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Kimura T, Mącznik A, Kinoda A, Yamada Y, Muramoto Y, Katsumata Y, Sato K. Prevalence and Factors Associated with Mental Health Complaints in Japanese Collegiate Athletes. Sports (Basel) 2024; 12:240. [PMID: 39330717 PMCID: PMC11435743 DOI: 10.3390/sports12090240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 08/25/2024] [Accepted: 08/29/2024] [Indexed: 09/28/2024] Open
Abstract
Investigations into mental health epidemiology in various cultural contexts were one of the main recommendations by the recent consensus statement on mental health in athletes, but the evidence in different sporting populations is rising slowly. This study aimed to investigate the prevalence of mental health complaints in Japanese collegiate athletes. The online survey was sent to the Japanese collegiate athletes associated with UNIVAS asking about the mental health complaints experienced during their sporting careers. Out of 10,999 athletes, 269 (2.4%) reported at least one complaint. Mental health complaints were more prevalent in female (3.6%) than male (1.5%) athletes. Skill sports had the highest prevalence (4.1%) of mental health complaints, and power sports had the lowest prevalence (1.5%) of mental health complaints. This study found a very low prevalence of self-reported mental health complaints in Japanese collegiate athletes. Preventive efforts should focus on monitoring early symptoms (rather than diagnoses), especially in skill sports and female athletes. Anxiety (38%) and depression (35%) were the most reported complaints and should be targeted first.
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Affiliation(s)
- Takeshi Kimura
- Institute for Integrated Sports Medicine, School of Medicine, Keio University, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan
| | - Aleksandra Mącznik
- Institute for Integrated Sports Medicine, School of Medicine, Keio University, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan
| | - Akira Kinoda
- Institute for Integrated Sports Medicine, School of Medicine, Keio University, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yuichi Yamada
- Institute for Integrated Sports Medicine, School of Medicine, Keio University, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yuki Muramoto
- Institute for Integrated Sports Medicine, School of Medicine, Keio University, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yoshinori Katsumata
- Institute for Integrated Sports Medicine, School of Medicine, Keio University, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan
| | - Kazuki Sato
- Institute for Integrated Sports Medicine, School of Medicine, Keio University, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan
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2
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Abstract
The emerging field of sports psychiatry has been developing steadily in recent years. This is not just a health concern but is likely to impact sporting performance and achievement significantly. An overview of sports psychiatry is provided. Psychiatric disorders of all varieties can and do present in sporting populations. Sports psychiatry keeps evolving to drive forward the importance of good mental health in sport as in life.
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3
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Stone BM. A positive psychology framework for why people use substances: Implications for treatment. Front Psychol 2022; 13:1017186. [PMID: 36248491 PMCID: PMC9557359 DOI: 10.3389/fpsyg.2022.1017186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/13/2022] [Indexed: 12/04/2022] Open
Affiliation(s)
- Bryant M. Stone
- Department of Psychological and Behavioral Sciences, Institute of Psychiatry, Medical University of South Carolina, Charleston, SC, United States
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4
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Sports Psychiatry: An Update and the Emerging Role of the Sports Psychiatrist on the Sports Medicine Team. Clin J Sport Med 2022; 32:1-2. [PMID: 33914492 DOI: 10.1097/jsm.0000000000000856] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 03/30/2020] [Indexed: 02/02/2023]
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5
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Schaffert J, Didehbani N, LoBue C, Hart J, Rossetti H, Lacritz L, Cullum CM. Frequency and Predictors of Traumatic Encephalopathy Syndrome in a Prospective Cohort of Retired Professional Athletes. Front Neurol 2021; 12:617526. [PMID: 33708171 PMCID: PMC7940833 DOI: 10.3389/fneur.2021.617526] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 01/28/2021] [Indexed: 11/13/2022] Open
Abstract
