Sage Journals: Discover world-class research

Abstract

Objectives

To examine the impact of rowing across the Atlantic on the mental health of an all-female crew.

Methods

This prospective cohort study included four female rowers (mean age, 32.3 ±4.3 years) who rowed 3000 miles across the Atlantic within 46 days. Validated mental health questionnaires were completed pre-race, during the race, and post-race to screen for depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), and exercise addiction (Exercise Addiction Inventory) as well as examine personality traits (International Personality Item Pool–Neuroticism, Extraversion, and Openness-60) and mood states (Profile of Mood States–Short Form). Additionally, personal accounts were collected. Descriptive statistics, generalized estimating equations, and correlations were used for analysis.

Results

Descriptive analysis revealed positive screening results for anxiety pre-race and major depression post-race in one rower and exercise addiction in another rower. Mood states deteriorated during the race, with subscores for tension–anxiety increasing over time. Scores of neuroticism decreased over time. Personal accounts of the participants provided insights into the challenges faced during this arduous race.

Conclusion

The results demonstrated the importance of mental health screening in our cohort. Mood states deteriorated during the race, with declining scores for personality traits of neuroticism, reflecting a reduction in negative emotions, which may have been beneficial in our specific team environment. Personal accounts demonstrated good team coherence despite challenging race and environmental conditions.

Keywords

Anxiety depression exercise addiction personality traits psychology ultra-endurance

Introduction

Participation in extreme endurance challenges has increased in recent years, with participants often seeking to test the limits of human performance.^1,2 Ocean rowing is a unique ultra-endurance sport, characterized by traversing oceans by human rowing power alone, including crossing the Indian, Pacific, and Atlantic Oceans.³ The first ocean row was completed in 1869,³ and approximately 200 new attempts are recorded annually.⁴ It is estimated that fewer than 2000 individuals (and fewer than 430 female rowers) have successfully rowed across an ocean (https://oceanrowing.com/statistics). Ocean rowing presents substantial challenges, including unpredictable environmental conditions, extreme isolation, and significant mental and physical demands.³ Ocean rowing expeditions typically involve shift-based rowing, with teams rotating in 2- to 4-h shifts per day.⁴

The World’s Toughest Row race is conducted annually, starting in La Gomera, Canary Islands, and covering approximately 3000 miles (4800 km) across the Atlantic, finishing at Antigua & Barbuda (www.worldstoughestrow.com/the-atlantic/). Studies on various transoceanic races have increased recently, primarily focusing on the physiological, nutritional, medical, and psychological impact of such endeavors on the human body.^3–8 However, given the importance of psychological and mental health issues, with high rates among the general population⁹ and in elite sports,¹⁰ data on mental health outcomes in ultra-endurance challenges and extreme environments remain limited.^11,12 Mental health issues and psychological aspects in ocean rowing have been examined only sparingly, often in single case studies.^8,13 A 37-year-old male, who rowed for 39 days across the North Atlantic, reported that he experienced loneliness, boredom, anxiety, and frustration.¹³ In another case of a female rower who crossed the Atlantic within 42 days, her mental wellness deteriorated due to physical deterioration.⁸

A recent systematic review of ultra-endurance athletes highlighted high rates of mental health issues, particularly exercise addiction (EA), anxiety, disordered eating, and depression.¹¹ A recent study suggested that 11.3% of ultra-endurance athletes screened positive for major depression and 21.6% for mild depression, particularly younger and female athletes. The rates of anxiety and sleep problems are also reportedly high in this group, particularly among female athletes.^11,14 Despite these mood changes and mental health issues in extreme ultra-endurance challenges,¹¹ remarkable achievements of human endeavors have been reported, such as the longest, solo Antarctic traverses by a female athlete, despite deterioration in sleep, affective states, and mood.^2,15

Only 30 all-female teams (with 4 crew members) have reportedly completed an Atlantic crossing to date (https://oceanrowing.com/statistics), and no previous data are available on mental health issues and mood changes in this population.

Therefore, our study aimed to investigate the mental health outcomes and mood changes of a four-member all-female rowing team who completed a 3000-mile race across the Atlantic, thereby examining the psychological impact of extreme ultra-endurance performance and providing novel scientific data in this under-researched population.

