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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—Executive Summary
  1. Cindy Chang1,
  2. Margot Putukian2,3,
  3. Giselle Aerni4,
  4. Alex Diamond5,
  5. Gene Hong6,
  6. Yvette Ingram7,
  7. Claudia L Reardon8,
  8. Andrew Wolanin9
  1. 1 Departments of Orthopaedics and Family & Community Medicine, University of California San Francisco, San Francisco, California, USA
  2. 2 Athletic Medicine, Princeton University, Princeton, New Jersey, USA
  3. 3 Department of Internal Medicine & Sports Medicine, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
  4. 4 Sports Medicine & Family Medicine, WellSpan Health, York, Pennsylvania, USA
  5. 5 Department of Pediatrics and Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  6. 6 Department of Orthopedics and Family Medicine, Medical University of South Carolina—College of Medicine, Charleston, South Carolina, USA
  7. 7 Department of Health Science, Lock Haven University of Pennsylvania, Lock Haven, Pennsylvania, USA
  8. 8 Department of Psychiatry, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA
  9. 9 Wolanin Consulting and Assessment Inc, Bala Cynwyd, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Margot Putukian, Athletic Medicine, Princeton University, Princeton, New Jersey, USA; putukian{at}


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.

  • anxiety
  • depression
  • overtraining and burnout
  • psychology
  • eating disorder

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  • CC and MP are joint first authors.

  • Twitter @Mputukian

  • Contributors All authors have made substantial contributions to the outline, drafted the work and revised it critically. In addition, all authors approved the final version to be published and are accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

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

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