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The Mental Health of Elite Athletes: A Narrative Systematic Review
Open accessAbstract
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.
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“To date, research has primarily examined the mental health outcomes of elite athletes [15–18], with comparatively less research focusing on understanding these psychological experiences among coaches [19].”
From The Mental Health of Elite-Level Coaches: A Systematic Scoping Review (2024) · cites this paper as [17]
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Eating disorders among athletes: causes, symptoms, and health consequences
Mikulska, J., Lewandowski, M., Kurkiewicz, W., Woźniak, O., Wąsik, J., Gryboś, K., Sepioło, W., Kiełbratowska, J., & Kwiatkowska, Z. (2025) · Quality in Sport · doi:10.12775/qs.2025.41.60061 · Cited by 1
Saraswati, P., Kanaujia, S., Thakur, G. S., & Kapri, B. C. (2025) · Cureus · doi:10.7759/cureus.85452 · Cited by 3
“Mental stress and conditions like anxiety, eating disorders, substance use disorders, depression, and psychological distress can be exacerbated by athletic culture [8,9].”
Muñoz, F., Herrera, F., Riquelme, S., Henríquez, M., Álvarez‐Ruf, J., Cornejo, M. I., & de Campos, L. F. C. C. (2025) · Sports · doi:10.3390/sports13070203 · Cited by 2
“Additionally, another relevant issue that may be a factor to highlight is career transitions, such as retirement from sports, which can be a high-risk period for depression due to the loss of identity, daily structure, and social support that sport provides [36].”
Wang, N., Lee, J.-H., & Cho, H. (2025) · International Journal of Sport and Exercise Psychology · doi:10.1080/1612197x.2025.2523001 · Cited by 3
The effect of endurance-based sports on athlete success and psychological well-being
Özpınar, S., YÜCEL, A. S., Korkmaz, M., Öztaş, D., Kuyucu, M. M., & Aras, G. (2025) · Sportis Scientific Journal of School Sport Physical Education and Psychomotricity · doi:10.17979/sportis.2025.11.3.11949 · Cited by 1
Exploring Need Segments of Recreational Sports Participants
Kang, P., Yoo, S., Davis, S. M., González‐Serrano, M. H., & Ko, Y. J. (2025) · Journal of Global Sport Management · doi:10.1080/24704067.2025.2525257 · Cited by 3
“For aggressive individual sports (e.g. boxing), policymakers can fund programs in community centers, using testimonials of resilience to attract at-risk youth, reducing inactivity (Rice et al., 2016).”
Ribeiro, A. F. M., Melo, R. D. S., Carvalho, D. C. R., Fernandes, J., de Oliveira, S. F. M., Monteiro, R. D. A., de Mello, A. D. S., de Souza, C. D. C. B., Cardoso, M. J. D. L., de Araújo, M. D. G. R., et al. (2025) · International Biomechanics · doi:10.1080/23335432.2025.2531944 · Cited by 1
“Rice et al. (2016) highlighted unique stressors for elite athletes, such as media scrutiny and career-ending injuries, which impact mental health and performance.”
Murray, K., McGregor, A., Jin, R., Xu, F., & Leach, L. (2025) · Body Image · doi:10.1016/j.bodyim.2025.101948 · Cited by 3
Paykan: Virtual reality gaming as a therapeutic tool for target panic disorder
Mohammadi, H. S., Bakhshi, F., Sekhavat, Y. A., Dasari, M., Ansaroudi, K. G., & Alilou, M. A. H. (2025) · Entertainment Computing · doi:10.1016/j.entcom.2025.101013 · Cited by 1
A Three‐Year Longitudinal Study of Athlete Mental Health: A Cricket Case Study
Ely, G., Woodman, T., Roberts, R., Jones, E. S., Williams, L., & Peirce, N. S. (2025) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/sms.70125 · Cited by 1
“Various mental health consensus statements [1, 2] and systematic reviews [3, 4] in sport have been published in the last decade.”
Ruud, H., & Jooste, J. (2025) · Performance Enhancement & Health · doi:10.1016/j.peh.2025.100369 · Cited by 1
Hilpisch, C., Zentgraf, K., & Mutz, M. (2025) · International Journal of Sport and Exercise Psychology · doi:10.1080/1612197x.2025.2563317 · Cited by 1
Evang, L. P., Lewis, J. E., & Nicanord, E. J. (2025) · American Journal of Lifestyle Medicine · doi:10.1177/15598276251388632 · Cited by 1
Petersen, B., & Schinke, R. J. (2025) · The Sport Psychologist · doi:10.1123/tsp.2025-0073 · Cited by 1
Xu, L., Peng, Z., Lian, J., Shao, Y., Dong, Y., & Fu, W. (2025) · Frontiers in Sports and Active Living · doi:10.3389/fspor.2025.1591411 · Cited by 1
Generoso, R. A., Vasudevan, V., Hamade, H., Sylvester-Omorodion, P., & Wolohan, M. (2025) · BMJ Open · doi:10.1136/bmjopen-2025-104620 · Cited by 1
Kaya, H. B., Karaduman, Z. O., Akpınar, S., Arıcan, M., Sağlam, S., Akşit, S., Koç, M., & Uludağ, V. (2025) · BMC Sports Science Medicine and Rehabilitation · doi:10.1186/s13102-025-01450-6 · Cited by 1
“These findings are consistent with previous research demonstrating that psychological factors—especially fear of movement and perceived readiness—are critical determinants of return-to-sport outcomes [26, 34].”