Traumatic encephalopathy syndrome (TES) is proposed to represent the long-term impact of repetitive head-injury exposure and the clinical manifestation of chronic traumatic encephalopathy (CTE). This study aimed to evaluate the frequency of TES in a cohort of retired professional contact sport athletes, compare the frequency of TES to clinical consensus diagnoses, and identify predictors that increase the likelihood of TES diagnosis. Participants were 85 retired professional contact sport athletes from a prospective cohort at the University of Texas Southwestern Medical Center and the University of Texas at Dallas. Participants ranged in age from 23 to 79 (M = 55.95, SD = 13.82) and obtained 7 to 19 years of education (M = 16.08, SD = 1.03). Retirees were either non-Hispanic white (n = 62) or African-American (n = 23). Retired athletes underwent a standard clinical evaluation, which included a clinical interview, neurological exam, neuroimaging, neuropsychological testing, and consensus diagnosis of normal, mild cognitive impairment, or dementia. TES criteria were applied to all 85 athletes, and frequencies of diagnoses were compared. Fourteen predictors of TES diagnosis were evaluated using binary logistic regressions, and included demographic, neuropsychological, depression symptoms, and head-injury exposure variables. A high frequency (56%) of TES was observed among this cohort of retired athletes, but 54% of those meeting criteria for TES were diagnosed as cognitively normal via consensus diagnosis. Games played in the National Football League (OR = 0.993, p = 0.087), number of concussions (OR = 1.020, p = 0.532), number of concussions with loss of consciousness (OR = 1.141 p = 0.188), and years playing professionally (OR = 0.976, p = 0.627) were not associated with TES diagnosis. Degree of depressive symptomatology, as measured by the total score on the Beck Depression Inventory-II, was the only predictor of TES diagnosis (OR = 1.297, p < 0.001). Our results add to previous findings underscoring the risk for false positive diagnosis, highlight the limitations of the TES criteria in clinical and research settings, and question the relationship between TES and head-injury exposure. Future research is needed to examine depression in retired professional athletes.
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Affiliation(s)
- Jeff Schaffert
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Nyaz Didehbani
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States.,Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Christian LoBue
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States.,Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - John Hart
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX, United States.,Callier Center, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, United States.,Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Heidi Rossetti
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Laura Lacritz
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States.,Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - C Munro Cullum
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States.,Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, TX, United States.,Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, United States
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6
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Reardon CL, Bindra A, Blauwet C, Budgett R, Campriani N, Currie A, Gouttebarge V, McDuff D, Mountjoy M, Purcell R, Putukian M, Rice S, Hainline B. Mental health management of elite athletes during COVID-19: a narrative review and recommendations. Br J Sports Med 2020; 55:bjsports-2020-102884. [PMID: 32967853 DOI: 10.1136/bjsports-2020-102884] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2020] [Indexed: 12/18/2022]
Abstract
Elite athletes suffer many mental health symptoms and disorders at rates equivalent to or exceeding those of the general population. COVID-19 has created new strains on elite athletes, thus potentially increasing their vulnerability to mental health symptoms. This manuscript serves as a narrative review of the impact of the pandemic on management of those symptoms in elite athletes and ensuing recommendations to guide that management. It specifically addresses psychotherapy, pharmacotherapy and higher levels of care. Within the realm of psychotherapy, crisis counselling might be indicated. Individual, couple/family and group psychotherapy modalities all may be helpful during the pandemic, with novel content and means of delivery. Regarding pharmacotherapy for mental health symptoms and disorders, some important aspects of management have changed during the pandemic, particularly for certain classes of medication including stimulants, medications for bipolar and psychotic disorders, antidepressants and medications for substance use disorders. Providers must consider when in-person management (eg, for physical examination, laboratory testing) or higher levels of care (eg, for crisis stabilisation) is necessary, despite potential risk of viral exposure during the pandemic. Management ultimately should continue to follow general principles of quality health care with some flexibility. Finally, the current pandemic provides an important opportunity for research on new methods of providing mental health care for athletes, and consideration for whether these new methods should extend beyond the pandemic.
