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Mental health management of elite athletes during COVID-19: a narrative review and recommendations
Reardon, Claudia L; Bindra, Abhinav; Blauwet, Cheri; Budgett, Richard; Campriani, Niccolo; Currie, Alan; Gouttebarge, Vincent; McDuff, David; Mountjoy, Margo; Purcell, Rosemary; Putukian, Margot; Rice, Simon; Hainline, Brian
Elite athletes suffer many mental health symptoms and disorders at rates equivalent to or exceeding those of the general population. COVID-19 has created new strains on elite athletes, thus potentially increasing their vulnerability to mental health symptoms. This manuscript serves as a narrative review of the impact of the pandemic on management of those symptoms in elite athletes and ensuing recommendations to guide that management. It specifically addresses psychotherapy, pharmacotherapy and higher levels of care. Within the realm of psychotherapy, crisis counselling might be indicated. Individual, couple/family and group psychotherapy modalities all may be helpful during the pandemic, with novel content and means of delivery. Regarding pharmacotherapy for mental health symptoms and disorders, some important aspects of management have changed during the pandemic, particularly for certain classes of medication including stimulants, medications for bipolar and psychotic disorders, antidepressants and medications for substance use disorders. Providers must consider when in-person management (eg, for physical examination, laboratory testing) or higher levels of care (eg, for crisis stabilisation) is necessary, despite potential risk of viral exposure during the pandemic. Management ultimately should continue to follow general principles of quality health care with some flexibility. Finally, the current pandemic provides an important opportunity for research on new methods of providing mental health care for athletes, and consideration for whether these new methods should extend beyond the pandemic.
PMID: 32967853
ISSN: 1473-0480
CID: 4606542
Preventing catastrophic injury and death in collegiate athletes: interassociation recommendations endorsed by 13 medical and sports medicine organisations
Parsons, John T; Anderson, Scott A; Casa, Douglas J; Hainline, Brian
The Second Safety in College Football Summit resulted in interassociation consensus recommendations for three paramount safety issues in collegiate athletics: (1) independent medical care for collegiate athletes; (2) diagnosis and management of sport-related concussion; and (3) year-round football practice contact for collegiate athletes. This document, the fourth arising from the 2016 event, addresses the prevention of catastrophic injury, including traumatic and non-traumatic death, in collegiate athletes. The final recommendations in this document are the result of presentations and discussions on key items that occurred at the summit. After those presentations and discussions, endorsing organisation representatives agreed on 18 foundational statements that became the basis for this consensus paper that has been subsequently reviewed by relevant stakeholders and endorsing organisations. This is the final endorsed document for preventing catastrophic injury and death in collegiate athletes. This document is divided into the following components. (1) Background-this section provides an overview of catastrophic injury and death in collegiate athletes. (2) Interassociation recommendations: preventing catastrophic injury and death in collegiate athletes-this section provides the final recommendations of the medical organisations for preventing catastrophic injuries in collegiate athletes. (3) Interassociation recommendations: checklist-this section provides a checklist for each member school. The checklist statements stem from foundational statements voted on by representatives of medical organisations during the summit, and they serve as the primary vehicle for each member school to implement the prevention recommendations. (4) References-this section provides the relevant references for this document. (5) Appendices-this section lists the foundational statements, agenda, summit attendees and medical organisations that endorsed this document.
PMID: 31537549
ISSN: 1473-0480
CID: 4175212
Infographic. Sleep disorders in athletes
Reardon, Claudia L; Hainline, Brian; Aron, Cindy Miller; Baron, David; Baum, Antonia L; Bindra, Abhinav; Budgett, Richard; Campriani, Niccolo; Castaldelli-Maia, João Mauricio; Currie, Alan; Derevensky, Jeffrey Lee; Glick, Ira D; Gorczynski, Paul; Gouttebarge, Vincent; Grandner, Michael A; Han, Doug Hyun; McDuff, David; Mountjoy, Margo; Polat, Aslihan; Purcell, Rosemary; Putukian, Margot; Rice, Simon M; Sills, Allen; Stull, Todd; Swartz, Leslie; Zhu, Li Jing; Engebretsen, Lars
PMID: 31227492
ISSN: 1473-0480
CID: 4174482
Administering mental health: Societal, coaching, and legislative approaches to mental health
Chapter by: Kroshus, Emily; Hainline, Brian
in: Mental Health in the Athlete: Modern Perspectives and Novel Challenges for the Sports Medicine Provider by
[S.l.] : Springer International Publishing, 2020
pp. 245-259
ISBN: 9783030447533
CID: 4579582
Infographic: Mental health in elite athletes. An IOC consensus statement
Reardon, Claudia L; Hainline, Brian; Aron, Cindy Miller; Baron, David; Baum, Antonia L; Bindra, Abhinav; Budgett, Richard; Campriani, Niccolo; Castaldelli-Maia, João Mauricio; Currie, Alan; Derevensky, Jeffrey Lee; Glick, Ira D; Gorczynski, Paul; Gouttebarge, Vincent; Grandner, Michael A; Han, Doug Hyun; McDuff, David; Mountjoy, Margo; Polat, Aslihan; Purcell, Rosemary; Putukian, Margot; Rice, Simon M; Sills, Allen; Stull, Todd; Swartz, Leslie; Zhu, Li Jing; Engebretsen, Lars
