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      The Mental Health of Elite Athletes: A Narrative Systematic Review

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          Abstract

          Background

          The physical impacts of elite sport participation have been well documented; however, there is comparatively less research on the mental health and psychological wellbeing of elite athletes.

          Objective

          This review appraises the evidence base regarding the mental health and wellbeing of elite-level athletes, including the incidence and/or nature of mental ill-health and substance use.

          Methods

          A systematic search of the PubMed, EMBASE, SPORTDiscus, PsycINFO, Cochrane and Google Scholar databases, up to and including May 2015, was conducted.

          Results

          The search yielded a total of 2279 records. Following double screening, 60 studies were included. The findings suggested that elite athletes experience a broadly comparable risk of high-prevalence mental disorders (i.e. anxiety, depression) relative to the general population. Evidence regarding other mental health domains (i.e. eating disorders, substance use, stress and coping) is less consistent. These results are prefaced, however, by the outcome of the quality assessment of the included studies, which demonstrated that relatively few studies (25 %) were well reported or methodologically rigorous. Furthermore, there is a lack of intervention-based research on this topic.

          Conclusion

          The evidence base regarding the mental health and wellbeing of elite athletes is limited by a paucity of high-quality, systematic studies. Nonetheless, the research demonstrates that this population is vulnerable to a range of mental health problems (including substance misuse), which may be related to both sporting factors (e.g. injury, overtraining and burnout) and non-sporting factors. More high-quality epidemiological and intervention studies are needed to inform optimal strategies to identify and respond to player mental health needs.

          Electronic supplementary material

          The online version of this article (doi:10.1007/s40279-016-0492-2) contains supplementary material, which is available to authorized users.

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          Most cited references87

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          How Emotions Influence Performance in Competitive Sports

          Richard S. Lazarus (2000)
          Article 0 comments Cited 198 times – based on 0 reviews     Review now
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            Psychological Balance in High Level Athletes: Gender-Based Differences and Sport-Specific Patterns

            Karine Schaal, Muriel Tafflet, Hala Nassif … (2011)
            Objectives Few epidemiological studies have focused on the psychological health of high level athletes. This study aimed to identify the principal psychological problems encountered within French high level athletes, and the variations in their prevalence based on sex and the sport practiced. Methods Multivariate analyses were conducted on nationwide data obtained from the athletes' yearly psychological evaluations. Results A representative sample of 13% of the French athlete population was obtained. 17% of athletes have at least one ongoing or recent disorder, generalized anxiety disorder (GAD) being the most prevalent (6%), followed by non-specific eating disorders (4.2%). Overall, 20.2% of women had at least one psychopathology, against 15.1% in men. This female predominance applied to anxiety and eating disorders, depression, sleep problems and self-harming behaviors. The highest rates of GAD appeared in aesthetic sports (16.7% vs. 6.8% in other sports for men and 38.9% vs. 10.3% for women); the lowest prevalence was found in high risk sports athletes (3.0% vs. 3.5%). Eating disorders are most common among women in racing sports (14% vs. 9%), but for men were found mostly in combat sports (7% vs. 4.8%). Discussion This study highlights important differences in psychopathology between male and female athletes, demonstrating that the many sex-based differences reported in the general population apply to elite athletes. While the prevalence of psychological problems is no higher than in the general population, the variations in psychopathology in different sports suggest that specific constraints could influence the development of some disorders.
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              Barriers and facilitators to mental health help-seeking for young elite athletes: a qualitative study

              Amelia Gulliver, Kathleen Griffiths, Helen Christensen (2012)
              Background Adolescents and young adults experience a high level of mental disorders, yet tend not to seek help. Research indicates that there are many barriers and facilitators to help-seeking for young people in the general community. However there are limited data available for young elite athletes. This study aims to determine what young elite athletes perceive as the barriers and facilitators to help-seeking for common mental health problems. Methods Fifteen elite athletes aged 16–23 years each participated in one of three focus group discussions. In addition to written data, verbal responses were audio taped, transcribed and thematically analysed. Results Participants’ written and verbal data suggested that stigma was the most important perceived barrier to seeking help for young elite athletes. Other notable barriers were a lack of mental health literacy, and negative past experiences of help-seeking. Facilitators to help-seeking were encouragement from others, having an established relationship with a provider, pleasant previous interactions with providers, the positive attitudes of others, especially their coach, and access to the internet. Conclusions Intervention strategies for improving help-seeking in young elite athletes should focus on reducing stigma, increasing mental health literacy, and improving relations with potential providers.
              Article 0 comments Cited 134 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Simon M. Rice: +61-3-1300679436 , simon.rice@unimelb.edu.au , simon.rice@orygen.org.au
                Journal
                Journal ID (nlm-ta): Sports Med
                Journal ID (iso-abbrev): Sports Med
                Title: Sports Medicine (Auckland, N.z.)
                Publisher: Springer International Publishing (Cham )
                ISSN (Print): 0112-1642
                ISSN (Electronic): 1179-2035
                Publication date (Electronic): 20 February 2016
                Publication date PMC-release: 20 February 2016
                Publication date (Print): 2016
                Volume: 46
                Issue: 9
                Pages: 1333-1353
                Affiliations
                [1 ]Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, Melbourne, VIC  3052 Australia
                [2 ]Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC Australia
                [3 ]Orygen Youth Health Clinical Program, Melbourne, VIC Australia
                Article
                Publisher ID: 492
                DOI: 10.1007/s40279-016-0492-2
                PMC ID: 4996886
                PubMed ID: 26896951
                SO-VID: 442473d5-bab9-4973-9a07-5ae968d98fe9
                Copyright © © The Author(s) 2016
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                Funding
                Funded by: Society for Mental Health Research
                Award ID: Early Career Fellowship
                Award Recipient :
                Categories
                Subject: Systematic Review
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                issue-copyright-statement © Springer International Publishing Switzerland 2016

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