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Gwyther K, Pilkington V, Bailey AP, Mountjoy M, Bergeron MF, Rice SM, Purcell R. Mental health and well-being of elite youth athletes: a scoping review. Br J Sports Med 2024; 58:1011-1019. [PMID: 39122370 DOI: 10.1136/bjsports-2024-108244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND There is increasing recognition of the prevalence and risk factors for mental health symptoms and disorders among adult elite athletes, with less research involving elite youth athletes. This scoping review aimed to characterise the mental health and well-being of elite youth athletes who travel internationally and compete for their sport. METHOD Four databases were searched in March 2023. Inclusion criteria were studies with elite youth athlete populations (mean age 12-17 years) reporting mental health and well-being outcomes. Data from included studies were charted by outcome, and risk/protective factors identified. RESULTS Searches retrieved 3088 records, of which 33 studies met inclusion criteria, encapsulating data from 5826 athletes (2538 males, 3288 females). The most frequently studied issue was disordered eating (k=16), followed by anxiety (k=7), depression (k=5) and mixed anxiety/depression (k=2). Caseness estimates (a symptom level where mental health treatment is typically indicated) for disordered eating were wide ranging (0%-14% for males; 11%-41% for females), whereas only two studies estimated caseness for depression (7% in a mixed-sex sample; 14% for males, 40% for females) and one for anxiety (8% for males, 28% for females). Common risk factors for mental ill-health included sex, athlete status (compared with non-athletes) and social/relationship factors (with coaches/parents/peers). Contradictory evidence was observed for elite/competition level, which was associated with higher and lower rates of disordered eating. CONCLUSION Further representative research into the mental health and well-being of elite youth athletes is needed to enhance understanding and guide prevention and intervention measures.
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Affiliation(s)
- Kate Gwyther
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Victoria, Australia
| | - Vita Pilkington
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Victoria, Australia
| | - Alan P Bailey
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Margo Mountjoy
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Michael F Bergeron
- Performance Health, WTA Women's Tennis Association, St. Petersburg, Florida, USA
| | - Simon M Rice
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Victoria, Australia
| | - Rosemary Purcell
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Victoria, Australia
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Bergeron MF, Côté J, Cumming SP, Purcell R, Armstrong N, Basilico L, Burrows K, Charrin JB, Felix A, Groesswang H, Iwasaki Y, Kocher MS, Martowicz M, McConnell K, Moran J, Holm Moseid C, Mountjoy M, Soligard T, Tetelbaum E, Thiel A, Vertommen T, Viseras G, Budgett R, Engebretsen L, Erdener U. IOC consensus statement on elite youth athletes competing at the Olympic Games: essentials to a healthy, safe and sustainable paradigm. Br J Sports Med 2024; 58:946-965. [PMID: 39197945 DOI: 10.1136/bjsports-2024-108186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2024] [Indexed: 09/01/2024]
Abstract
With the pronounced ongoing growth of global youth sports, opportunities for and participation of youth athletes on the world sports stage, including the Olympic Games, are expected to escalate. Yet, adolescence is a vulnerable period of development and inherently dynamic, with non-linear and asynchronous progression of physical, physiological, psychological and social attributes. These non-concurrent changes within and between individuals are accompanied by irregular and unpredictable threats and impediments. Likewise, the evident age-based criteria and conventional path for those youth athletes deemed eligible candidates for the Olympic Games are not well or consistently defined. Furthermore, the unstructured and largely varying policies and practices across the sporting International Federations specific to youth participation underscore the need to establish a contemporary universal paradigm that would enable elite youth athletes to navigate an individualised healthy pathway to personal, athletic and sport success. First, we reviewed and summarised key challenges facing elite youth athletes and the relevant evidence fundamental to facilitating and supporting central aspects of health and well-being, while empowering safe, sustainable and positive engagement during athletic and personal advancement and competition. Second, we developed and present a modern elite youth athlete model that emphasises a child-centred, practical framework with corresponding guidelines and recommendations to protect health and well-being while safely and favourably managing international sport competition. Our proposed evidence-informed paradigm will enable and support individualised pathways for healthy, well-rounded and sustainable positive engagement while achieving sport success for youth contending or aiming to compete at world-class international sporting events.