Material and methods

Ethical approval

This is a prospective cohort study of descriptive and exploratory nature. The participants were informed of the study protocol prior to the first test, and written informed consent was obtained. Ethics approval was obtained by the Faculty of Sport, Technology and Health Sciences Ethics Committee at St Mary’s University, London (approval number: SMU_ETHICS_2024-25_745), and the research was conducted in accordance with the Declaration of Helsinki of 1975, as revised in 2024.¹⁶ The study follows the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cohort studies.¹⁷

Race details

The World’s Toughest Row race (www.worldstoughestrow.com/the-atlantic/) is an annual race that starts in early December in San Sebastián in La Gomera, Canary Islands (28°N, 17°W) and finishes at English Harbour, Antigua & Barbuda (17°N, 62°W). It covers approximately 3000 miles (4800 km), with temperatures ranging from approximately 10°C at night to 30°C near the finish, with increased humidity and frequent exposure to extreme winds, storms, and high ocean waves. Several teams (solo, pairs, trios, and fours/fives) categorized into three classes (males, females, and mixed class) participate, with the objective of taking on a unique challenge of crossing an ocean in a rowing boat. The race started on 11 December 2024, and the study team finished the race on 25 January 2025, after 46 days, 0 h, and 55 min. Overall, they placed 18^th (winner time: 37 days, 13 h, and 20 min; all-male team of four individuals) and 2^nd in the all-female team category (winner time: 44 days, 14 h, and 52 min).

Participants

The rowing team consisted of four female participants (mean age, 32.3 years; standard deviation (SD), ± 4.3; range, 29–38 years). None of them had previous rowing experience. Specific training started approximately 2 years prior to the race, which was largely conducted individually because the team members lived in different geographical locations. Training included running, cycling, stationary rowing sessions, and strength and conditioning training in the gym approximately six times per week for 1–2 h per session. Specific rowing training in the boat started approximately 7 months prior to the race and included approximately 140 h, mostly for security and technical training aspects. More specific water-based training could not be conducted due to the geographical locations of the team members and job demands. The boat used was a Rannoch R45, with a hull length of 8.64 m and a beam width of 1.74 m (www.rannochadventure.com/boats-2/r45). The boat included two cabins that could be used for sleeping: one in the bow, which was slightly more comfortable and where the rower could lie completely flat, and one in the stern that was smaller, with restricted leg space making sleeping on the side or turning almost impossible. The team rowed in pairs for 2-h shifts, followed by 2-h rest periods, resulting in a minimum of 12 h of rowing per day, which was occasionally exceeded under challenging sea conditions with three people rowing, changing to a 3-h on/1-h off pattern, losing valuable break time. During break times, rowers conducted technical checks (e.g. communicating with safety officer/family for weather and route), cleaning (e.g. solar panels and boat), preparing food and eating, and sleeping. Rowers generally slept during their night-shift breaks, aiming to maintain a circadian rhythm, cooler temperatures, and reduced noise exposure.

Testing protocol

Participants completed five questionnaires: (a) Patient Health Questionnaire 9 (PHQ-9); (b) Generalized Anxiety Disorder 7 (GAD-7); (c) Exercise Addiction Inventory (EAI-R); (d) International Personality Item Pool–Neuroticism, Extraversion and Openness-60 (IPIP-NEO-60); and (e) Profile of Mood States–Short Form (POMS-SF). Additionally, participants provided short personal account statements of their race experience in an open, unstructured format. The PHQ-9, GAD-7, EAI-R, and IPIP-NEO-60 were completed pre- and post-race, while the POMS-SF, IPIP-NEO-60 and personal accounts were completed at various time points during the race (days 10, 17, 21, and 35).

Questionnaires

The PHQ-9 is a brief, validated, self-administered screening instrument used to measure the severity of depressive symptoms over the past 14 days. It consists of nine items¹⁸ and has been identified as one of the most reliable screening tools for depression.¹⁹ Each item is scored on a 4-point Likert scale (0 = not at all, 1 = several days, 2 = more than half the days, and 3 = nearly every day), providing a composite score ranging from 0 to 27. Scores of 5–9 are used to classify mild depression¹⁸ and scores of ≥10 are used as a cutoff value to identify major depression.²⁰ Item 9 of the PHQ-9 (“Thoughts that you would be better off dead or of hurting yourself”) is considered a proxy indicator for suicidal ideation and risk¹⁸ and a predictor of suicidal attempts and death, regardless of age.²¹

Anxiety was assessed using the GAD-7, a brief 7-item anxiety screening instrument.²² A composite score of 0–4 indicates minimal anxiety, 5–9 indicates mild anxiety, and ≥10 is used as a cutoff value (10–14 for moderate anxiety and 15–21 for severe anxiety).^10,18

