Mental health in recreational and professional dancers: a genetically informed study in Sweden.

While recreational dancing has been associated with positive health outcomes, professional dancers tend to experience more mental health problems. Here, we studied the relationship between self-reported engagement and achievement in dance (from no involvement to high-level professional dancing) and mental health problems including work-related depressive symptoms, emotional exhaustion, and registry-based psychiatric diagnoses (major depression, anxiety, and stress-related diseases). Utilizing a genetically informative population sample of 6610 Swedish twins, we estimated heritability for dance achievement and associations between dance achievement and mental health outcomes, and tested whether observed associations are consistent with causal effects by accounting for familial confounding using a co-twin control design. Individual differences in dance achievement were more heritable in females (60%) than in males (29%). Professional dancers had a higher risk for mental health problems than recreational dancers and non-dancers, but these associations became non-significant after adjusting for familial confounding, suggesting that shared familial factors - rather than professional dancing itself - largely explained the elevated risk. In contrast, we found no evidence for a protective effect of recreational dancing on mental health. These findings highlight the importance of considering underlying familial and genetic factors when addressing mental health risks in professional dancers, and they point toward future interventions focusing on early identification and support for vulnerable individuals rather than targeting dance practice itself as a causal factor.