ObjectivesFew epidemiological studies have focused on the psychological health of high level athletes. This study aimed to identify the principal psychological problems encountered within French high level athletes, and the variations in their prevalence based on sex and the sport practiced.MethodsMultivariate analyses were conducted on nationwide data obtained from the athletes' yearly psychological evaluations.ResultsA representative sample of 13% of the French athlete population was obtained. 17% of athletes have at least one ongoing or recent disorder, generalized anxiety disorder (GAD) being the most prevalent (6%), followed by non-specific eating disorders (4.2%). Overall, 20.2% of women had at least one psychopathology, against 15.1% in men. This female predominance applied to anxiety and eating disorders, depression, sleep problems and self-harming behaviors. The highest rates of GAD appeared in aesthetic sports (16.7% vs. 6.8% in other sports for men and 38.9% vs. 10.3% for women); the lowest prevalence was found in high risk sports athletes (3.0% vs. 3.5%). Eating disorders are most common among women in racing sports (14% vs. 9%), but for men were found mostly in combat sports (7% vs. 4.8%).DiscussionThis study highlights important differences in psychopathology between male and female athletes, demonstrating that the many sex-based differences reported in the general population apply to elite athletes. While the prevalence of psychological problems is no higher than in the general population, the variations in psychopathology in different sports suggest that specific constraints could influence the development of some disorders.

Background-Although such data are available for young competitive athletes, the prevalence, characteristics, and outcome of sports-related sudden death have not been assessed previously in the general population. Methods and Results-A prospective and comprehensive national survey was performed throughout France from 2005 to 2010, involving subjects 10 to 75 years of age. Case detection for sports-related sudden death, including resuscitated cardiac arrest, was undertaken via national ambulance service reporting and Web-based screening of media releases. The overall burden of sports-related sudden death was 4.6 cases per million population per year, with 6% of cases occurring in young competitive athletes. Sensitivity analyses used to address suspected underreporting demonstrated an incidence ranging from 5 to 17 new cases per million population per year. More than 90% of cases occurred in the context of recreational sports. The age of subjects was relatively young (meanϮSD 46Ϯ15 years), with a predominance of men (95%). Although most cases were witnessed (93%), bystander cardiopulmonary resuscitation was only commenced in 30.7% of cases. Bystander cardiopulmonary resuscitation (odds ratio 3.73, 95% confidence interval 2.19 to 6.39, PϽ0.0001) and initial use of cardiac defibrillation (odds ratio 3.71, 95% confidence interval 2.07 to 6.64, PϽ0.0001) were the strongest independent predictors for survival to hospital discharge (15.7%, 95% confidence interval 13.2% to 18.2%). Conclusions-Sports-related sudden death in the general population is considerably more common than previously suspected. Most cases are witnessed, yet bystander cardiopulmonary resuscitation was only initiated in one third of cases. Given the often predictable setting of sports-related sudden death and that prompt interventions were significantly associated with improved survival, these data have implications for health services planning. (Circulation. 2011;124: 672-681.)Key Words: arrhythmia Ⅲ cardiac arrest Ⅲ athletes Ⅲ cardiopulmonary resuscitation Ⅲ defibrillation Ⅲ bystander help Ⅲ exercise, physical A lthough regular physical activity benefits cardiovascular health, 1 sport, particularly when practiced vigorously, has been shown to increase the risk of dying suddenly during or shortly after exercise. 2,3 The devastating consequences of unexpected sports-related sudden death (SD) and the recent availability of public access defibrillation mandate a thorough understanding of this phenomenon across the general population. 4 -6 To date, the large majority of data regarding sports-related SD have focused on young competitive athletes, 7,8 whereas literature on sports-related SD during recreational sports activities in the community remains sparse. 9,10 No prospective evaluation of sports-related SD in the general population, including young competitive athletes, has been published to date. Clinical Perspective on p 681Sports-related SDs in young competitive athletes are highly visible and usually attract considerable public and media atten...