EA was assessed using the revised EAI-R, a short, valid, and reliable instrument to evaluate the risk of EA.^23,24 It contains 6 questions, with each item scored on a 6-point Likert scale (1 = strongly disagree, 2 = disagree, 3 = slightly disagree, 4 = slightly agree, 5 = agree, and 6 = strongly agree), producing a composite score. A validated cutoff point of ≥29 indicates a risk of EA.²³

The POMS–SF is a modified and abbreviated version of the original 65-item POMS. The POMS-SF assesses mood state changes using 37 items on a 5-point Likert scale (0 = not at all to 4 = extremely). Six mood subscales (tension–anxiety, depression–dejection, anger–hostility, vigor, fatigue–inertia, and confusion–bewilderment) are rated, providing a measure of total mood disturbance when all factors are summed (with the vigor scale being negatively weighted).²⁵

The IPIP-NEO-60 is a personality questionnaire assessing personality traits of openness, conscientiousness, extraversion, agreeableness, and neuroticism. It contains 60 items, with 12 items per trait, scored on a Likert-type scale from 1 to 5, producing trait scores ranging from 12 to 60, with higher scores indicating a greater likelihood of that particular trait.²⁶

Statistical analysis

Descriptive statistics were presented as means and SD and in graphical form. Statistical analyses for the IPIP-NEO-60 and POMS-SF questionnaires were performed using generalized estimating equations (GEE) test with normal distribution and identity link function, implemented in Jamovi software (Version 2.7.6). All analyses adopted a significance level of p < 0.05 and should be interpreted as indicators of potential trends rather than definitive generalization to the broader population.

Results

Table 1 presents the results of the pre- and post-race mental health questionnaires (PHQ-9, GAD-7, and EAI-R). One rower who screened positive for mild depression pre-race, exhibited signs of major depression post-race. None of the rowers screened positive for suicidal thoughts (item 9 of the PHQ-9). Results from the GAD-7 revealed that three rowers exhibited minimal anxiety pre-race, with one rower screening positive for moderate anxiety (the same rower also screened positive for mild/major depression). Post-race, anxiety scores decreased in all participants, with only one rower exhibiting minimal anxiety levels. Results from the EAI-R revealed that one rower exhibited scores above the cutoff level for EA both pre- and post-race.

Table 1.

Pre- and post-race data from the four rowers for the Patient Health Questionnaire (PHQ-9; scores of ≥10 used as a cutoff score to identify major depression), Generalized Anxiety Disorder (GAD-7; score of ≥10 used as a cutoff score (10–14 for moderate and 15–21 for severe anxiety)), and Exercise Addiction Inventory (EAI-R; cutoff score of ≥29 indicating a risk of exercise addiction).

	Pre-racePHQ-9	Post-racePHQ-9	Pre-raceGAD-7	Post-raceGAD-7	Pre-raceEAI-R	Post-raceEAI-R
Rower 1	2	1	3	0	10	18
Rower 2	7	11^a	11^a	4	23	24
Rower 3	0	5	1	0	27	26
Rower 4	0	0	4	0	36^a	34^a

Indicating scores above cutoff scores.

Results of the POMS–SF are shown in Figure 1, with subscale scores depicted in Figure 2. Although the total mood disturbance scores did not reveal statistically significant differences, an increase in the mean scores was observed across measurement points: expedition day (ED) 17 (−1.50 ±5.97), ED21 (3.25 ± 9), and ED35 (9.25 ±13.5). Subscale analysis demonstrated significant differences in the tension–anxiety component [F (6,2) = 6.82; p = 0.29], with mean scores being lower at ED17 (0.5 ±0.57) and ED21 (0.5 ± 0.57) compared with that at ED35 (1.75 ± 1.26) during the crossing. Other subscales did not demonstrate statistically significant differences. Scores for depression–dejection increased across the measurement points: ED17 (0.5 ± 0.57), ED21 (1.75 ± 2.06), and ED35 (3 ± 4.24).

Figure 1.

Results of the Profile of Mood States–Short Form (POMS–SF), represented as mean values (standard deviation) during various expedition days (EDs). Total scores did not show any significant differences (p > 0.05); however, an increase in the mean scores was observed over the measurement points: ED17 (−1.50 ± 5.97), ED21 (3.25 ± 9), and ED35 (9.25 ± 13.5).

Figure 2.

Subscores of the Profile of Mood States–Short Form (POMS–SF), represented as mean values (standard deviation) during various expedition days (EDs). a) depression–dejection, n.s. (no significant differences), with mean scores increasing over time; b) tension–anxiety with significant differences over time, with mean scores being lower at ED17 (0.5 ± 0.57) and ED21 (0.5 ± 0.57) compared with that at ED35 (1.75 ± 1.26); c) confusion–bewilderment, n.s. over time; d) vigor–activity, n.s. over time; e) anger–hostility; f) fatigue–inertia, n.s. over time.

