Skip to main content
Top
Published in: European Archives of Psychiatry and Clinical Neuroscience 2/2013

01-11-2013 | Review

Sport specificity of mental disorders: the issue of sport psychiatry

Authors: Karl-Jürgen Bär, Valentin Z. Markser

Published in: European Archives of Psychiatry and Clinical Neuroscience | Special Issue 2/2013

Login to get access

Abstract

The prevalence of psychiatric conditions among elite athletes is still under debate. More and more evidence has accumulated that high-performance athletes are not protected from mental disorders as previously thought. The authors discuss the issue of the sport specificity of selected mental diseases in elite athletes. Specific aspects of eating disorders, exercise addiction, chronic traumatic encephalopathy and mood disorders in the context of overtraining syndrome are examined. In particular, the interrelationship between life and work characteristics unique to elite athletes and the development of mental disorders are reviewed. Differences of clinical presentation and some therapeutic consequences are discussed. The authors suggest that the physical and mental strains endured by elite athletes might influence the onset and severity of their psychiatric disorder. Beside the existing research strategies dealing with the amount of exercise, its intensity and lack of recreation experienced by athletes, further research on psycho-social factors is needed to better understand the sport-specific aetiology of mental disorders in high-performance athletes.
Literature
1.
go back to reference Allegre B, Souville M, Therme P, Griffiths M (2006) Definitions and measures of exercise dependence. Addict Res Theory 14:631–644CrossRef Allegre B, Souville M, Therme P, Griffiths M (2006) Definitions and measures of exercise dependence. Addict Res Theory 14:631–644CrossRef
2.
go back to reference Armstrong LE, VanHeest JL (2002) The unknown mechanism of the overtraining syndrome: clues from depression and psychoneuroimmunology. Sports Med 32:185–209PubMedCrossRef Armstrong LE, VanHeest JL (2002) The unknown mechanism of the overtraining syndrome: clues from depression and psychoneuroimmunology. Sports Med 32:185–209PubMedCrossRef
3.
go back to reference Babiss LA, Gangwisch JE (2009) Sports participation as a protective factor against depression and suicidal ideation in adolescents as mediated by self-esteem and social support. J Dev Behav Pediatr (JDBP) 30:376–384CrossRef Babiss LA, Gangwisch JE (2009) Sports participation as a protective factor against depression and suicidal ideation in adolescents as mediated by self-esteem and social support. J Dev Behav Pediatr (JDBP) 30:376–384CrossRef
4.
go back to reference Barrack MT, Ackerman KE, Gibbs JC (2013) Update on the female athlete triad. Curr Rev Musculoskelet Med 6:195–204PubMedCrossRef Barrack MT, Ackerman KE, Gibbs JC (2013) Update on the female athlete triad. Curr Rev Musculoskelet Med 6:195–204PubMedCrossRef
5.
go back to reference Beals KA, Manore MM (1994) The prevalence and consequences of subclinical eating disorders in female athletes. Int J Sport Nutr 4:175–195PubMed Beals KA, Manore MM (1994) The prevalence and consequences of subclinical eating disorders in female athletes. Int J Sport Nutr 4:175–195PubMed
6.
go back to reference Begel D (2000) Family systems-based treatment of the athlete family. W.W. Norton, New York Begel D (2000) Family systems-based treatment of the athlete family. W.W. Norton, New York
7.
go back to reference Begel D (1992) An overview of sport psychiatry. Am J Psychiatry 149:606–614PubMed Begel D (1992) An overview of sport psychiatry. Am J Psychiatry 149:606–614PubMed
8.
go back to reference Berglund L, Sundgot-Borgen J, Berglund B (2011) Adipositas athletica: a group of neglected conditions associated with medical risks. Scand J Med Sci Sports 21:617–624PubMedCrossRef Berglund L, Sundgot-Borgen J, Berglund B (2011) Adipositas athletica: a group of neglected conditions associated with medical risks. Scand J Med Sci Sports 21:617–624PubMedCrossRef
9.