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Affiliation(s)
- Michael F Bergeron
- Performance Health, WTA Women's Tennis Association, St. Petersburg, Florida, USA
- Health Sciences, University of Hartford, West Hartford, Connecticut, USA
| | - Jean Côté
- School of Kinesiology and Health Studies, Queen's University, Kingston, Jamaica, Canada
| | | | - Rosemary Purcell
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Neil Armstrong
- Childrens Health and Exercise Research Centre, University of Exeter, Exeter, UK
| | - Luca Basilico
- World Skate, Maison du Sport International, Lausanne, Switzerland
| | - Kirsty Burrows
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Jean-Benoit Charrin
- Corporate and Sustainable Development Department, International Olympic Committee, Lausanne, Switzerland
| | - Allyson Felix
- Athletes' Commission, International Olympic Committee, Lausanne, Switzerland
| | - Heike Groesswang
- International Bobsleigh & Skeleton Federation (IBSF), Salzburg, Austria
| | - Yasunobu Iwasaki
- Anti-Doping, Medical and Scientific Commission, Fédération Internationale de Gymnastique, Lausanne, Switzerland
- Anshinkai Anshin Hospital, Kobe, Hyogo, Japan
| | - Mininder S Kocher
- Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Magali Martowicz
- Corporate and Sustainable Development Department, International Olympic Committee, Lausanne, Switzerland
| | - Kit McConnell
- Sports Department, International Olympic Committee, Lausanne, Switzerland
| | - Jane Moran
- Medical Commission, International Skating Union, Lausanne, Switzerland
- Faculty of Medicine, The University of British Columbia - Vancouver Campus, Vancouver, British Columbia, Canada
| | - Christine Holm Moseid
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Margo Mountjoy
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Torbjørn Soligard
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Evgenia Tetelbaum
- Sports Department, International Olympic Committee, Lausanne, Switzerland
| | - Ansgar Thiel
- President, German Sport University, Cologne, Germany
| | - Tine Vertommen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
- Expertise Center People and Well-being, Thomas More University of Applied Sciences, Antwerp, Belgium
| | - Gloria Viseras
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Richard Budgett
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Lars Engebretsen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Uğur Erdener
- Medical and Scientific Commission, International Olympic Committee, Lausanne, Switzerland
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Greydanus DE, Nazeer A, Qayyum Z, Patel DR, Rausch R, Hoang LN, Miller C, Chahin S, Apple RW, Saha G, Prasad Rao G, Javed A. Pediatric suicide: Review of a preventable tragedy. Dis Mon 2024; 70:101725. [PMID: 38480023 DOI: 10.1016/j.disamonth.2024.101725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2024]
Abstract
Concepts of suicide are explored in this issue with a focus on suicide in children and adolescents. The epidemiology of pediatric suicide in the United States is reviewed; also, risk and protective factors, as well as prevention strategies, are discussed. Suicide in the pediatric athlete and the potential protective effect of exercise are examined. In addition, this analysis addresses the beneficial role of psychological management as well as current research on pharmacologic treatment and brain stimulation procedures as part of comprehensive pediatric suicide prevention. Though death by suicide in pediatric persons has been and remains a tragic phenomenon, there is much that clinicians, other healthcare professionals, and society itself can accomplish in the prevention of pediatric suicide as well as the management of suicidality in our children and adolescents.
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Affiliation(s)
- Donald E Greydanus
- Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States.
| | - Ahsan Nazeer
- Division of Child and Adolescent Psychiatry, Sidra Medicine/Weill Cornell Medicine, Doha, Qatar
| | - Zheala Qayyum
- Harvard Medical School, Boston, Massachusetts, United States
| | - Dilip R Patel
- Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Rebecca Rausch
- Division of Pediatric Psychology, Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Linh-Nhu Hoang
- Western Michigan University, Kalamazoo, MI, United States
| | - Caroline Miller
- Fielding Graduate University, Santa Barbara, CA, United States
| | - Summer Chahin
- Mott Children's Hospital, University of Michigan, Ann Arbor, MI, United States
| | - Roger W Apple
- Division of Pediatric Psychology, Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Gautam Saha
- Immediate Past President of the SAARC (South Asian Association for Regional Cooperation) Psychiatric Federation (SPF), India
| | - G Prasad Rao
- President, Asian Federation of Psychiatric Association (AFPA), India
| | - Afzal Javed
- Chairman Pakistan Psychiatric Research Centre, Immediate Past President of the World Psychiatric Association (WPA), Pakistan
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Fitzgerald H, Fitzgerald DA, Selvadurai H. Exercise testing for young athletes. Paediatr Respir Rev 2023:S1526-0542(23)00082-9. [PMID: 38176989 DOI: 10.1016/j.prrv.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 12/12/2023] [Indexed: 01/06/2024]
Abstract
With increasing competitiveness across the sporting landscape, there is a need for more research into monitoring and managing the young athlete, as the needs of a young athlete are vastly different to those of an older athlete who is already established in their respective sport. As the age of sports specialisation seems to decrease, exercise testing in the younger cohort of athletes is crucial for safety and long-term success. This article provides a comprehensive summary of available testing and monitoring methods that can be used to assist young athletes as they mature and attempt to excel in their chosen sport.
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Affiliation(s)
- H Fitzgerald
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Westmead, Sydney, NSW 2145, Australia.
| | - D A Fitzgerald
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Westmead, Sydney, NSW 2145, Australia; Discipline of Paediatrics and Child Health, Faculty of Medicine, University of Sydney, Camperdown, Sydney, NSW 2006, Australia
| | - H Selvadurai
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Westmead, Sydney, NSW 2145, Australia; Discipline of Paediatrics and Child Health, Faculty of Medicine, University of Sydney, Camperdown, Sydney, NSW 2006, Australia
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