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Affiliation(s)
- Claudia L Reardon
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- University Health Services, University of Wisconsin, Madison, Wisconsin, USA
| | | | - Cheri Blauwet
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Richard Budgett
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Niccolo Campriani
- Sports Department, International Olympic Committee, Lausanne, Switzerland
| | - Alan Currie
- Regional Affective Disorders Service, Northumberland Tyne and Wear NHS Foundation Trust, Newcastle, UK
- Department of Sport and Exercise Sciences, University of Sunderland, Sunderland, Tyne and Wear, UK
| | - Vincent Gouttebarge
- Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- AMC/VUmc IOC Research Center of Excellence, Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam, The Netherlands
| | - David McDuff
- Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
- MD Sports Performance, Ellicott City, Maryland, USA
| | - Margo Mountjoy
- Family Medicine, McMaster University Michael G DeGroote School of Medicine, Waterloo, Ontario, Canada
- Bureau, FINA, Lausanne, Switzerland
| | - Rosemary Purcell
- Department of Research and Translation, Orygen The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Margot Putukian
- Athletic Medicine, Princeton University, Princeton, New Jersey, USA
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Simon Rice
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Research and Translation, Orygen The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
| | - Brian Hainline
- National Collegiate Athletic Association (NCAA), Indianapolis, Indiana, USA
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7
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Zeiger JS, Silvers WS, Fleegler EM, Zeiger RS. Attitudes about cannabis mediate the relationship between cannabis knowledge and use in active adult athletes. J Cannabis Res 2020; 2:18. [PMID: 33526137 PMCID: PMC7819330 DOI: 10.1186/s42238-020-00023-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 04/02/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Little is known about how cannabis knowledge and attitudes impact cannabis use behavior. OBJECTIVE To test the knowledge-attitudes-behavior paradigm in active adult athletes. DESIGN The Athlete Pain, Exercise, and Cannabis Experience (PEACE) Survey, a cross-sectional survey study, used social media and email blasts to recruit participants and SurveyGizmo to collect data. PARTICIPANTS Self-defined active adult athletes (n = 1161). MAIN MEASURES Knowledge about cannabis was evaluated with four questions. Attitudes toward cannabis was evaluated with 11 questions. The attitudes questions were used in a TwoStep Cluster analysis in SPSS to assign group membership by attitudes. Chi-square was used to determine if there were differences in cluster membership by demographic factors and if knowledge about cannabis differed by cluster membership. Regression analysis was performed to determine if cannabis attitudes mediated the relationship between cannabis knowledge and cannabis use. KEY RESULTS A three-cluster solution was the best fit to the data. The clusters were named Conservative (n = 374, 32.2%), Unsure (n = 533, 45.9%), and Liberal (n = 254, 21.9). There was a significant difference among the clusters for all 11 attitudes items (all p < 0.001). Attitude cluster membership was significantly different by age (p < 0.001), primary sport (p < 0.05), and knowledge about cannabis (p < 0.001). Athletes in the liberal cluster answered the knowledge questions correctly most often. Attitudes mediated the relationship between cannabis knowledge and cannabis use [Never (32.4%), Past (41.6%), Current (26.0%)] with athletes in the liberal cluster showing more knowledge and greater likelihood to be a current cannabis user (p < 0.001). Among current cannabis users there were differential patterns of cannabis use depending on their attitudes and knowledge; liberal athletes tended to co-use THC and CBD and used cannabis longer. (p < 0.001). CONCLUSIONS Cannabis education needs to consider attitudes about cannabis, especially among those who might benefit from medical cannabis.
