Abstract: Background: Sports psychiatry is an emerging field focused on working with elite athletes throughout their careers. Not only can athletes experience common mental health diagnoses such as depression and anxiety, they also face unique challenges that contribute to sports-specific symptoms and diagnoses (1). The presented program involves a sports psychiatrist included within an undergraduate athletics department since 2018 and demonstrates the key role of a team psychiatrist in diagnosing and treating such mental health conditions, as well as promoting and enhancing well-being and performance among athletes.
Methods: Student athletes were referred to sports psychiatrist by embedded therapists or team physician. Athletes were seen for full psychiatric evaluation with initiation of medications as indicated based on DSM diagnoses and shared decision-making. Information regarding athlete demographic information (e.g. gender, academic year, sport), diagnoses and medications were maintained since inception of the program. Consistent collaboration was continued with both team therapists and sports physician through monthly team meetings. Care was advanced beyond individual medication management and psychotherapy through additional resources in the athletics department (e.g. sports dietician referral for disordered eating, DBT class) and in the local area (e.g. trauma-specific treatment for victims of sexual assault).
Results: During the first five years, 639 visits were completed (mean = 128 per year) with 148 student athletes (mean = 30 athletes per year). The majority of athletes identified as female (73.6%). Students were seen across academic years and across a variety of sports, with greatest numbers in track/cross country (21.6%), swimming/diving (19.6%), football (14.9%) and gymnastics (12.2%). The most common diagnoses seen were anxiety (30%) and depression (27.8%). Among athletes prescribed medications, 66.1% were prescribed one medication, whereas 3.9% were prescribed four or more medications; 16 athletes (7.5%) were not prescribed medications. Selective serotonin reuptake inhibitors (SSRIs) were the most commonly prescribed medication class (53.3%), followed by sleep aids (12.3%).
Discussion: Despite specific challenges faced due to the global pandemic, staffing and leadership changes, this 5-year data indicates that sports psychiatry is utilized by an undergraduate athletics program. While depression and anxiety are the most commonly treated conditions, subspecialty training in other areas of psychiatry (e.g. eating and substance use disorders) are highly useful for the sports psychiatrist, as well as increased knowledge on non-pharmacologic strategies for addressing concerns raised by athletes. Barriers exist that may interfere with the maximal utilization of sports psychiatrist, including those related to stigma and racism (2).
Conclusion/Implications: Sports psychiatry is a growing field dedicated towards advancing the science and practice of psychiatry to the athletic community. This example of an integrated sports psychiatrist in an undergraduate athletics department serves as a model for the promotion and enhancement of well-being and performance of student athletes. References:
Strohle A. Sports psychiatry: mental health and mental disorders in athletes and exercise treatment of mental disorders. European Archives of Psychiatry and Clinical Neuroscience (2019) 269:485–498.
Stewart A, Malveaux WC, Vieux U. Sports psychiatry: assuring a diverse workforce in an area of increasing professional interest. Child Adolesc Psychiatric Clin N Am 33 (2024) e1–e15.
Presentation Eligibility: Not previously published or presented.
Diversity, Equity, and Inclusion: A specific section of this presentation will involve discussion of the role of stigma and racism within athletics and how this can impact sports psychiatry.
REFERENCE: Stewart A, Malveaux WC, Vieux U. Sports psychiatry: assuring a diverse workforce in an area of increasing professional interest. Child Adolesc Psychiatric Clin N Am 33 (2024)
.jpg "Robin Valpey, MD (she/her/hers) photo")