Results of the IPIP-NEO-60 are shown in Figure 3. The GEE test did not show any significant differences for the five components of the questionnaire across six different time points during the trans-Atlantic crossing. Descriptive analysis revealed that the neuroticism score was the highest at the pre-race time point (28.5 ± 5.57). Across the evaluation periods, the neuroticism score decreased at ED10 (26 ± 10), ED17 (23.3 ± 9.07), ED21 (26.3 ± 8.73), and ED35 (25.5 ± 12.3), reaching its lowest value at the post-race time point (18 ±7.35). Scores for extraversion remained relatively stable across all measurement points: (a) pre-race (40 ± 6.16); (b) ED10 (40.3 ± 10.5); (c) ED17 (42.7 ± 2.31); (d) ED21 (39.5 ± 1.29); (e) ED35 (41 ± 4.24); and (f) post-race (42 ± 9.13) during the crossing. Scores for openness remained similar across the pre-race (42 ± 7.79), ED10 (42.8 ± 13.9), ED17 (42 ± 6.56), and ED21 (43 ± 9.42) time points; however, slight reduction in the scores was noted in last two evaluations, ED35 (38.5 ± 6.56) and post-race (39.3 ± 7.54). The agreeableness domain remained stable across all time points: (a) pre-race (56.8 ± 2.50); (b) ED10 (56.5 ± 3); (c) ED17 (56.7 ± 3.06); (d) ED21 (57.5 ± 2.38); (e) ED35 (56 ± 2.83); and (f) post-race (56.3 ± 2.22. Similarly, conscientiousness scores remained consistent across assessment points: (a) pre-race (49.8 ± 7.8); (b) ED10 (52 ± 10.4); (c) ED21 (49.8 ±9.22); (d) ED35 (51.3 ± 10.4); and (e) post-race (53.5 ± 4.12).

Figure 3.

Results of the International Personality Item Pool–Neuroticism, Extraversion and Openness-60 (IPIP-NEO-60), represented as mean values (standard deviation) during various expedition days (EDs) and pre-post scores. No significant differences were observed in any of the subscores over time a) Neuroticism; b) Openness; c) Extraversion; d) Agreeableness; e) Conscientiousness.

Results from the personal accounts of the rowers are presented in Table 2. Days highlighted in the table (race days 10, 17, 21, and 35) coincide with the time points when the POMS-SF and/or IPIP-NEO-60 questionnaires were completed. Additional days during the race were grouped together.

Table 2.

Short personal accounts from the rowers during the race. Days highlighted (days 10, 17, 21, and 35) coincide with days when the Profile of Mood States–Short Form (POMS-SF) and/or International Personality Item Pool–Neuroticism, Extraversion and Openness-60 (IPIP-NEO-60) were completed.

Day	Personal accounts from rowers
10	Great during day. Struggle at night. Emotional. Unsettled. All good, going with the flow.
11–16	Body operates normally. Good still maintaining power. A little bit over it. Challenging night. Sleep in 30–40 min chunks. Ashamed as I missed an overnight shift change timing. Uninterrupted 90 min sleep. Relaxed day. Christmas day! Morale high! Unique Xmas.
17	Good routine, eating and sleeping well
18–20	Steady day/night. Disrupted night! Tired.
21	Consistent night and day routine. Tired.
22–28	NYE (New Year Eve), everything damp in cabin all bedding. Feel grim even though had flannel wash with fresh water. Flat seas, good sleep, alert in day and on night shifts. Hot, no wind. Good routine. Uninterrupted sleep. Routine 24 hrs. Shortened sleep, less rest, rowing 3 up. Emotional/tired, satellite issue at 0000 took 2 rest periods to fix then back on oars, also rowing 3 up dawn and dusk = less rest = urgh! No naps shortened sleeps. Got told end date likely now end of January = low morale - 2 more weeks! Settled day/night. Reduced sleep as 3 up rowing. Cooler cloudy days = needed
29–34	Unclear end date. 3 up rowing. Feeling fatigued on night shifts. Uninterrupted sleeps. Deep sleep, being caught by other boats. Now 3 up and sleep/rest. Stormy night. Rowed through night and day. Hour nap in day. Push hard overnight experienced whole-body weakness and had to come off oars as couldn't sit up = exhaustion. Very fatigued. Felt better after nap and nighttime routine. Hot therefore rowing hard.
35	Shortened night sleeps. So hot! Good morale, less than 1000 miles! Potentially saw a whale = cool.
36–40	Good conditions, minimal sleep periods. Covering ground well. 2 × 1 h 20 sleeps and 20 min nap. Hot day, routine rowing. Battling with team morale. Less than 750 miles to go! Good conditions. Changed row schedule to improve sleep. Back to 3 × 2 h sleep blocks. 77 miles covered. Less than 10 days to go. Awful night, up all night due to poor conditions. No daytime naps. Challenging conditions = very hard night. 8 h mistake = no sleep
41–45	Emotional. Keen to finish. Poor weather. Disrupted sleep. Difficult night but good day. Lots of heavy rain showers. Challenging conditions. Nearly there! Disoriented shift? Still asleep, weather bad = little sleep. 2 × 1.5 h sleeps. No naps. Difficult seas. Weather conditions = highs/lows. Navy chasing. 48 h to push.
46	It is the final day! All the excitement