go back to reference Bonci CM, Bonci LJ, Granger LR, Johnson CL, Malina RM, Milne LW, Ryan RR, Vanderbunt EM (2008) National athletic trainers’ association position statement: preventing, detecting, and managing disordered eating in athletes. J Athl Train 43:80–108PubMedCrossRef Bonci CM, Bonci LJ, Granger LR, Johnson CL, Malina RM, Milne LW, Ryan RR, Vanderbunt EM (2008) National athletic trainers’ association position statement: preventing, detecting, and managing disordered eating in athletes. J Athl Train 43:80–108PubMedCrossRef
10.
go back to reference Byrne S, McLean N (2001) Eating disorders in athletes: a review of the literature. J Sci Med Sport 4:145–159PubMedCrossRef Byrne S, McLean N (2001) Eating disorders in athletes: a review of the literature. J Sci Med Sport 4:145–159PubMedCrossRef
11.
go back to reference Byrne S, McLean N (2002) Elite athletes: effects of the pressure to be thin. J Sci Med Sport/Sports Med Aust 5:80–94CrossRef Byrne S, McLean N (2002) Elite athletes: effects of the pressure to be thin. J Sci Med Sport/Sports Med Aust 5:80–94CrossRef
12.
go back to reference Calhoun JW, Ogilvie BC, Hendrickson TP, Fritz GK (1998) The psychiatric consultant in professional team sports. Child Adolesc Psychiatr Clin N Am 7:791–802PubMed Calhoun JW, Ogilvie BC, Hendrickson TP, Fritz GK (1998) The psychiatric consultant in professional team sports. Child Adolesc Psychiatr Clin N Am 7:791–802PubMed
13.
14.
go back to reference Costanza A, Weber K, Gandy S, Bouras C, Hof PR, Giannakopoulos P, Canuto A (2011) Review: contact sport-related chronic traumatic encephalopathy in the elderly: clinical expression and structural substrates. Neuropathol Appl Neurobiol 37:570–584PubMedCrossRef Costanza A, Weber K, Gandy S, Bouras C, Hof PR, Giannakopoulos P, Canuto A (2011) Review: contact sport-related chronic traumatic encephalopathy in the elderly: clinical expression and structural substrates. Neuropathol Appl Neurobiol 37:570–584PubMedCrossRef
15.
go back to reference Davis JM (1995) Carbohydrates, branched-chain amino acids, and endurance: the central fatigue hypothesis. Int J Sport Nutr 5:S29–S38PubMed Davis JM (1995) Carbohydrates, branched-chain amino acids, and endurance: the central fatigue hypothesis. Int J Sport Nutr 5:S29–S38PubMed
16.
go back to reference Freimuth M, Moniz S, Kim SR (2011) Clarifying exercise addiction: differential diagnosis, co-occurring disorders, and phases of addiction. Int J Environ Res Public Health 8:4069–4081PubMedCrossRef Freimuth M, Moniz S, Kim SR (2011) Clarifying exercise addiction: differential diagnosis, co-occurring disorders, and phases of addiction. Int J Environ Res Public Health 8:4069–4081PubMedCrossRef
17.
go back to reference Glick ID, Horsfall JL (2009) Psychiatric conditions in sports: diagnosis, treatment, and quality of life. Physician Sportsmedicine 37:29–34PubMedCrossRef Glick ID, Horsfall JL (2009) Psychiatric conditions in sports: diagnosis, treatment, and quality of life. Physician Sportsmedicine 37:29–34PubMedCrossRef
18.
go back to reference Greiner E, Arndt KH (2004) Der erste sportärztliche kongress 1912—programm für ein jahrhundert. Deutsche Zeitschrift für Sportmedizin 55:314 Greiner E, Arndt KH (2004) Der erste sportärztliche kongress 1912—programm für ein jahrhundert. Deutsche Zeitschrift für Sportmedizin 55:314
19.
