Athletes at all levels of participation, including athletes of color, have no natural immunity to mental health challenges. There is considerable evidence to support that no matter the level of participation, athletic identity including race, may be linked to psychological distress. This article provides the clinical context needed to offer therapeutic interventions to athletes and recommendations for how training programs can prepare psychiatrists for this work and opportunities for future development and inclusion of psychiatrists as members of the \"medical\" team, especially when working to address the needs of the increasingly diverse population of athletes today.

Elite athletes and their entourage are exposed to intense stressors and commonly experience mental health symptoms and disorders. While there is limited literature on prevalence rates in a South African setting, initial data show that both current and retired athletes may experience these symptoms, but with low treatment rates. There is a need to improve mental health literacy and mental health care in athletes. Athletes may benefit from systematic mental health surveillance and additional screening during high-risk periods, such as injury or retirement. This commentary brings athlete mental health into focus and advocates for the inclusion of sport and exercise psychiatry into the athlete entourage and broader mental health team, in order to close the treatment gap. We provide seven recommendations for the initial way forward for sport and exercise psychiatry in South Africa.

UNASSIGNED: Coaches play an important role in promoting mental health in elite sports. However, they themselves are exposed to risks affecting their mental health, and their fears and worries are often overlooked. Moreover, it remains unclear how coaches\' mental health affects their athletes\' mental health.
UNASSIGNED: To create a compilation of the literature on (1) elite coaches\' mental health and (2) how coaches\' mental health influences elite athletes\' mental health. Building on this, recommendations for improving coaches\' psychological well-being should be elaborated upon and discussed.
UNASSIGNED: A literature search was conducted up to November 30, 2021, using the following databases: PubMed, PsycINFO, Scopus, Web of Science, and SportDiscus.
UNASSIGNED: Studies reporting elite coaches\' mental health symptoms and disorders and the influence of elite coaches\' mental health on elite athletes\' mental health were included.
UNASSIGNED: Scoping review.
UNASSIGNED: Level 4.
UNASSIGNED: Data regarding elite coaches\' mental health, as well as their influence on athletes\' mental health and performance, were included in a descriptive analysis. The PRISMA guidelines were used to guide this review.
UNASSIGNED: Little research has been done on elite coaches\' mental health disorders, although studies confirm that they do experience, for example, symptoms of burnout, anxiety, and depression. The influence of coaches\' mental health on their athletes is underinvestigated, with research focused mainly on the influence of coaches\' stress.
UNASSIGNED: Knowledge about coaches\' mental health is still limited. Coaches\' poor mental health diminishes coaching performance and might impair athletes\' mental health. Coaches should receive more support, including sports psychiatric care and education on the importance of mental health. This could improve the mental health of both coaches and athletes, and positively affect athlete performance.

Sports and Physical Exercise Therapy in the Treatment of Mental Health Issues in Children and Adolescents Abstract: Mental disorders are among the most common chronic diseases in childhood and adolescence in Germany and worldwide. The health benefits of a physically active lifestyle during adolescence are well documented. Furthermore, a growing body of evidence suggests a positive impact of physical activity on mental health and emotional well-being. Longitudinal studies also show an association between physical activity and reduced risk of developing a mental disorder. Therefore, therapeutic exercise plays an important role in child and adolescent psychiatry. High-quality randomized-controlled trials are needed to substantiate the described effects.
Zusammenfassung: Psychische Störungen gehören in Deutschland und weltweit zu den häufigsten chronischen Erkrankungen im Kindes- und Jugendalter. Die gesundheitlichen Vorteile eines sportlich aktiven Lebenswandels in der Kindheit und Jugend sind gut belegt. Es besteht zudem ein Zusammenhang zwischen regelmäßiger körperlicher Aktivität und psychischer Gesundheit sowie emotionalem Wohlbefinden. Auch scheint Sport das Risiko für die Entwicklung psychischer Erkrankungen zu reduzieren. Bewegungs- und sporttherapeutische Angebote nehmen daher in der klinischen Kinder- und Jugendpsychiatrie einen hohen Stellenwert ein. Die beschriebenen Effekte sollten in randomisiert-kontrollierte Studien mit ausreichend hohen Fallzahlen noch besser evaluiert werden.

