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Mental health in elite athletes: International Olympic Committee consensus statement (2019)
  1. Claudia L Reardon1,
  2. Brian Hainline2,
  3. Cindy Miller Aron3,
  4. David Baron4,
  5. Antonia L Baum5,
  6. Abhinav Bindra6,
  7. Richard Budgett7,
  8. Niccolo Campriani8,
  9. João Mauricio Castaldelli-Maia9,10,
  10. Alan Currie11,12,
  11. Jeffrey Lee Derevensky13,
  12. Ira D Glick14,
  13. Paul Gorczynski15,
  14. Vincent Gouttebarge16,17,
  15. Michael A Grandner18,
  16. Doug Hyun Han19,
  17. David McDuff20,
  18. Margo Mountjoy21,22,
  19. Aslihan Polat23,24,
  20. Rosemary Purcell25,26,
  21. Margot Putukian27,28,
  22. Simon Rice29,30,
  23. Allen Sills31,32,
  24. Todd Stull33,
  25. Leslie Swartz34,
  26. Li Jing Zhu35,36,
  27. Lars Engebretsen37,38
  1. 1 Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
  2. 2 National Collegiate Athletic Association, Indianapolis, Indiana, USA
  3. 3 Department of Psychiatry, Samaritan Health Services, Corvallis, Oregon, USA
  4. 4 Office of the President, Western University of Health Sciences, Pomona, California, USA
  5. 5 Department of Psychiatry and Behavioral Sciences, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
  6. 6 Mohali, Punjab, India
  7. 7 Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
  8. 8 Sports Department, International Olympic Committee, Lausanne, Switzerland
  9. 9 Department of Neuroscience, Faculdade de Medicina do ABC, Santo Andre, Brazil
  10. 10 Universidade de Sao Paulo Faculdade de Medicina Hospital das Clinicas Instituto de Psiquiatria, Sao Paulo, Brazil
  11. 11 Regional Affective Disorders Service, Northumberland Tyne and Wear NHS Foundation Trust, Newcastle, UK
  12. 12 Department of Sport and Exercise Sciences, The University Of Sunderland, Sunderland, UK
  13. 13 International Centre for Youth Gambling Problems and High Risk Behaviors, McGill University, Montreal, Quebec, Canada
  14. 14 Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
  15. 15 Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, Hampshire, UK
  16. 16 Department of Orthopaedic Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, The Netherlands
  17. 17 Amsterdam Collaboration on Health and Safety in Sports (ACHSS), AMC/VUmc IOC Research Centre of Excellence, Amsterdam, The Netherlands
  18. 18 Department of Psychiatry, University of Arizona, Tucson, Arizona, USA
  19. 19 Department of Psychiatry, Chung Ang University Hospital, Seoul, Republic of Korea
  20. 20 Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
  21. 21 Department of Family Medicine-Sport, McMaster University, Hamilton, Ontario, Canada
  22. 22 FINA Bureau Liaison to Sport Medicine, Lausanne, Switzerland
  23. 23 Department of Psychiatry, Kocaeli University, Faculty of Medicine, Kocaeli, Turkey
  24. 24 Kocaeli University, Community Mental Health Centre, Kocaeli, Turkey
  25. 25 Research and Translation, Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
  26. 26 Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
  27. 27 Athletic Medicine, University Health Services, Princeton University, Princeton, New Jersey, USA
  28. 28 Department of Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
  29. 29 Department of Research and Translation, Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
  30. 30 Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
  31. 31 National Football League, New York, New York, USA
  32. 32 Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  33. 33 Athletic Department, University of Nebraska, Lincoln, Nebraska, USA
  34. 34 Department of Psychology, Stellenbosch University, Stellenbosch, Western Cape, South Africa
  35. 35 Social Sport, Zheng Zhou University, Zheng Zhou, He Nan Province, China
  36. 36 Social Aesthetic and Mental Health Institute, Vienna Sigmund Freud University, Vienna, Austria
  37. 37 Orthopaedic Clinic, University of Oslo, Oslo, Norway
  38. 38 Medical Sciences, International Olympic Committee, Lausanne, Switzerland
  1. Correspondence to Dr Claudia L Reardon, Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI 53719, USA; clreardon{at}wisc.edu

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.

  • elite performance
  • consensus statement
  • mental
  • psychiatry
  • psychology
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Footnotes

  • Contributors All authors meet criteria for authorship, as all have contributed in the following ways: substantial contributions to the conception or design of the work, or the acquisition, analysis or interpretation of the data; drafting the work or revising it critically for important intellectual content; final approval of the version published; and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. No one meeting the criteria for authorship has been excluded from authorship.

  • Disclaimer This consensus paper provides an overview of mental health symptoms and disorders in elite athletes that are important to physicians and other clinicians who treat elite athletes. It is not intended as a clinical practice guideline or legal standard of care and should not be interpreted as such. This consensus paper serves as a guide and, as such, is of a general nature, consistent with the reasonable practice of the healthcare professional. Individual treatment will depend on the facts and circumstances specific to each individual case.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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