Kruger, A., Jooste, J., & Krüger, P. (2025) · Cogent Psychology · doi:10.1080/23311908.2025.2592902 · Cited by 1
“…entails a range of complex pressures and challenges that athletes must navigate throughout their professional careers (lane, 2024). according to Rice et al. (2016), the impact of mental health among professional athletes is less understood. studies indicate that athletes are especially…”
Noninvasive brain stimulation and athletic performance: a critical narrative review
Deng, J., Chen, Q., Luo, L., Wang, Q., Lv, Z., Luo, X., & Liang, J. (2025) · BMC Sports Science Medicine and Rehabilitation · doi:10.1186/s13102-025-01455-1 · Cited by 4
Tanwar, E., Kalpana, K., Khanna, G. L., Rao, B. D., & Saifi, A. (2025) · Scientific Reports · doi:10.1038/s41598-025-30523-2 · Cited by 1
Factorial Validity and Measurement Invariance of the CCAPS-Screen Among College Student-Athletes
Worley, J. T., Davis, S., Sullivan, L., & Houle, J. L. W. (2025) · Journal of Clinical Sport Psychology · doi:10.1123/jcsp.2025-0038 · Cited by 1
Yamaguchi, T., Takagi, S., Hori, H., Nishida, M., Koeda, T., Matsumoto, T., Kawata, Y., Ota, T., & Takazawa, Y. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1713901 · Cited by 1
“For instance, professional athletes face anxieties directly linked to livelihood, contracts, and intense public scrutiny, which may manifest differently than the academic and athletic pressures faced by university athletes (Li et al., 2021; Rice et al., 2016).”
Mulla, M., Langaliya, A. K., Jawahar, A., Mulla, M., Galletti, C., Mathur, A. S., & Fiorillo, L. (2026) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000012176 · Cited by 1
Ji, T., JONGE, J. D., Peeters, M. C. W., & Taris, T. W. (2026) · Humanities and Social Sciences Communications · doi:10.1057/s41599-026-06541-4 · Cited by 1
“…athletes with higher levels of cognitive liveliness are more likely to exhibit positive work-related behaviors, such as increased task performance (Rice et al., 2016; Yongtawee et al., 2022), greater effort in their job tasks (Balk and De Jonge, 2021), and a proactive approach to challenges (Rice…”
Kara, M., Genç, M., Talaghir, L.-G., Benţea, C. C., Olaru, B. S., & Ivan, P. (2026) · Behavioral Sciences · doi:10.3390/bs16020205 · Cited by 1
“Recent research has highlighted that athletes, despite perceptions of high mental fortitude, are susceptible to depressive symptoms, which can directly impair cognitive functions crucial for performance, such as attention and decision-making (Gouttebarge et al., 2015; Rice et al., 2016).”
Stressed minds, altered strategies: Acute stress impairs proactive control in table tennis athletes
Xu, L., Peng, Z., Lian, J., Gong, X., Shao, Y., Han, M., & Jiao, F. (2026) · Brain Research Bulletin · doi:10.1016/j.brainresbull.2026.111766 · Cited by 1
Mansell, P. C., Clark, K., Brookes, J., Wright, J., Westley, S., Sparks, K. V., & Slater, M. J. (2026) · Psychology International · doi:10.3390/psycholint8010009 · Cited by 1
“However, athletes are still prone to symptoms of mental ill health and mental illness (Rice et al., 2016), with an estimate of 34% of athletes experiencing anxiety or depression (Gouttebarge et al., 2019), while some studies report that these figures can be even higher (e.g., 46.4% in Gulliver et…”
Influential
Metadata
- Authors
- Rice, S. M., Purcell, R., De Silva, S., Mawren, D., McGorry, P. D., & Parker, A. G.
- Affiliations
- The University of Melbourne (AU)
- Orygen (AU)
- Corresponding author
- Rice, Simon M.
- Venue
- Sports Medicine
- Published
- 2016-02-20
- Volume
- 46
- Issue
- 9
- Pages
- 1333-1353
- ISSN
- 0112-1642 (ISSN-L)
- 1179-2035
- PMC
- PMC4996886
- OpenAlex
- W2278084024
- Cited by
- 1,205
- References
- 110
- Citations by year
- 2026: 175 · 2025: 161 · 2024: 157 · 2023: 148 · 2022: 155 · 2021: 129 · 2020: 105 · 2019: 74 · 2018: 64 · 2017: 27 · 2016: 10
- FWCI
- 10.78
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Sports Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Victoria University Research Repository (Victoria University) (submittedVersion, cc-by)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- Swinburne figshare (Swinburne University of Technology) (submittedVersion, cc-by)
- Funders
- Society for Mental Health Research (Early Career Fellowship)
- Topics
- Social Sciences › Psychology › Developmental and Educational Psychology › Sport Psychology and Performance
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- elite athletes, mental health, psychological well-being, anxiety, depression, eating disorders, substance use, stress coping, burnout, overtraining, injuries, mental health interventions
- MeSH terms
- Adaptation, Psychological, Anxiety, Feeding and Eating Disorders, Competitive Behavior, Depression, Humans, Mental Health, Risk Factors, Stress, Psychological, Incidence, Substance-Related Disorders, Athletes
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