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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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“Trotz methodischer Einschränkungen weisen die beschriebenen Studien bei Leistungssportlern insgesamt auf ein der Allgemeinbevölkerung entsprechendes Risiko für 36 DNP – Der Neurologe & Psychiater 2017; 18 (11-12) Fortbildung psychische Erkrankungen hin.”
BackgroundInfluentialEhlers, N., & Eichenberg, C. (2017) · Sigmund Freud PrivatUniversität Wien (SFU) · doi:10.15135/2017.5.2.63-81
“Im Leistungssport gilt der fortlaufende Wettbewerbsdruck als zentraler Stressor (Rice et al., 2016).”
BackgroundPsychological ill-being in athletes: The role of perfectionism within the football environment
Smith, E. P. (2017) · White Rose eTheses Online (University of Leeds, The University of Sheffield, University of York)
Jacobs, K. (2018) · Scholarship@Western (Western University)
Rúbio, K., Costa, M. R. L., & Lima, L. T. (2018) · Revista Brasileira de Psicologia do Esporte · doi:10.31501/rbpe.v8i2.9531
A longitudinal examination of the motivation and mental health of elite athletes
Sheehan, R. B. (2018) · University of Limerick Institutional Repository (University of Limerick) · doi:10.34961/5974
Spindler, D. J. (2018) · Research Online (University of Wollongong)
Changes in Athletes’ Psycho-Emotional Stress in the Course of Annual Macrocycle
Gamzin, M. A., Петрович, Б. К., Савченко, А. А., & Kakukhin, A. D. (2019) · Journal of Siberian Federal University Humanities & Social Sciences · doi:10.17516/1997-1370-0436
What sporting factors have an impact on the mood of male professional athletes
White, S. A. (2019) · White Rose eTheses Online (University of Leeds, The University of Sheffield, University of York)
Retired Female Gymnasts' Reflections on Body Image and Sense of Self
Casanova, B. (2019) · doi:10.31390/gradschool_theses.4993
“…image perspectives being positively influenced and perhaps protected them from the aforementioned detriments such as depression, anxiety and identity loss/confusion associated with early stages of sport retirement (Haase et al., 2002; Nordin et al., 2003; Rice et al., 2016; Rudd & Carter, 2006).”
BackgroundInfluentialPromotion of mental health referral efficacy in college athletic trainers
Dettl, M. G. (2019) · NC Digital Online Collection of Knowledge and Scholarship (The University of North Carolina at Greensboro)
Innovation of Self-service System of College Mental Health in the Age of Big Data
Zhang, T., & Xu, C. (2020) · Advances in intelligent systems and computing · doi:10.1007/978-981-15-2568-1_59
Connaughton, E. (2019) · Arrow@dit (Dublin Institute of Technology)
Kearns, M. L. (2017) · University of Limerick Institutional Repository (University of Limerick) · doi:10.13140/rg.2.2.23989.12002
Rogers, T., Larkin, J., & Cavaday, N. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108767187.012
Athletics: Energy Levels, Exercise Addiction and Disordered Eating
Dudgeon, E., McGregor, R., & Robinson, R. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108767187.004
American Football: Cognitive Impairment
McCabe, T., Stewart, W., Pandya, M. A., Kasper, J., & Sanders, S. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108767187.003
Football: Alcohol and Barriers to Support
Mistry, A., Peters, S., Chatterjee, R., & Cotterill, D. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108767187.008
Golf: Alcohol, Anxiety and Sleep Problems
Creado, S., Hopley, P., Murray, A., & Hull, M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108767187.009
Cricket: Mental Health Emergencies
Mahmood, H., Hopley, P., & Foster, P. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108767187.006
Johnston, A., Al-Dawoud, M., & Pattinson, C. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108767187.005
Rugby: Concussion and Mental Health Symptoms
McCabe, T., Lester, C., Kemp, S. P. T., & Vickerman, R. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108767187.010
Addressing the context and make up of mental health issues in high-performing athletes
Lebrun, F. (2020) · CLOK (University of Central Lancashire)
Assessing the level of well-being in individuals practicing sport
Pieniążek, M., Mańko, G., Sosulska, A., Jaszczur-Nowicki, J., Lozinska, I., & Jarząbek, B. (2020) · Rehabilitacja Medyczna · doi:10.5604/01.3001.0014.2672
Langlois-Pelletier, N., Verret, C., & Massé, L. (2020) · Revue de psychoéducation · doi:10.7202/1073995ar
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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