Historically, bicycle riding connoted freedom, independence, and enhanced mental and physical wellbeing for women. Persevering through criticism and moral panic, female cyclists have been competitive since the late 19th century-many earning substantial prize money and prestige. Unfortunately, this progress was not linear in its trajectory and contemporary professional women\'s cycling continues to be pervaded by structural and cultural challenges, which can have deleterious effects on athlete mental health. Notably, socioeconomic pressures endure, like unstable employment terms, limited team support, and role conflicts. Furthermore, sexual harassment, body shaming, and manipulation may characterize women\'s experiences with their coaches and teams. Sizable investment gaps between men\'s and women\'s teams and competitions often underpin these scenarios of disadvantage. Alongside hindering the development of women\'s cycling, these adverse circumstances may induce psychosocial risk factors. Within this context, by highlighting sport-specific and sex-specific considerations, the emerging subdiscipline of sports psychiatry can be valuable for protecting and promoting athlete welfare in women\'s cycling. Raising awareness about extant symptoms, vulnerabilities, contributing behaviours, and systemic issues, can bolster efforts to develop better conditions and care equivalence. To that end, this perspective article draws upon anecdotal and scholarly evidence to provide an overview of psychiatric concerns in women\'s professional cycling. This informs recommended strategies to improve mental health and advance equality within the sport, which should involve actions from several stakeholders, such as athletes, teams, and governing bodies.

There has been a growing interest around the broader effects of psychopathic traits, particularly in relation to deviant behaviors and the notion of so-called \"successful psychopathy\". As significant sociocultural touchstones, sporting events are often characterized by competitiveness and a sense of prestige. However, there has been limited attention towards psychopathic traits across recreational, amateur, and elite sports. Accordingly, we conducted a narrative review synthesizing primary observations on this topic, searching keywords in Scopus, APA PsychNet, and PubMed. Twenty-four academic papers were included in our results, which we thematized around demographic groups, namely: athletes and sport-adjacent non-athletes (i.e., coaches and spectators). Based on empirical findings from the reviewed papers, psychopathic traits could have medicolegal and forensic implications in relation to substance use, aggression, and violence. These could intersect with wider issues around doping, cheating, foul play, and have adverse outcomes for fellow participants, team dynamics, and spectators. Interestingly, our review also indicates that psychopathic traits may have correlations with determination and achievement in sport, echoing developing ideas around \"successful psychopathy\" in other domains. As such, increased awareness from all stakeholders and further multidisciplinary exchanges are vital to better understand the effects of psychopathic traits in sporting frameworks and their wider consequences.

Though research is inconclusive in being able to determine if young athletes are more or less likely to suffer from mental health disorders compared with their non-athlete peers, there are important psychological considerations that are unique to the athletic population. This includes depression in the context of overtraining and burnout, performance anxiety, perfectionism, psychological sequalae of concussion, and injury as an independent risk factor for depression, anxiety, post-traumatic stress, and high-risk behaviors. Optimization of mental health care in youth athletes requires continued efforts to improve mental health literacy, decrease stigma, encourage help-seeking behaviors, and advance the routine implementation of effective screening practices.

