908 · Cited by 5
“Recent research has suggested a positive relationship between sport participation and mental health in young people (Panza et al., 2020).”
BackgroundMeyers, R., Brna, M., Hogg-Cornejo, V., Donahue, C. C., Sweeney, E. A., Armento, A., & Howell, D. R. (2025) · Frontiers in Sports and Active Living · doi:10.3389/fspor.2025.1527622 · Cited by 4
Drapeau, C., Lenze, L., Montiel, C., Gallant, F., Bélanger, M. F., & Doré, I. (2025) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-025-01847-z · Cited by 6
“Specifically, physical activity among adolescents is associated with reduced anxiety [50] and depressive symptoms [6, 10, 46, 50], reduced occurrence of depression disorder [3, 6, 10], and reduced stress, negative affect and psychological distress [54].”
Self-citationAlawie, F., Olivier, E., & Dupéré, V. (2024) · Journal of Early Adolescence · doi:10.1177/02724316231224812 · Cited by 5
“These results are consistent with the conclusions of previous systematic reviews that have demonstrated the bene fi ts of PA in reducing symptoms of depression in the general adolescent population (Biddle et al., 2019; Panza et al., 2020).”
Fossli, K., & Lorentzen, C. (2025) · Behavioral Sciences · doi:10.3390/bs15091239 · Cited by 7
“…settings may facilitate the development of social skills, such as collaboration and leadership, and offer access to peers and adults who can serve as successful role models and provide support and encouragement (Evans et al., 2017; Oberle et al., 2019; Panza et al., 2020; Zuckerman et al., 2021).”
Lundqvist, C., Asratian, A., & Dahlström, Ö. (2023) · BMJ Open Sport & Exercise Medicine · doi:10.1136/bmjsem-2023-001648 · Cited by 9
Zhang, Y., & Halgunseth, L. C. (2024) · Mental Health Science · doi:10.1002/mhs2.98 · Cited by 4
Are There Common Correlates of Adolescents’ Sport Participation and Screen Time?
Parker, K. E., Brown, H. L., & Salmon, J. (2022) · Research Quarterly for Exercise and Sport · doi:10.1080/02701367.2021.1998305 · Cited by 4
“…social interactions and social competence) and physical health (e.g., improved cardio-metabolic health and peak bone mass) (Logan et al., 2020; Panza et al., 2020; Tenforde & Fredericson, 2011), as well as a contribution to the development of physical literacy elements that are essential for…”
BackgroundSitko, S., Francín-Gallego, M., Pano-Rodríguez, Á., Oviedo‐Caro, M. Á., Mayolas-Pi, C., & Legaz‐Arrese, A. (2024) · Journal of science and medicine in sport · doi:10.1016/j.jsams.2024.07.009 · Cited by 3
Feng, B., Luo, F., Chen, Y., Zhao, Y., Wang, P., & Bao, R. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1338190 · Cited by 6
Francín-Gallego, M., Oviedo‐Caro, M. Á., Sitko, S., Legaz‐Arrese, A., Pano-Rodríguez, Á., Munguía‐Izquierdo, D., Masià, J. R., & Mayolas-Pi, C. (2024) · Journal of Public Health · doi:10.1007/s10389-024-02358-0 · Cited by 3
“Previous studies have shown that sports participation during adolescence may represent a protective environment against anxiety (Panza et al. 2020).”
White‐Gosselin, C., Poulin, F., & Denault, A. (2024) · Journal of Youth and Adolescence · doi:10.1007/s10964-024-02126-z · Cited by 3
“If this is the case, it could be explained by the fact that sport activities in general are widely recognized as having bene fi ts for adolescents (Panza et al., 2020).”
Simpson, A., Jackson, B., Willis, C., Lin, A. P., Thornton, A., Furzer, B. J., Dimmock, J. A., Jeftic, I., Rosenberg, M., & Budden, T. (2025) · Psychology of sport and exercise · doi:10.1016/j.psychsport.2025.102802 · Cited by 3
Metadata
- Authors
- Panza, M. J., Graupensperger, S., Agans, J. P., Doré, I., Vella, S. A., & Evans, M. B.
- Affiliations
- Pennsylvania State University (US)
- University of Washington (US)
- Université de Montréal (CA)
- University of Wollongong (AU)
- Venue
- Journal of Sport and Exercise Psychology
- Publisher
- Human Kinetics
- Published
- 2020-06-01
- Volume
- 42
- Issue
- 3
- Pages
- 201-218
- ISSN
- 0895-2779 (ISSN-L)
- 1543-2904
- PMC
- PMC7679280
- OpenAlex
- W3026226008
- Cited by
- 202
- References
- 72
- Citations by year
- 2026: 36 · 2025: 49 · 2024: 40 · 2023: 32 · 2022: 29 · 2021: 15 · 2020: 1
- FWCI
- 3.74
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Sport and Exercise Psychology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Research Online (University of Wollongong) (submittedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (F31AA027685)
- National Institute on Drug Abuse (T32DA017629)
- Topics
- Social Sciences › Psychology › Developmental and Educational Psychology › Youth Development and Social Support
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Social Sciences › Life-span and Life-course Studies › Recreational Sport and Physical Activity
- Keywords
- youth sport participation, organized sport, anxiety symptoms, depressive symptoms, mental health, protective factors, sex differences, age differences
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