Discussion

This study aimed to investigate and describe the mental health outcomes and mood changes of a four-member all-female rowing team who completed a 3000-mile race across the Atlantic in 46 days.

The main findings were as follows: 1. Mental health screening demonstrated anxiety pre-race and major depression post-race in one rower and EA pre- and post-race in another rower; 2. Overall, mood states deteriorated during the race, although not to a statistically significant level, with tension–anxiety subscores increasing significantly over time; 3. No significant differences were found in personality trait changes over time; and 4. Personal accounts revealed the challenges faced during this arduous endurance task.

Mental health screening

Mental health issues are common in the general population⁹ as well as in elite and ultra-endurance sports.^11,27,28 These issues can have a critical impact on athletic performance, physical health, psychological wellbeing, and team cohesion, particularly if they remain unrecognized, as they may worsen during extreme challenges.^11,27,28 Therefore, mental health screening represents an important tool for early identification, risk stratification, and the planning of preventive, supportive, and therapeutic interventions.^10,27 Although a positive screening result should be followed up by a formal clinical assessment to establish a definite diagnosis,²⁹ initial screening provides important findings. To the best of our knowledge, no previous data are available on mental health screening among endurance rowers.

One rower who screened positive for mild depression pre-race, exhibited signs of major depression post-race. A recent study in endurance and ultra-endurance athletes found that approximately one-third of athletes screened positive for depression, with 11.3% testing positive for major depression.²⁷ Therefore, the finding that one rower in our cohort screened positive for depression is consistent with existing epidemiological data. None of the rowers exhibited suicidal thoughts, which aligns with findings reported in other ultra-endurance athlete populations (approximately 8.0%, representing a 2–2.5-fold higher risk than that in the general population).³⁰

The rower who screened positive for depression also screened positive for anxiety pre-race; however, the scores returned to baseline post-race. Anxiety is one of the most common mental health disorders, both in the general public and among athletes,^22,28,31 particularly in females.³² In sports, the highest prevalence rates of anxiety have been reported in esthetic sports, particularly among female athletes (up to 38.9%).³² Female athletes were found to have a 1.2 times higher risk of anxiety than male athletes, particularly for mild-to-moderate anxiety levels.³² Positive pre-race screening for anxiety may also reflect competitive status anxiety, a response to the characteristics and/or similar states of stressful exercise-related situations.³³ It is worth noting that low levels of pre-competition anxiety may be related to lower performance, whereas moderate, optimal anxiety levels may facilitate performance by enhancing psychological readiness for competition.³⁴ Pre-race mental training interventions may be effective in improving athletic performance and control stress in rowers, particularly in female Spanish national youth rowers.³⁵ However, whether such interventions are applicable to ultra-endurance ocean rowing remains unknown and warrants further investigation.

One rower screened positive for EA pre- and post-race. EA is considered a behavioral addiction despite the lack of clinical diagnosis criteria.^14,23,36 EA is characterized by a loss of control over exercise behavior, compulsive engagement, withdrawal symptoms when exercise is not possible, and associated negative life consequences.^37–39 Prevalence estimates range from 0.3% to 8.5%⁴⁰ and approximately 3.0% in the general exercising population.⁴¹ In endurance athletes, prevalence rates of 11.5%–18.2% have been reported, particularly among female athletes.^11,42

These findings further support the importance of mental health screenings and targeted psychological support in future endurance rowers.