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Affiliation(s)
- Joanna S Zeiger
- Canna Research Group, 3996 Savannah Ct, Boulder, CO, 80301, USA.
| | - William S Silvers
- Canna Research Group, 3996 Savannah Ct, Boulder, CO, 80301, USA
- Division of Allergy and Clinical Immunology, University of Colorado Denver School of Medicine, 12700 E. 19th Ave., Room 10C03, Aurora, CO, 80045, USA
| | - Edward M Fleegler
- Canna Research Group, 3996 Savannah Ct, Boulder, CO, 80301, USA
- To-Life in Peace, LLC, 3812 Taft Court, Wheat Ridge, CO, 80033, USA
| | - Robert S Zeiger
- Canna Research Group, 3996 Savannah Ct, Boulder, CO, 80301, USA
- Kaiser Permanente Southern California, 7060 Clairemont Mesa Blvd, San Diego, CA, 92111, USA
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8
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American Medical Society for Sports Medicine Position Statement: Mental Health Issues and Psychological Factors in Athletes: Detection, Management, Effect on Performance, and Prevention-Executive Summary. Clin J Sport Med 2020; 30:91-95. [PMID: 32000168 DOI: 10.1097/jsm.0000000000000799] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The American Medical Society for Sports Medicine convened a panel of experts to provide an evidence-based, best practice document to assist sports medicine physicians and other members of the athletic care network with the detection, treatment, and prevention of mental health (MH) issues in competitive athletes. This statement discusses how members of the sports medicine team, including team physicians, athletic trainers, and MH providers, work together in providing comprehensive psychological care to athletes. It specifically addresses psychological factors in athletes including personality issues and the psychological response to injury and illness. The statement also examines the athletic culture and environmental factors that commonly impact MH, including sexuality and gender issues, hazing, bullying, sexual misconduct, and transition from sport. Specific MH disorders in athletes, such as eating disorders/disordered eating, depression and suicide, anxiety and stress, overtraining, sleep disorders and attention-deficit/hyperactivity disorder, are reviewed with a focus on detection, management, the effect on performance, and prevention. This document uses the Strength of Recommendation Taxonomy to grade level of evidence.
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9
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Mental Health Issues and Psychological Factors in Athletes: Detection, Management, Effect on Performance, and Prevention: American Medical Society for Sports Medicine Position Statement. Clin J Sport Med 2020; 30:e61-e87. [PMID: 32000169 DOI: 10.1097/jsm.0000000000000817] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The American Medical Society for Sports Medicine convened a panel of experts to provide an evidence-based, best practices document to assist sports medicine physicians and other members of the athletic care network with the detection, treatment, and prevention of mental health issues in competitive athletes. This statement discusses how members of the sports medicine team, including team physicians, athletic trainers, and mental health providers, work together in providing comprehensive psychological care to athletes. It specifically addresses psychological factors in athletes including personality issues and the psychological response to injury and illness. The statement also examines the athletic culture and environmental factors that commonly impact mental health, including sexuality and gender issues, hazing, bullying, sexual misconduct, and transition from sport. Specific mental health disorders in athletes, such as eating disorders/disordered eating, depression and suicide, anxiety and stress, overtraining, sleep disorders, and attention-deficit/hyperactivity disorder, are reviewed with a focus on detection, management, the effect on performance, and prevention. This document uses the Strength of Recommendation Taxonomy (SORT) to grade level of evidence.
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10
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Chang C, Putukian M, Aerni G, Diamond A, Hong G, Ingram Y, Reardon CL, Wolanin A. Mental health issues and psychological factors in athletes: detection, management, effect on performance and prevention: American Medical Society for Sports Medicine Position Statement—Executive Summary. Br J Sports Med 2019; 54:216-220. [DOI: 10.1136/bjsports-2019-101583] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2019] [Indexed: 01/25/2023]
Abstract
The American Medical Society for Sports Medicine convened a panel of experts to provide an evidence-based, best practices document to assist sports medicine physicians and other members of the athletic care network with the detection, treatment and prevention of mental health issues in competitive athletes. This statement discusses how members of the sports medicine team, including team physicians, athletic trainers and mental health providers, work together in providing comprehensive psychological care to athletes. It specifically addresses psychological factors in athletes including personality issues and the psychological response to injury and illness. The statement also examines the athletic culture and environmental factors that commonly impact mental health, including sexuality and gender issues, hazing, bullying, sexual misconduct and transition from sport. Specific mental health disorders in athletes, such as eating disorders/disordered eating, depression and suicide, anxiety and stress, overtraining, sleep disorders and attention-deficit/hyperactivity disorder, are reviewed with a focus on detection, management, the effect on performance and prevention. This document uses the Strength of Recommendation Taxonomy to grade level of evidence.