go back to reference Guskiewicz KM, Marshall SW, Bailes J, McCrea M, Harding HP Jr, Matthews A, Mihalik JR, Cantu RC (2007) Recurrent concussion and risk of depression in retired professional football players. Med Sci Sports Exerc 39:903–909PubMedCrossRef Guskiewicz KM, Marshall SW, Bailes J, McCrea M, Harding HP Jr, Matthews A, Mihalik JR, Cantu RC (2007) Recurrent concussion and risk of depression in retired professional football players. Med Sci Sports Exerc 39:903–909PubMedCrossRef
20.
go back to reference Hammond T, Gialloreto C, Kubas H, Davis HH (2013) The prevalence of failure-based depression among elite athletes. Clin J Sport Med Off J Can Acad Sport Med 23:273–277CrossRef Hammond T, Gialloreto C, Kubas H, Davis HH (2013) The prevalence of failure-based depression among elite athletes. Clin J Sport Med Off J Can Acad Sport Med 23:273–277CrossRef
21.
go back to reference Hausenblas HA, Giacobbi PR (2004) Relationship between exercise dependence symptoms and personality. Pers Individ Differ 36:1265–1273CrossRef Hausenblas HA, Giacobbi PR (2004) Relationship between exercise dependence symptoms and personality. Pers Individ Differ 36:1265–1273CrossRef
22.
go back to reference Herholz K, Buskies W, Rist M, Pawlik G, Hollmann W, Heiss WD (1987) Regional cerebral blood flow in man at rest and during exercise. J Neurol 234:9–13PubMedCrossRef Herholz K, Buskies W, Rist M, Pawlik G, Hollmann W, Heiss WD (1987) Regional cerebral blood flow in man at rest and during exercise. J Neurol 234:9–13PubMedCrossRef
23.
go back to reference Hoyer J, Kleinert J (2010) Leistungssport und psychische Störungen. Psychotherapeutenjournal 3:252–260 Hoyer J, Kleinert J (2010) Leistungssport und psychische Störungen. Psychotherapeutenjournal 3:252–260
24.
go back to reference Iverson GL, Gaetz M, Lovell MR, Collins MW (2004) Cumulative effects of concussion in amateur athletes. Brain Injury [BI] 18:433–443CrossRef Iverson GL, Gaetz M, Lovell MR, Collins MW (2004) Cumulative effects of concussion in amateur athletes. Brain Injury [BI] 18:433–443CrossRef
25.
go back to reference Johnson C, Powers PS, Dick R (1999) Athletes and eating disorders: the national collegiate athletic association study. Int J Eat Disord 26:179–188PubMedCrossRef Johnson C, Powers PS, Dick R (1999) Athletes and eating disorders: the national collegiate athletic association study. Int J Eat Disord 26:179–188PubMedCrossRef
26.
go back to reference Jokl E, Guttmann E (1932) Psychiatrisch-neurologische kasuistik aus der sportärztlichen praxis. Zeitschrift für die gesamte Neurologie und Psychiatrie 141:153–161CrossRef Jokl E, Guttmann E (1932) Psychiatrisch-neurologische kasuistik aus der sportärztlichen praxis. Zeitschrift für die gesamte Neurologie und Psychiatrie 141:153–161CrossRef
28.
go back to reference Kreider RB (1998) Central fatigue hypothesis and overtraining. In: Kreider RB, Fry AC, O’Toole ML (eds) Overtraining in sport. Human Kinetics, Champaign, IL, pp 309–334 Kreider RB (1998) Central fatigue hypothesis and overtraining. In: Kreider RB, Fry AC, O’Toole ML (eds) Overtraining in sport. Human Kinetics, Champaign, IL, pp 309–334
30.
go back to reference Markser VZ (2011) Sport psychiatry and psychotherapy. Mental strains and disorders in professional sports. Challenge and answer to societal changes. Eur Arch Psychiatry Clin Neurosci 261(Suppl 2):S182–S185PubMedCrossRef Markser VZ (2011) Sport psychiatry and psychotherapy. Mental strains and disorders in professional sports. Challenge and answer to societal changes. Eur Arch Psychiatry Clin Neurosci 261(Suppl 2):S182–S185PubMedCrossRef
32.
