Mental health management of elite athletes during COVID-19: a narrative review and recommendations
Reardon CL, et al. Br J Sports Med 2020;0:1–10. doi:10.1136/bjsports-2020-102884
Claudia L Reardon, Abhinav Bindra, Cheri Blauwet,
Richard Budgett, Niccolo Campriani,Alan Currie, Vincent Gouttebarge, David McDuff,
Margo Mountjoy, Rosemary Purcell, Margot Putukian, Simon Rice, Brian Hainline
ABSTRACT: 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.
The study states :
What is already known:
► Elite athletes suffer from many mental health symptoms and disorders at rates equivalent to or exceeding those in the general population.
► The COVID-19 pandemic has created several new stressors for elite athletes.
► Management for athletes during the COVID-19 pandemic has focused on cardiac complications, screening for asymptomatic disease and return to sport, incorporating hygiene measures
What are the new findings:
► The COVID-19 pandemic has created changes in the way in which management of mental health symptoms and disorders in elite athletes—inclusive of community-based or outpatient psychotherapy, outpatient pharmacotherapy and higher levels of care—should be delivered.
► Within the realm of psychotherapy, crisis counselling and other forms of individual psychotherapy, couple/family and group psychotherapy all may be helpful during the COVID-19 pandemic, with novel content and means of delivery.
► Some important aspects of pharmacotherapy for management of mental health symptoms and disorders in elite athletes 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.
► It is important for providers to consider when in-person management or higher levels of care for mental health symptoms and disorders are necessary for elite athletes, despite potential risk of viral exposure during the COVID-19 pandemic.
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