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11
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Wilson PB. 'I think I'm gonna hurl': A Narrative Review of the Causes of Nausea and Vomiting in Sport. Sports (Basel) 2019; 7:E162. [PMID: 31277403 PMCID: PMC6680692 DOI: 10.3390/sports7070162] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 06/25/2019] [Accepted: 07/02/2019] [Indexed: 12/27/2022] Open
Abstract
Exercise-associated gastrointestinal (GI) distress can negatively impact athletic performance and interfere with exercise training. Although there are a few universal underlying causes of GI distress, each symptom often has its own unique triggers and, therefore, its own prevention and management strategies. One of the most troubling GI symptoms an athlete can experience during training and competition is nausea/vomiting. The prevalence of nausea varies with several factors, two of the most important being exercise intensity and duration. Relatively brief, high-intensity exercise (e.g., sprinting, tempo runs) and ultra-endurance exercise are both associated with more frequent and severe nausea. The potential causes of nausea in sport are numerous and can include catecholamine secretion, hypohydration, heat stress, hyponatremia, altitude exposure, excessive fluid/food consumption, hypertonic beverage intake, pre-exercise intake of fatty- or protein-rich foods (especially in close proximity to exercise), prolonged fasting, various supplements (caffeine, sodium bicarbonate, ketones), certain drugs (antibiotics, opioids), GI infections, and competition-related anxiety. Beyond directly addressing these aforementioned causes, antiemetic drugs (e.g., ondansetron) may also be useful for alleviating nausea in some competitive situations. Given the commonness of nausea in sport and its potential impact on exercise performance, athletes and sports medicine practitioners should be aware of the origins of nausea and strategies for dealing with this troublesome gut complaint.
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Affiliation(s)
- Patrick B Wilson
- Human Movement Sciences, Old Dominion University, Norfolk, VA 23529, USA.
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12
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McDuff D, Stull T, Castaldelli-Maia JM, Hitchcock ME, Hainline B, Reardon CL. Recreational and ergogenic substance use and substance use disorders in elite athletes: a narrative review. Br J Sports Med 2019; 53:754-760. [PMID: 31097457 DOI: 10.1136/bjsports-2019-100669] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Substances from various classes may be used for recreational purposes, self-treatment or to boost performance. When substance use shifts from occasional to regular, heavy or hazardous use, positive and negative effects can develop that vary by substance class and athlete. Regular use of recreational or performance enhancing substances can lead to misuse, sanctions or use disorders. OBJECTIVE To review the prevalence, patterns of use, risk factors, performance effects and types of intervention for all classes of recreational and performance enhancing substances in elite athletes by sport, ethnicity, country and gender. METHODS A comprehensive search was conducted to identify studies that compared the prevalence and patterns of substance use, misuse and use disorders in elite athletes with those of non-athletes and provided detailed demographic and sport variations in reasons for use, risk factors and performance effects for each main substance class. RESULTS Alcohol, cannabis, tobacco (nicotine) and prescribed opioids and stimulants are the most commonly used substances in elite athletes, but generally used at lower rates than in non-athletes. In contrast, use/misuse rates for binge alcohol, oral tobacco, non-prescription opioids and anabolic-androgenic steroids are higher among athletes than non-athletes, especially in power and collision sports. Cannabis/cannabinoids seem to have replaced nicotine as the second most commonly used substance. CONCLUSIONS Substance use in elite athletes varies by country, ethnicity, gender, sport and competitive level. There are no studies on substance use disorder prevalence in elite male and female athletes and few studies with direct comparison groups.