go back to reference McCrory P (2013) Traumatic brain injury: revisiting the AAN guidelines on sport-related concussion. Nat Rev Neurol 9:361–362PubMedCrossRef McCrory P (2013) Traumatic brain injury: revisiting the AAN guidelines on sport-related concussion. Nat Rev Neurol 9:361–362PubMedCrossRef
33.
go back to reference McCrory P, Meeuwisse WH, Kutcher JS, Jordan BD, Gardner A (2013) What is the evidence for chronic concussion-related changes in retired athletes: behavioural, pathological and clinical outcomes? Br J Sports Med 47:327–330PubMedCrossRef McCrory P, Meeuwisse WH, Kutcher JS, Jordan BD, Gardner A (2013) What is the evidence for chronic concussion-related changes in retired athletes: behavioural, pathological and clinical outcomes? Br J Sports Med 47:327–330PubMedCrossRef
34.
go back to reference McKee AC, Cantu RC, Nowinski CJ, Hedley-Whyte ET, Gavett BE, Budson AE, Santini VE, Lee HS, Kubilus CA, Stern RA (2009) Chronic traumatic encephalopathy in athletes: progressive tauopathy after repetitive head injury. J Neuropathol Exp Neurol 68:709–735PubMedCrossRef McKee AC, Cantu RC, Nowinski CJ, Hedley-Whyte ET, Gavett BE, Budson AE, Santini VE, Lee HS, Kubilus CA, Stern RA (2009) Chronic traumatic encephalopathy in athletes: progressive tauopathy after repetitive head injury. J Neuropathol Exp Neurol 68:709–735PubMedCrossRef
35.
go back to reference Meeusen R, Watson P, Hasegawa H, Roelands B, Piacentini MF (2007) Brain neurotransmitters in fatigue and overtraining. Appl Physiol Nutr Metab 32:857–864PubMedCrossRef Meeusen R, Watson P, Hasegawa H, Roelands B, Piacentini MF (2007) Brain neurotransmitters in fatigue and overtraining. Appl Physiol Nutr Metab 32:857–864PubMedCrossRef
36.
go back to reference Modolo VB, Antunes HK, Gimenez PR, Santiago ML, Tufik S, Mello MT (2011) Negative addiction to exercise: are there differences between genders? Clinics (Sao Paulo) 66:255–260CrossRef Modolo VB, Antunes HK, Gimenez PR, Santiago ML, Tufik S, Mello MT (2011) Negative addiction to exercise: are there differences between genders? Clinics (Sao Paulo) 66:255–260CrossRef
37.
go back to reference Mónok K, Berczik K, Urbán R, Szabo A, Griffiths MD, Farkas J, Magi A, Eisinger A, Kurimay T, Kökönyei G, Kun B, Paksi B, Demetrovics Z (2012) Psychometric properties and concurrent validity of two exercise addiction measures: a population wide study. Psychol Sport Exerc 13:739–746CrossRef Mónok K, Berczik K, Urbán R, Szabo A, Griffiths MD, Farkas J, Magi A, Eisinger A, Kurimay T, Kökönyei G, Kun B, Paksi B, Demetrovics Z (2012) Psychometric properties and concurrent validity of two exercise addiction measures: a population wide study. Psychol Sport Exerc 13:739–746CrossRef
38.
go back to reference Nattiv A, Loucks AB, Manore MM, Sanborn CF, Sundgot-Borgen J, Warren MP (2007) American college of sports medicine position stand. The female athlete triad. Med Sci Sports Exerc 39:1867–1882PubMedCrossRef Nattiv A, Loucks AB, Manore MM, Sanborn CF, Sundgot-Borgen J, Warren MP (2007) American college of sports medicine position stand. The female athlete triad. Med Sci Sports Exerc 39:1867–1882PubMedCrossRef
39.