Mood changes

Mood changes are common during extreme endurance challenges² and can change with increasing exercise loads.^43,44 Psychological aspects and mood states have only been examined sparingly in ocean rowing. A 37-year old male who rowed solo across the North Atlantic within 39 days reported loneliness, boredom, anxiety, and frustration.¹³ A female rower participating in a 12-person team crossing the Atlantic within 42 days demonstrated progressive deterioration in mental wellness, influenced by physical exhaustion.⁸ Although mood changes and mental health issues are common,¹¹ remarkable achievements of human endeavors have been reported, such as the longest, solo Antarctic traverse by a female military personnel, despite deterioration in sleep, affective states, and mood.^2,12,45 Similar findings have been observed in extreme ultra-endurance running, including the 690-km Yukon Arctic Ultra, the longest and coldest ultramarathon, where increased scores of depressive mood and tension were observed.⁴⁶ The findings in the present study are consistent with the literature, demonstrating deterioration in mood states, particularly tension and anxiety.

Personality traits

It has been proposed that certain personality traits may be beneficial for successful completion of extreme challenges, including emotional stability, openness, conscientiousness, introversion, self-control, hardiness, and reduced dependence on social support.⁴⁷ Data from female team members successfully trekking across Antarctica showed high scores on positive emotionality as well as boldness and low scores in poor emotional regulation and callousness.⁴⁸ Data from elite male Danish military patrol teams operating for extended periods in Greenland reported low scores for neuroticism and high scores for conscientiousness.⁴⁹ Neuroticism reflects susceptibility to negative emotional states; therefore, lower scores may be advantageous in team-based extreme environments.⁴⁹ Our findings align with this framework, with progressively decreasing neuroticism scores, while openness remained relatively stable initially, followed by a slight decline toward the end of the crossing, potentially helping team structure in our specific environment. Meanwhile, extraversion, agreeableness, and conscientiousness components showed no significant variation during the crossing. However, more frequent personality assessments combined with qualitative approaches may provide deeper insights into team coherence in future research projects.

Personal accounts

Personal accounts provided valuable qualitative insight into increasing mental and physical demands and challenging environmental conditions, particularly highlighting sleep deprivation and sustained physical and mental fatigue. Despite these stressors, participants reported positive emotional experiences (e.g. watching wildlife) and sustained team morale overall. When integrated with quantitative questionnaire data, these narratives provide a unique insight into the emotional states of our team of rowers. Similar findings have been reported in previous extreme expedition studies, including solo Antarctic traverses.²

Limitations

This study is a descriptive, exploratory investigation using a small sample size. Although GEE appropriately handles the repeated-measures structure, the limited sample size restricts the external validity of the inferential statistics, and p-values should be interpreted as indicators of potential trends rather than definitive evidence for generalization to the broader population. However, due to the nature of extreme challenge expeditions, larger sample sizes are often not feasible. Nevertheless, the study provides unique insights into the psychological aspects of such an extreme challenge, particularly in female athletes. The questionnaires were administered at multiple time points; however, more frequent assessment may have demonstrated greater intra- and inter-individual variability. However, due to the nature of the race and associated time constraints, more frequent data collection was not feasible. Personal accounts were presented descriptively; however, a retrospective qualitative thematic content analysis may provide additional scientific insights and should be considered in future similar studies. Although validated and widely recognized screening tools were used for mental health assessment, a positive screening result should be followed by a formal diagnostic evaluation using standardized clinical criteria.^18,27

Conclusions

This exploratory cohort study describes the mental health and psychological aspects of the successful completion of a 3000-mile trans-Atlantic crossing by a team of four female rowers. Personal accounts demonstrated the challenges faced during this arduous endurance expedition, including sleep deprivation, extreme physical demands, sustained fatigue, and challenging environmental conditions. Overall, mood states deteriorated during the race, particularly tension and anxiety. Personality traits did not change significantly during the race; however, neuroticism scores, reflecting the frequency of negative emotions, decreased over time, which may have been beneficial within this specific team environment. Mental health screening demonstrated positive results in two rowers; anxiety pre-race and major depression post-race in one rower and EA pre- and post-race in another rower, highlighting the importance of screening for mental health issues in our team of rowers. Although wider generalization is not possible owing to the small sample size attributable to the nature of the extreme challenge, our study provides novel data and potential objectives for future research in this area.

Footnotes

Declaration of conflicting interest

VS does sessional work at the Royal Air Force Honington, Regional Rehabilitation Unit Colchester, Honington Clinic. The contents reported here do not represent the views of the Royal Air Force Honington, Regional Rehabilitation Unit Colchester, Honington Clinic.

HdSS received financial support from the Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG #APQ-02146-22) but not related to the current research project.

The rest of the authors have no competing interest.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

ORCID iDs

Volker Scheer

Helton de Sá Souza

George Morris

References

Scheer

Participation trends of ultra endurance events. Sports Med Arthrosc Rev 2019; 27: 3–7.