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Affiliation(s)
- David McDuff
- Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA .,MD Sports Performance, Ellicott, Maryland, USA
| | - Todd Stull
- Athletics, University of Nebraska-Lincoln University Health Center, Lincoln, Nebraska, USA
| | - João Mauricio Castaldelli-Maia
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil.,Department of Neuroscience, Medical School, Fundação do ABC, Santo André, Brazil
| | - Mary E Hitchcock
- Ebling Library for the Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Brian Hainline
- National Collegiate Athletic Association (NCAA), Indianapolis, Indiana, USA
| | - Claudia L Reardon
- Department of Psychiatry, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA
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13
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Mental health in elite athletes: International Olympic Committee consensus statement (2019). Br J Sports Med 2019; 53:667-699. [DOI: 10.1136/bjsports-2019-100715] [Citation(s) in RCA: 349] [Impact Index Per Article: 69.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2019] [Indexed: 11/03/2022]
Abstract
Mental health symptoms and disorders are common among elite athletes, may have sport related manifestations within this population and impair performance. Mental health cannot be separated from physical health, as evidenced by mental health symptoms and disorders increasing the risk of physical injury and delaying subsequent recovery. There are no evidence or consensus based guidelines for diagnosis and management of mental health symptoms and disorders in elite athletes. Diagnosis must differentiate character traits particular to elite athletes from psychosocial maladaptations.Management strategies should address all contributors to mental health symptoms and consider biopsychosocial factors relevant to athletes to maximise benefit and minimise harm. Management must involve both treatment of affected individual athletes and optimising environments in which all elite athletes train and compete. To advance a more standardised, evidence based approach to mental health symptoms and disorders in elite athletes, an International Olympic Committee Consensus Work Group critically evaluated the current state of science and provided recommendations.
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14
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Castaldelli-Maia JM, Gallinaro JGDME, Falcão RS, Gouttebarge V, Hitchcock ME, Hainline B, Reardon CL, Stull T. Mental health symptoms and disorders in elite athletes: a systematic review on cultural influencers and barriers to athletes seeking treatment. Br J Sports Med 2019; 53:707-721. [PMID: 31092400 DOI: 10.1136/bjsports-2019-100710] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To summarise the literature on the barriers to athletes seeking mental health treatment and cultural influencers of mental health in elite athletes. DESIGN Systematic review DATA SOURCES: PubMed, Cochrane, Scopus, SportDiscus (Ebsco), and PsycINFO (ProQuest) up to November 2018. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Qualitative and quantitative original studies of elite athletes (those who competed at the professional, Olympic, or collegiate/university levels), published in any language. RESULTS Stigma, low mental health literacy, negative past experiences with mental health treatment-seeking, busy schedules, and hypermasculinity are barriers to elite athletes seeking mental health treatment. Cultural influencers of mental health in elite athletes include: (1) the lack of acceptance of women as athletes; (2) lower acceptability of mental health symptoms and disorders among non-white athletes; (3) non-disclosure of religious beliefs; and (4) higher dependence on economic benefits. Coaches have an important role in supporting elite athletes in obtaining treatment for mental illness. Brief anti-stigma interventions in elite athletes decrease stigma and improve literary about mental health. CONCLUSION There is a need for various actors to provide more effective strategies to overcome the stigma that surrounds mental illness, increase mental health literacy in the athlete/coach community, and address athlete-specific barriers to seeking treatment for mental illness. In this systematic review, we identified strategies that, if implemented, can overcome the cultural factors that may otherwise limit athletes seeking treatment. Coaches are critical for promoting a culture within elite athletes' environments that encourages athletes to seek treatment.