go back to reference Newsholme EA, Parry-Billings M, McAndrew N, Budgett R (1991) A biochemical mechanism to explain some characteristics of overtraining. In: Brouns F (ed) Advances in nutrition and top sport. Basel, Karger, pp 79–83 Newsholme EA, Parry-Billings M, McAndrew N, Budgett R (1991) A biochemical mechanism to explain some characteristics of overtraining. In: Brouns F (ed) Advances in nutrition and top sport. Basel, Karger, pp 79–83
40.
go back to reference Petibois C, Cazorla G, Poortmans JR, Deleris G (2002) Biochemical aspects of overtraining in endurance sports: a review. Sports Med 32:867–878PubMedCrossRef Petibois C, Cazorla G, Poortmans JR, Deleris G (2002) Biochemical aspects of overtraining in endurance sports: a review. Sports Med 32:867–878PubMedCrossRef
41.
go back to reference Pugliese MT, Lifshitz F, Grad G, Fort P, Marks-Katz M (1983) Fear of obesity. A cause of short stature and delayed puberty. N Engl J Med 309:513–518PubMedCrossRef Pugliese MT, Lifshitz F, Grad G, Fort P, Marks-Katz M (1983) Fear of obesity. A cause of short stature and delayed puberty. N Engl J Med 309:513–518PubMedCrossRef
42.
go back to reference Reardon CL, Factor RM (2010) Sport psychiatry: a systematic review of diagnosis and medical treatment of mental illness in athletes. Sports Med 40:961–980PubMedCrossRef Reardon CL, Factor RM (2010) Sport psychiatry: a systematic review of diagnosis and medical treatment of mental illness in athletes. Sports Med 40:961–980PubMedCrossRef
43.
44.
go back to reference Resch M, Haasz P (2009) The first epidemiologic survey among Hungarian elite athletes: eating disorders, depression and risk factors. Orv Hetil 150:35–40PubMedCrossRef Resch M, Haasz P (2009) The first epidemiologic survey among Hungarian elite athletes: eating disorders, depression and risk factors. Orv Hetil 150:35–40PubMedCrossRef
45.
go back to reference Schmolzer B, Muller W (2002) The importance of being light: aerodynamic forces and weight in ski jumping. J Biomech 35:1059–1069PubMedCrossRef Schmolzer B, Muller W (2002) The importance of being light: aerodynamic forces and weight in ski jumping. J Biomech 35:1059–1069PubMedCrossRef
46.
go back to reference Simma B, Lutschg J, Callahan JM (2013) Mild head injury in pediatrics: algorithms for management in the ED and in young athletes. Am J Emerg Med 31:1133–1138PubMedCrossRef Simma B, Lutschg J, Callahan JM (2013) Mild head injury in pediatrics: algorithms for management in the ED and in young athletes. Am J Emerg Med 31:1133–1138PubMedCrossRef
47.
go back to reference Snyder AC (1998) Overtraining and glycogen depletion hypothesis. Med Sci Sports Exerc 30:1146–1150PubMedCrossRef Snyder AC (1998) Overtraining and glycogen depletion hypothesis. Med Sci Sports Exerc 30:1146–1150PubMedCrossRef
48.
go back to reference Sudi K, Ottl K, Payerl D, Baumgartl P, Tauschmann K, Muller W (2004) Anorexia athletica. Nutrition 20:657–661PubMedCrossRef Sudi K, Ottl K, Payerl D, Baumgartl P, Tauschmann K, Muller W (2004) Anorexia athletica. Nutrition 20:657–661PubMedCrossRef
49.
go back to reference Sundgot-Borgen J (1993) Prevalence of eating disorders in elite female athletes. Int J Sport Nutr 3:29–40PubMed Sundgot-Borgen J (1993) Prevalence of eating disorders in elite female athletes. Int J Sport Nutr 3:29–40PubMed
50.