PMID: 31308063
ISSN: 1473-0480
CID: 4174742
Early Sport Specialization: Shifting Societal Norms [Editorial]
Hainline, Brian
PMCID:6805060
PMID: 31633422
ISSN: 1938-162x
CID: 4165392
Determinants of anxiety in elite athletes: a systematic review and meta-analysis
Rice, Simon M; Gwyther, Kate; Santesteban-Echarri, Olga; Baron, David; Gorczynski, Paul; Gouttebarge, Vincent; Reardon, Claudia L; Hitchcock, Mary E; Hainline, Brian; Purcell, Rosemary
OBJECTIVE:To identify and quantify determinants of anxiety symptoms and disorders experienced by elite athletes. DESIGN/METHODS:Systematic review and meta-analysis. DATA SOURCES/METHODS:Five online databases (PubMed, SportDiscus, PsycINFO, Scopus and Cochrane) were searched up to November 2018 to identify eligible citations. ELIGIBILITY CRITERIA FOR SELECTING STUDIES/UNASSIGNED:Articles were included if they were published in English, were quantitative studies and measured a symptom-level anxiety outcome in competing or retired athletes at the professional (including professional youth), Olympic or collegiate/university levels. RESULTS AND SUMMARY/UNASSIGNED:=0.26)-higher anxiety in athletes who had experienced one or more recent adverse life events. CONCLUSION/CONCLUSIONS:Determinants of anxiety in elite populations broadly reflect those experienced by the general population. Clinicians should be aware of these general and athlete-specific determinants of anxiety among elite athletes.
PMCID:6579501
PMID: 31097452
ISSN: 1473-0480
CID: 4174082
Bipolar and psychotic disorders in elite athletes: a narrative review
Currie, Alan; Gorczynski, Paul; Rice, Simon M; Purcell, Rosemary; McAllister-Williams, R Hamish; Hitchcock, Mary E; Hainline, Brian; Reardon, Claudia L
Bipolar and psychotic disorders are relatively common and likely to have a significant impact on quality of life and functioning which, in the context of elite sport, includes a potential negative impact on sporting performance. For this narrative review article, the literature on bipolar and psychotic disorders in elite athletes was comprehensively searched, and little empirical research was found. A diagnosis of bipolar or psychotic disorders may be challenging in elite athletes because of complicating factors related to the modifying role of exercise and potential precipitating impact of substance use. Medications used to treat bipolar and psychotic disorders may have side effects particularly problematic for elite athletes. Future research should be tailored to the specific characteristics and needs of elite athletes and to the sporting context in which the disorders may arise. Specifically, further research is needed on the prevalence and incidence of these conditions in elite athletes and the impact of both the disorders and their treatments on sporting performance.
PMID: 31097458
ISSN: 1473-0480
CID: 4174102
Recreational and ergogenic substance use and substance use disorders in elite athletes: a narrative review
McDuff, David; Stull, Todd; Castaldelli-Maia, João Mauricio; Hitchcock, Mary E; Hainline, Brian; Reardon, Claudia L
BACKGROUND:Substances from various classes may be used for recreational purposes, self-treatment or to boost performance. When substance use shifts from occasional to regular, heavy or hazardous use, positive and negative effects can develop that vary by substance class and athlete. Regular use of recreational or performance enhancing substances can lead to misuse, sanctions or use disorders. OBJECTIVE:To review the prevalence, patterns of use, risk factors, performance effects and types of intervention for all classes of recreational and performance enhancing substances in elite athletes by sport, ethnicity, country and gender. METHODS:A comprehensive search was conducted to identify studies that compared the prevalence and patterns of substance use, misuse and use disorders in elite athletes with those of non-athletes and provided detailed demographic and sport variations in reasons for use, risk factors and performance effects for each main substance class. RESULTS:Alcohol, cannabis, tobacco (nicotine) and prescribed opioids and stimulants are the most commonly used substances in elite athletes, but generally used at lower rates than in non-athletes. In contrast, use/misuse rates for binge alcohol, oral tobacco, non-prescription opioids and anabolic-androgenic steroids are higher among athletes than non-athletes, especially in power and collision sports. Cannabis/cannabinoids seem to have replaced nicotine as the second most commonly used substance. CONCLUSIONS:Substance use in elite athletes varies by country, ethnicity, gender, sport and competitive level. There are no studies on substance use disorder prevalence in elite male and female athletes and few studies with direct comparison groups.
PMID: 31097457
ISSN: 1473-0480
CID: 4174092
Management of mental health emergencies in elite athletes: a narrative review
Currie, Alan; McDuff, David; Johnston, Allan; Hopley, Phil; Hitchcock, Mary E; Reardon, Claudia L; Hainline, Brian
Mental health emergencies require a rapid, effective response. We searched the literature on mental health emergencies in athletes and found five papers. None of these addressed elite athletes. Nonetheless, common mental health emergencies may present in the sports environment and may place the athlete and others at risk. Sports teams and organisations should anticipate which emergencies are likely and how medical and support staff can best respond. Responses should be based on general non-sporting guidelines. We stress the importance of clinicians following standard procedures.
PMID: 31097462
ISSN: 1473-0480
CID: 4174142