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Affiliation(s)
- João Mauricio Castaldelli-Maia
- Department of Neuroscience, Medical School, Fundação do ABC, Santo Andre, SP, Brazil .,Department of Psychiatry, Medical School, University of São Paulo, Sao Paulo, SP, Brazil.,ABC Center for Mental Health Studies, Santo André, SP, Brazil
| | | | | | - Vincent Gouttebarge
- Amsterdam UMC, Univ of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, The Netherlands
| | - Mary E Hitchcock
- Ebling Library for the Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Brian Hainline
- National Collegiate Athletic Association (NCAA), Indianapolis, Indiana, USA
| | - Claudia L Reardon
- Department of Psychiatry, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Todd Stull
- Athletic Department, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
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15
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Souter G, Lewis R, Serrant L. Men, Mental Health and Elite Sport: a Narrative Review. SPORTS MEDICINE-OPEN 2018; 4:57. [PMID: 30569248 PMCID: PMC6300449 DOI: 10.1186/s40798-018-0175-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 12/03/2018] [Indexed: 12/19/2022]
Abstract
Mental health in elite sport is receiving more publicity due to an increase in male athletes sharing their personal experiences. Sports injury is recognised as the major risk factor for psychological distress amongst male athletes, although anecdotally this may be that athletes are more likely to discuss their emotional wellbeing when related to the injury they are experiencing. Stress can be amplified within elite sport and the pressure they experience in relation to competition and performance can be exacerbated by adverse life events. This ongoing stress does not end when their sporting career does, it can follow them into retirement. The physical and psychological demands placed upon them by the sporting environment may predispose athletes to developing depression. As an athlete’s symptoms of mental illness intensify, their performance can be negatively affected leaving them vulnerable and exposed to further symptoms of common mental disorders. The pressure of performance can also expose male athletes to overtraining syndrome which can be difficult to distinguish from depression. Male athletes are more vulnerable to eating disorders compared with males in the general population and they do have anxieties, particularly around their bodies, but find it difficult to disclose their concerns. In addition to this, male athletes are more likely to use substances, including opioids to improve both sport and non-sport performance. Despite the prevalence of common mental disorders in male athletes, stigma still exists, and although some athletes discuss their issues publicly after their career has ended, the majority of athletes prefer to remain silent. There remains a view that athletes who seek help for psychological problems may be seen as weak. Although there is an improvement in help-seeking attitudes within elite sport, further research and education is needed to encourage men to talk about their mental health, share their experiences and to enjoy a greater sense of emotional wellbeing.
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Affiliation(s)
- Gary Souter
- Sheffield Hallam University, Faculty of Health & Wellbeing, F426 Robert Winston Building, 11-15 Broomhall Road, Sheffield, S10 2BP, UK.
| | - Robin Lewis
- Sheffield Hallam University, Faculty of Health & Wellbeing, M104 Mundella House, 34 Collegiate Crescent, Sheffield, S10 2BP, UK
| | - Laura Serrant
- Manchester Metropolitan University, Brooks Building Manchester Campus, Manchester, UK
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Thevis M, Kuuranne T, Geyer H. Annual banned-substance review: Analytical approaches in human sports drug testing. Drug Test Anal 2017; 10:9-27. [DOI: 10.1002/dta.2336] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 10/30/2017] [Indexed: 12/17/2022]
Affiliation(s)
- Mario Thevis
- Center for Preventive Doping Research - Institute of Biochemistry; German Sport University Cologne; Germany
- European Monitoring Center for Emerging Doping Agents; Cologne Germany
| | - Tiia Kuuranne
- Swiss Laboratory for Doping Analyses; University Center of Legal Medicine, Genève and Lausanne, Centre Hospitalier Universitaire Vaudois and University of Lausanne; Epalinges Switzerland
| | - Hans Geyer
- Center for Preventive Doping Research - Institute of Biochemistry; German Sport University Cologne; Germany
- European Monitoring Center for Emerging Doping Agents; Cologne Germany
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