go back to reference Sundgot-Borgen J (1996) Eating disorders, energy intake, training volume, and menstrual function in high-level modern rhythmic gymnasts. Int J Sport Nutr 6:100–109PubMed Sundgot-Borgen J (1996) Eating disorders, energy intake, training volume, and menstrual function in high-level modern rhythmic gymnasts. Int J Sport Nutr 6:100–109PubMed
51.
go back to reference Sundgot-Borgen J, Torstveit MK (2004) Prevalence of eating disorders in elite athletes is higher than in the general population. Clin J Sport Med Off J Can Acad Sport Med 14:25–32CrossRef Sundgot-Borgen J, Torstveit MK (2004) Prevalence of eating disorders in elite athletes is higher than in the general population. Clin J Sport Med Off J Can Acad Sport Med 14:25–32CrossRef
52.
go back to reference Sundgot-Borgen J, Torstveit MK (2010) Aspects of disordered eating continuum in elite high-intensity sports. Scand J Med Sci Sports 20(Suppl 2):112–121PubMedCrossRef Sundgot-Borgen J, Torstveit MK (2010) Aspects of disordered eating continuum in elite high-intensity sports. Scand J Med Sci Sports 20(Suppl 2):112–121PubMedCrossRef
53.
go back to reference Veale D (1995) Does primary exercise dependence really exist? In: Annett J, Cripps B, Steinberg H (eds) Exercise addiction: motivation for participation in sport and exercise. The British Psychological Society, Leicester, pp 1–5 Veale D (1995) Does primary exercise dependence really exist? In: Annett J, Cripps B, Steinberg H (eds) Exercise addiction: motivation for participation in sport and exercise. The British Psychological Society, Leicester, pp 1–5
54.
go back to reference Wanke EM, Petruschke A, Korsten-Reck U (2004) Eating disorders in athletes—an inventory. Deutsche Zeitschrift für Sportmedizin 55:286–294 Wanke EM, Petruschke A, Korsten-Reck U (2004) Eating disorders in athletes—an inventory. Deutsche Zeitschrift für Sportmedizin 55:286–294
55.
go back to reference Weinstein A, Weinstein Y (2013) Exercise addiction- diagnosis, bio-psychological mechanisms and treatment issues. Curr Pharm Des Weinstein A, Weinstein Y (2013) Exercise addiction- diagnosis, bio-psychological mechanisms and treatment issues. Curr Pharm Des
56.
go back to reference Whiting HTA (1994) Exercise addiction: motivation for participation in sport and exercise’. In: Submission for a satellite professional development workshop. The British Psychological Society, Sport and Exercise Psychology Section Whiting HTA (1994) Exercise addiction: motivation for participation in sport and exercise’. In: Submission for a satellite professional development workshop. The British Psychological Society, Sport and Exercise Psychology Section
57.
go back to reference Wilson WM, Maughan RJ (1992) Evidence for a possible role of 5-hydroxytryptamine in the genesis of fatigue in man: administration of paroxetine, a 5-ht re-uptake inhibitor, reduces the capacity to perform prolonged exercise. Exp Physiol 77:921–924PubMed Wilson WM, Maughan RJ (1992) Evidence for a possible role of 5-hydroxytryptamine in the genesis of fatigue in man: administration of paroxetine, a 5-ht re-uptake inhibitor, reduces the capacity to perform prolonged exercise. Exp Physiol 77:921–924PubMed
Metadata
Title
Sport specificity of mental disorders: the issue of sport psychiatry
Authors
Karl-Jürgen Bär
Valentin Z. Markser
Publication date
01-11-2013
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Psychiatry and Clinical Neuroscience / Issue Special Issue 2/2013
Print ISSN: 0940-1334
Electronic ISSN: 1433-8491
DOI
https://doi.org/10.1007/s00406-013-0458-4

Other articles of this Special Issue 2/2013

European Archives of Psychiatry and Clinical Neuroscience 2/2013 Go to the issue