Scheer

Chandi

Valero Burgos

, et al. Psychological aspects of the longest, solo, unsupported one-way polar ski expedition in Antarctica by a female adventurer. BMJ Mil Health 2025; 171: 549–554.

Galsworthy

WJH

Carr

JAJ

Hearn

Common health issues and advised treatments reported in an ultraendurance ocean rowing race. BMJ Open Sport Exerc Med 2022; 8: e001120.

Welman

Young

Larkin

, et al. Trigger finger from ocean rowing: an observational study. Hand (N Y) 2022; 17: 254–260.

Carron

Coulange

Dupuy

, et al. Preparation and medical follow-up for a single-handed transatlantic rowing race. Int Marit Health 2017; 68: 7–11.

Keohane

Woods

McCarthy

, et al. A repeated-measures case series of physiological responses to a transoceanic rowing race. Int J Sports Med 2019; 40: 152–157.

Holsgrove‐West

Revuelta Iniesta

Abdelrahman

, et al. Maximal sustainable energy intake during transatlantic ocean rowing is insufficient for total energy expenditure and skeletal muscle mass maintenance. Exp Physiol 2024; 109: 227–239.

Zeiner

Dabiri

Burns

, et al. Mental and physiological wellbeing while rowing across the North Atlantic: a single-case study of subjective versus objective data. Front Physiol 2023; 14: 1244438.

GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392: 1789–1858.

10.

Gouttebarge

Bindra

Blauwet

, et al. International Olympic Committee (IOC) Sport Mental Health Assessment Tool 1 (SMHAT-1) and Sport Mental Health Recognition Tool 1 (SMHRT-1): towards better support of athletes’ mental health. Br J Sports Med 2021; 55: 30–37.

11.

Thuany

Viljoen

Gomes

, et al. Mental health in ultra-endurance runners: a systematic review. Sports Med 2023; 53: 1891–1904.

12.

Thuany

Viljoen

Gomes

, et al. Antarctic expeditions: a systematic review of the physiological, nutritional, body composition and psychological responses to treks across the continental ice. Sports Med 2024; 55: 1145–1163.

13.

Alschuler

Whibley

Alberts

, et al. The physical and psychological experience of rowing the North Atlantic solo and unassisted. Wilderness Environ Med 2020; 31: 144–150.

14.

Weinstein

Szabo

Exercise addiction: A narrative overview of research issues. Dialogues Clin Neurosci 2023; 25: 1–13.

15.

Scheer

Chandi

Valero

, et al. Sleep, fatigue, and recovery profiles of the longest solo unsupported one-way polar ski journey across Antarctica. Int J Sports Physiol Perform 2024; 19: 1328–1333.

16.

World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2013; 310: 2191.

17.

Von Elm

Altman

Egger

; STROBE Initiativeet al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ 2007; 335: 806–808.

18.

Kroenke

Spitzer

Williams

JBW.

The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001; 16: 606–613.

19.

Costantini

Pasquarella

Odone

, et al. Screening for depression in primary care with Patient Health Questionnaire-9 (PHQ-9): a systematic review. J Affect Disord 2021; 279: 473–483.

20.

Negeri

Levis

Sun

; Depression Screening Data (DEPRESSD) PHQ Groupet al. Accuracy of the Patient Health Questionnaire-9 for screening to detect major depression: updated systematic review and individual participant data meta-analysis. BMJ 2021; 375: n2183.

21.

Rossom

Coleman

Ahmedani

, et al. Suicidal ideation reported on the PHQ9 and risk of suicidal behavior across age groups. J Affect Disord 2017; 215: 77–84.

22.

Spitzer

Kroenke

Williams

JBW

, et al. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 2006; 166: 1092–1097.

23.

Attila

Amit

Mark D

, et al. The psychometric evaluation of the Revised Exercise Addiction Inventory: improved psychometric properties by changing item response rating. J Behav Addict 2019; 8: 157–161.

24.

Szabo

Griffiths

MD.

Exercise addiction in British sport science students. Int J Ment Health Addiction 2007; 5: 25–28.

25.

Shacham

A shortened version of the profile of mood states. J Pers Assess 1983; 47: 305–306.

26.

Maples-Keller

Williamson

Sleep

, et al. Using item response theory to develop a 60-item representation of the NEO PI–R using the International Personality Item Pool: development of the IPIP–NEO–60. J Pers Assess 2019; 101: 4–15.

27.

Scheer

Valero

Thuany

, et al. Are endurance runners at higher risk of depression? Screening for depression and risk factors. Int J Sports Med 2025; 46: 281–289.