UNASSIGNED: Interest in ultra endurance sport (UES) is increasing, with relevant events growing in popularity. However, these activities may encompass more complex characteristics and demands that do not correspond to scientifically validated correlations between physical activity and improved health. It is unknown whether high volume training for UES can have adverse implications, although certain sociocultural aspects of western society, such as an emphasis on autonomy and self-directed success, may encourage participation as a representation of personal achievement. As media depictions of UES can be highly influential, we aimed to explore prominent messages to better comprehend the values and aspirations of established and aspiring ultra endurance athletes (UEA).
UNASSIGNED: Using qualitative, conventional content analysis techniques, we evaluated n = 15 popular YouTube videos on various UES to synthesize the most common themes. A YouTube search was conducted, and videos were selected based on sport and relevance. Subsequently, videos were analyzed and coded to discern the most frequently repeated themes.
UNASSIGNED: Five recurring themes were identified: discussion of the mental aspects of UES participation; the adoption of folk-tale storytelling; dietary habits of UEA; a focus on pain and suffering; the use of words associated with mental illness as a colloquial descriptor of UES/UEA.
UNASSIGNED: YouTube depictions of UES participation appear to accentuate suffering and co-occurring phenomena as attractive qualities. These resonate with sociocultural ideologies in western contexts, which emphasize fitness and personal success, but appear inconsistent with evidence around potentially adverse health-related implications of UES.
UNASSIGNED: Discrepancies between popular portrayals of UES and scientific evidence suggest a need for greater community education and information sharing about sport-specific risk factors for physical and mental health conditions and appropriate training protocols. Further research is also required to better define the relationship between motivations for UES participation and overall health using interdisciplinary approaches.

Elite athletes are exposed to a considerable amount of physical and psychological stress throughout their entire professional life, but the exploration of the consequences of this stressful regimen on mental health is still in its early stages. Eating disorders (EDs), substance use disorders, and behavioral addictions represent only several domains that are worth more investigation in this vulnerable population, in order to find preventative and therapeutic strategies. The exploration of EDs in athletes is important because this population is very vulnerable to the impact that weight and body shape may have on their professional performances, and epidemiological studies support this concern, i.e., the prevalence of EDs in athletes is significantly higher than in the general population. This article is dedicated to the synthesis of available data regarding a specific pathology reported in elite athletes, i.e., anorexia athletica (AA), based on a narrative reviewing methodology. The information about risk factors, pathophysiology, positive and differential diagnosis, epidemiology, structured evaluation, and treatment of AA have been summarized and future research directions have been highlighted. While tentative diagnostic criteria for AA and a self-administered questionnaire exist, its pathophysiology is still insufficiently explored, and the treatment is not based on good-quality trials. According to the retrieved data, more research targeting the physical and mental health of elite athletes, especially those practicing esthetic sports, is needed, in order to implement adequate screening and early intervention programs. Future studies targeting various sub-populations of elite athletes, i.e., esthetic vs. non-esthetic sports, individuals presenting a history of ED vs. those without such a history, and those practicing individual sports vs. team sports are needed to reach the objective of improving the quality of life in this population.

BACKGROUND: Although research suggests that exercise benefits mental health, psychiatric disorders have been acknowledged in the ultra-endurance-athlete population. At present, the mental-health consequences of high-volume training associated with ultra-endurance sports are not well understood.
METHODS: We conducted a narrative review summarizing primary observations about mental disorders per ICD-11 criteria in ultra-endurance athletes using a keyword search in Scopus and PubMed.
RESULTS: We identified 25 papers discussing ICD-11-classified psychiatric disorders such as depression, anxiety, eating disorders, attention-deficit/hyperactivity disorder, and schizophrenia in ultra-endurance athletes.
CONCLUSIONS: Although evidence is limited, available papers indicate that there is a sizable incidence of mental-health issues and composite psychopathological vulnerabilities in this community. We contend that ultra-endurance athletes may represent a different, though similar, demographic than elite and/or professional athletes, as they often engage in high-volume training with similarly high motivation. This can have regulatory implications, which we also highlight.
CONCLUSIONS: Mental illness in ultra-endurance athletes is an underrepresented topic in sports medicine, though psychiatric disorders may be especially prevalent in this population. Further inquiry is necessary to inform athletes and healthcare practitioners about the possible mental-health implications associated with participation in ultra-endurance sports.