Bipolar and psychotic disorders in elite athletes: a narrative review

Currie, Alan; Gorczynski, Paul; Rice, Simon; Purcell, Rosemary; McAllister-Williams, R. Hamish; Hitchcock, Mary; Hainline, Brian; Reardon, Claudia L.

doi:10.1136/bjsports-2019-100685

Cited by 45 publications

(23 citation statements)

References 84 publications

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“…A partial AIMS examination can be conducted via virtual video appointment, but full implementation would require in-person visits at periodic intervals 34 and would be recommended for elite athletes, whose careers would be impacted by movement disorder side effects of medications. 24…”

Section: Medications For Bipolar and Psychotic Disordersmentioning

confidence: 99%

Mental health management of elite athletes during COVID-19: a narrative review and recommendations

Bindra²,

et al. 2020

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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.

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Section: Medications For Bipolar and Psychotic Disordersmentioning

confidence: 99%

Mental health management of elite athletes during COVID-19: a narrative review and recommendations

Bindra²,

et al. 2020

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“…Bipolar disorders are characterised by episodes of extreme changes in mood (e.g., mania or depressed mood) and associated functional impairment (Currie, Gorczynski, et al, 2019). Psychotic disorders (e.g., schizophrenia) are characterised by symptoms such as delusions and hallucinations .…”

Section: Bipolar and Psychotic Disordersmentioning

confidence: 99%

“…Psychotic disorders (e.g., schizophrenia) are characterised by symptoms such as delusions and hallucinations . Whilst much is known about bipolar and psychotic disorders in the general population little is known about their prevalence and impact in athletes, however, there are anecdotal reports of athletes having such conditions and as the peak age of onset crosses over with the peak age of performance in most sports they are a consideration (Currie, Gorczynski, et al, 2019). These conditions are likely to have a significant impact on sports performance as the conditions are often chronic and the symptoms enduring, although, some athletes have had successful sports careers despite this .…”

Section: Bipolar and Psychotic Disordersmentioning

confidence: 99%

“…These conditions are likely to have a significant impact on sports performance as the conditions are often chronic and the symptoms enduring, although, some athletes have had successful sports careers despite this . Bipolar and psychotic disorders can be categorised as primary or secondary, with secondary often induced through substance abuse (Currie, Gorczynski, et al, 2019). Currie, Gorczynski, et al (2019) report that the prevalence of bipolar disorder in the general population is 0.4-0.6% and 0.5% for psychotic disorders.…”

Section: Bipolar and Psychotic Disordersmentioning

confidence: 99%

“…Bipolar and psychotic disorders can be categorised as primary or secondary, with secondary often induced through substance abuse (Currie, Gorczynski, et al, 2019). Currie, Gorczynski, et al (2019) report that the prevalence of bipolar disorder in the general population is 0.4-0.6% and 0.5% for psychotic disorders.…”

Section: Bipolar and Psychotic Disordersmentioning

confidence: 99%

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Understanding Mental Health and Wellbeing in Sport

Heaney¹

2021

Athletic Development

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According to the World Health Organisation (2018) mental health can be defined as "a state of wellbeing in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community". This definition acknowledges that mental health is more than the absence of mental disorders (Galderisi et al., 2015) and shows that sport can potentially create situations that challenge mental health where, for example, the athlete is unable to cope with the stresses of training and competition. As the quote from Kelly Holmes demonstrates athletes, like all members of society, can be affected by mental health difficulties. Mental health is perhaps best conceptualised as a continuum ranging from negative (ill health) to positive (good health/mental wealth; Kuettel & Larsen, 2019), where both clinically diagnosed mental health disorders and sub-clinical symptoms can have an impact on an individual's quality of life. Indeed, research has explored both clinical and sub-clinical symptoms in athletes and consequently throughout this chapter the term mental health difficulties is used to describe both clinically diagnosed mental health conditions and sub-clinical symptoms. The chapter explores the mental health of athletes by examining the prevalence of mental health difficulties in athletes, the mental health difficulties that can affect athletes, why athletes might be vulnerable to these, how they can be prevented or treated, and how positive mental health and wellbeing can be promoted in sporting environments. This will be further explored in Chapters 12-14 which investigate resilience, thriving, and athlete welfare which are all closely allied to mental health.

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Anabolic androgenic steroids used as performance and image enhancing drugs in professional and amateur athletes: Toxicological and psychopathological findings

Piacentino

Sani

Kotzalidis

et al. 2021

Human Psychopharmacology

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Objective: The use of anabolic androgenic steroids (AASs) as performance and image enhancing drugs (PIEDs), once restricted to professional athletes, now includes amateurs and regular gym visitors. AAS use is associated with psychopathology, yet this relationship is complex and not fully understood. We aimed to assess the presence of AASs and other misused substances in athletes' biological samples and link toxicological to psychopathological findings. Methods: A multicentre, cross-sectional study in fitness centres in Italy recruited 122 professional and amateur athletes training in several sports (84 men; age range = 18-45 years). Athletes completed questionnaires, interviews, and toxicology testing for AASs, other PIEDs, illicit drugs, and non-prescribed psychotropics.Toxicology was conducted in blood, urine, and hair.Results: Self-reported and toxicologically detected use rates of AASs and other misused substances showed slight-to-fair agreement (Fleiss' κ = 0.104-0.375). There was slight-to-moderate agreement among the three biological samples used for AAS testing (κ = 0.112-0.436). Thirty-one athletes (25.4%) tested positive for AASs.More sport hours/week, narcissistic or antisocial personality disorders, and higher Daria Piacentino and Gabriele Sani are the co-first authors.

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Bipolar and psychotic disorders in elite athletes: a narrative review

Cited by 45 publications

References 84 publications

Mental health management of elite athletes during COVID-19: a narrative review and recommendations

Mental health management of elite athletes during COVID-19: a narrative review and recommendations

Understanding Mental Health and Wellbeing in Sport

Anabolic androgenic steroids used as performance and image enhancing drugs in professional and amateur athletes: Toxicological and psychopathological findings

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