28.

Reardon

Hainline

Aron

, et al. Mental health in elite athletes: International Olympic Committee consensus statement (2019). Br J Sports Med 2019; 53: 667–699.

29.

Couwenbergh

Van Der Gaag

Koeter

, et al. Screening for substance abuse among adolescents validity of the CAGE-AID in youth mental health care. Subst Use Misuse 2009; 44: 823–834.

30.

Scheer

Valero

Knechtle

, et al. Screening for suicidal thoughts, attempts, and associated factors in endurance and ultra-endurance runners. J Sports Med Phys Fitness 2025; 65: 1670–1679.

31.

Schaal

Tafflet

Nassif

, et al. Psychological balance in high level athletes: gender-based differences and sport-specific patterns. PloS One 2011; 6: e19007.

32.

Kew

Dave

Marmor

, et al. Sex differences in mental health symptoms in elite athletes: a systematic review and meta-analysis. Sports Health 2024; 17: 732–743.

33.

Ford

Ildefonso

Jones

, et al. Sport-related anxiety: current insights. Open Access J Sports Med 2017; 8: 205–212.

34.

Yerkes

Dodson

JD.

The relation of strength of stimulus to rapidity of habit‐formation. J Comp Neurol Psychol 1908; 18: 459–482.

35.

Isorna-Folgar

Leirós-Rodríguez

López-Roel

, et al. Effects of a cognitive-behavioral therapy intervention on the rowers of the junior Spain national team. Healthcare 2022; 10: 2357.

36.

Egorov

Szabo

The exercise paradox: An interactional model for a clearer conceptualization of exercise addiction. J Behav Addict 2013; 2: 199–208.

37.

Griffiths

Szabo

Terry

The exercise addiction inventory: a quick and easy screening tool for health practitioners. Br J Sports Med 2005; 39: e30.

38.

Griffiths

MD.

A ‘components’ model of addiction within a biopsychosocial framework. J Subst Use 2005; 10: 191–197.

39.

Szabo

Griffiths

De La Vega Marcos

, et al. Methodological and conceptual limitations in exercise addiction research. Yale J Biol Med 2015; 88: 303–308.

40.

Berczik

Szabó

Griffiths

, et al. Exercise addiction: symptoms, diagnosis, epidemiology, and etiology. Subst Use Misuse 2012; 47: 403–417.

41.

Sussman

Lisha

Griffiths

Prevalence of the addictions: a problem of the majority or the minority?

Eval Health Prof 2011; 34: 3–56.

42.

Szabo

De La Vega

Ruiz-Barquín

, et al. Exercise addiction in Spanish athletes: Investigation of the roles of gender, social context and level of involvement. J Behav Addict 2013; 2: 249–252.

43.

Morgan

Brown

Raglin

, et al. Psychological monitoring of overtraining and staleness. Br J Sports Med 1987; 21: 107–114.

44.

Watson

Clark

Tellegen

Development and validation of brief measures of positive and negative affect: The PANAS scales. J Pers Soc Psychol 1988; 54: 1063–1070.

45.

Scheer

Chandi

Valero

, et al. Polar thigh and other medical observations during the longest solo unsupported one-way polar ski expedition in Antarctica. Wilderness Environ Med 2024; 35: 336–341.

46.

Kienast

Biere

Coker

, et al. Adiponectin, leptin, cortisol, neuropeptide Y and profile of mood states in athletes participating in an ultramarathon during winter: An observational study. Front Physiol 2022; 13: 970016.

47.

Bartone

Krueger

Bartone

JV.

Individual differences in adaptability to isolated, confined, and extreme environments. Aerosp Med Hum Perform 2018; 89: 536–546.

48.

Blackadder-Weinstein

Leon

Norris

, et al. Individual attributes, values, and goals of an all-military women Antarctic expedition. Aerosp Med Hum Perform 2019; 90: 18–25.

49.

Corneliussen

Leon

Kjærgaard

, et al. Individual traits, personal values, and conflict resolution in an isolated, confined, extreme environment. Aerosp Med Hum Perform 2017; 88: 535–543.

Rowing across the Atlantic in an all-female team: Impact on mental health and mood changes—a cohort study

Abstract

Objectives

Methods

Results

Conclusion

Keywords

Introduction

Material and methods

Ethical approval

Race details

Participants

Testing protocol

Questionnaires

Statistical analysis

Results

Discussion

Mental health screening

Mood changes

Personality traits

Personal accounts

Limitations

Conclusions

Footnotes

Declaration of conflicting interest

Funding

ORCID iDs

References