The Olympic Games tradition dates back to antiquity. And we learned the quote „mens sana in corpore sano est“ coming from that period. It became a paradigm in the western world, undermining any efforts of psychiatric relevance in high performance sports. With world renowned athletes himself as suffering from depression, things began to move; nowadays, sport psychiatry has moved from a theoretical option to an accepted necessity in elite sports [1].
Major depressive Disorder (MDD) is a widespread and burdensome disease. People with MDD suffer from loss of interest and pleasure in activities that they would usually enjoy. In addition, they report anxiety, complex somatic pain syndromes, cognitive restrictions, loss of sexual interest, impaired sleep and social withdrawal. MDD is the leading cause for years lived with disability (YLD) in women and men and has a lifetime prevalence of 10-20 %.
The current ideal of beauty consists of a strong shift towards physical activity and aims to develop a muscular, athletic physique. While the athletic ideal for women has been a product of recent years, the muscular ideal for men has been observed since the 1970s. Increasing pressure to achieve this muscular ideal is associated with both body dissatisfaction and a strong desire to increase muscularity. In extreme terms, the pursuit of a muscular body and its associated behaviours, such as strength training and dieting, may lead to the development of muscle dysmorphia.
LGBTQI 1) people and especially transgender, non-binary and intersex people have a longstanding history of discrimination when it comes to sports. While the media focuses on the discussion whether transgender, non binary, and intersex people should be allowed to compete in elite amateur and professional sports at all, the majority of transgender, non-binary and intersex athletes are facing obstacles in everyday sports beyond cis and dyadic peoples’ imagination.
The global lifetime prevalence rate of all image and performance enhancing drugs (IPED) is unknown, however it is 6.4% in men an 1.6% in women for anabolic androgenic steroids (1). IPED are widely used in the bodybuilding scene and have found a bigger audience through social media platforms.
Among elite athletes disordered eating (DE) behavior as well as eating disorders (ED) are one of the most common mental illnesses. According to Sundgot-Borgen et al. [1] DE can be illustrated by a continuum ranging from performance-oriented eating and exercise behaviors to subclinical EDs and clinical EDs such as Anorexia nervosa (AN) and Bulimia nervosa (BN) along with other medical complications and impairment of performance.
Changes in public life, isolation, quarantine, and associated constraints within usual routine, as well as anxieties and concerns, are just some of many examples of psychiatric burdens caused by the COVID-19 pandemic (1). Not only the general population, but professional athletes in particular, are exposed to these challenges, as professional sports came to an abrupt halt upon occurrence of COVID-19.
Anxiety is in principle a normal and (often) helpful emotion in humans and animals. However, anxiety can get excessive and be impairing and disabling. If anxiety is excessive in intensity and duration, occurs in actually non-dangerous situations, uncontrollable, and impairs actions, an anxiety disorder is typically diagnosed [2].
Alpine sports are comprised of multiple disciplines like mountaineering, climbing, ice-climbing, high-altitude mountaineering, trekking, canyoning and ski-mountaineering. However, there is no standardised definition of alpine sports. Alpinism in a broader sense includes as well mountain science, mountain guiding and alpine rescue. Hence this article focuses on sport activities in an alpine environment and on the possible psychiatric impact thereof.
Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder which is characterized by symptoms of inattention, hyperactivity, and impulsivity. The estimated prevalence of ADHD in the general population is 7,2% in children, with persistence into adulthood of approximately 35%. [1,2]
The SSSPP established a three level curriculum for additional training in Sports Psychiatry and Psychotherapy. Level 1 “Basic Healthcare In Sports Psychiatry And Psychotherapy” is imparted. The curriculum contains a theoretical part, practical experience and supervision within 80 hours of additional training, leading to a SSSPP certificate
Mental disorders are common in competitive sports. They can influence performance, increase the risk of physical injuries and prolong rehabilitation. A specialized discipline for mental health has not (yet) been established. This position paper will emphasize the connection between the special requirements in competitive sports and the need of psychiatric specialization.
Promoting physical activity (PA) has not yet been established as a standard procedure in psychiatric care. Psychiatric patients are at higher chance to be physically inactive which contributes to increased morbidity and mortality. Regular PA has shown to improve mental wellbeing in the general population and reduces the risk to develop several mental disorders. Assessing PA and motivation for change should be established as routine in psychiatric practice.
The ongoing COVID-19 pandemic is a global crisis of unprecedented scale in modern times. The initial outbreak of COVID-19 in Wuhan spread rapidly, affecting other parts of China and soon other countries becoming a global threat. (1) On 11 March 2020, the WHO has declared the ‘Pandemic state’ calling the governments to take ‘urgent and aggressive action’ to delay and mitigate the peak of infection.
Competitive and elite sport often challenges the balance between health and performance, especially when it involves youth athletes. As Lausanne was getting ready to host the 2020 winter Youth Olympic Games, we had the opportunity to reflect on these challenges and on what they mean for sports medicine practitioners. Elite sport pushes athletes to the limit, be it through their own intrinsic drive to achieve ever more, or through the pressures of the multiple stakeholders around sport.
How fortunate to have been able to take part in the medical organisation of the Lausanne 2020 Winter Youth Olympic Games (YOG) as head of the Olympic Village Medical Clinic and Medical Education Programme manager, while introducing some innovations to the Games! From a clinical point of view, the temporary creation of a high quality interdisciplinary medical clinic provided all participants aged 14 to 18 years old with global and equitable care. We adopted the WHO criteria to offer an adolescent friendly setting.
