Mental stress in elite athletes: A systematic review




Psychological stress; Athletes; Mental health; Mental health associations.


Mental stress represents a public health problem and exercise can boost mental health improvement. However, athletes are not immune to mental health challenges, including the high physical demand of elite athletes can negatively influence mental health and cause stress. This relationship of mental stress and elite athletes is still not well understood in reading and receives little attention from researchers. Thus, a systematic review study was carried out with the objective of analyzing the existence and impacts of mental stress in elite athletes. In this review, the following descriptors were used: Stress, Psychological; Athletes; Mental Health; Mental Health Associations. The databases used were PubMed, Web of Science and Scopus in English with articles published in the last five years. After qualitative selection and synthesis, seven studies were included. It was found that mental stress is common in athletes even compared to non-athletes. In the included studies there was a predominance of young women in varied sports, mainly summer sports such as volleyball and athletics. Mental stress seems to be related to training load. Studies with larger samples are needed in different sports to check mental stress in elite athletes with greater methodological rigor.


Ahn, E., & Kang, H. (2018). Introduction to systematic review and meta-analysis. Korean journal of anesthesiology, 71(2), 103.

Åkesdotter, C., Kenttä, G., Eloranta, S., & Franck, J. (2020). The prevalence of mental health problems in elite athletes. Journal of science and medicine in sport, 23(4), 329-335.

Belz, J., Heidari, J., Levenig, C., Hasenbring, M., Kellmann, M., & Kleinert, J. (2018). Stress and risk for depression in competitive athletes suffering from back pain–Do age and gender matter?. European journal of sport science, 18(7), 1029-1037.

Cianconi, P., Betrò, S., & Janiri, L. (2020). The impact of climate change on mental health: a systematic descriptive review. Frontiers in psychiatry, 11.

Codonhato, R., Rubio, V., Oliveira, P. M. P., Resende, C. F., Rosa, B. A. M., Pujals, C., & Fiorese, L. (2018). Resilience, stress and injuries in the context of the Brazilian elite rhythmic gymnastics. PloS one, 13(12), e0210174.

Delgado-Rodríguez, M., & Sillero-Arenas, M. (2018). Systematic review and meta-analysis. Medicina Intensiva, 42(7), 444-453.

Donato, H., & Donato, M. (2019). Stages for undertaking a systematic review. Acta medica portuguesa, 32(3), 227-235.

Dziembowska, I., Wójcik, M., Hołyńska-Iwan, I., Litwic-Kaminska, K., Słomka, A., & Żekanowska, E. (2019). Female volleyball players are more prone to cortisol anticipatory stress response than sedentary women. Medicina, 55(6), 258.

Foskett, R. L., & Longstaff, F. (2018). The mental health of elite athletes in the United Kingdom. Journal of science and medicine in sport, 21(8), 765-770.

Gorczynski, P. F., Coyle, M., & Gibson, K. (2017). Depressive symptoms in high-performance athletes and non-athletes: a comparative meta-analysis. British Journal of Sports Medicine, 51(18), 1348-1354.

Horta, T. A., Bara Filho, M. G., Coimbra, D. R., Miranda, R., & Werneck, F. Z. (2019). Training load, physical performance, biochemical markers, and psychological stress during a short preparatory period in brazilian elite male volleyball players. The Journal of Strength & Conditioning Research, 33(12), 3392-3399.

Lebrun, F., & Collins, D. (2017). Is elite sport (really) bad for you? Can we answer the question?. Frontiers in psychology, 8, 324.

Melnyk, B. M., & Fineout-Overholt, E. (Eds.). (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.

Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & Prisma Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS medicine, 6(7), e1000097.

Moreland, J. J., Coxe, K. A., & Yang, J. (2018). Collegiate athletes' mental health services utilization: A systematic review of conceptualizations, operationalizations, facilitators, and barriers. Journal of sport and health science, 7(1), 58-69.

O’Donnell, S., Bird, S., Jacobson, G., & Driller, M. (2018). Sleep and stress hormone responses to training and competition in elite female athletes. European journal of sport science, 18(5), 611-618.

Paiano, M., Jaques, A. E., Nacamura, P. A. B., Salci, M. A., Radovanovic, C. A. T., & Carreira, L. (2020). Saúde mental dos profissionais de saúde na China durante pandemia do novo coronavírus: revisão integrativa. Revista Brasileira de Enfermagem, 73.

Purcell, R., Rice, S., Butterworth, M., & Clements, M. (2020). Rates and correlates of mental health symptoms in currently competing elite athletes from the Australian National high-performance sports system. Sports Medicine, 1-12.

Putukian, M. (2016). The psychological response to injury in student athletes: a narrative review with a focus on mental health. British Journal of Sports Medicine, 50(3), 145-148.

Reardon, C. L., Hainline, B., Aron, C. M., Baron, D., Baum, A. L., Bindra, A., & Engebretsen, L. (2019). Mental health in elite athletes: International Olympic Committee consensus statement (2019). British journal of sports medicine, 53(11), 667-699.

Rice, S. M., Purcell, R., De Silva, S., Mawren, D., McGorry, P. D., & Parker, A. G. (2016). The mental health of elite athletes: a narrative systematic review. Sports medicine, 46(9), 1333-1353.

Russell, S., Jenkins, D., Rynne, S., Halson, S. L., & Kelly, V. (2019). What is mental fatigue in elite sport? Perceptions from athletes and staff. European Journal of Sport Science, 19(10), 1367-1376.

Schinke, R. J., Stambulova, N. B., Si, G., & Moore, Z. (2018). International society of sport psychology position stand: Athletes’ mental health, performance, and development. International journal of sport and exercise psychology, 16(6), 622-639.

Siart, B., Nimmerichter, A., Vidotto, C., & Wallner, B. (2017). Status, stress and performance in track and field athletes during the european games in Baku (Azerbaijan). Scientific reports, 7(1), 1-9.

Stillman, M. A., Glick, I. D., McDuff, D., Reardon, C. L., Hitchcock, M. E., Fitch, V. M., & Hainline, B. (2019). Psychotherapy for mental health symptoms and disorders in elite athletes: a narrative review. British journal of sports medicine, 53(12), 767-771.

Van Slingerland, K. J., Durand-Bush, N., Bradley, L., Goldfield, G., Archambault, R., Smith, D., & Kenttä, G. (2019). Canadian Centre for Mental Health and Sport (CCMHS) position statement: Principles of mental health in competitive and high-performance sport. Clinical journal of sport medicine, 29(3), 173-180.

Vannuccini, S., Fondelli, F., Clemenza, S., Galanti, G., & Petraglia, F. (2020). Dysmenorrhea and heavy menstrual bleeding in elite female athletes: quality of life and perceived stress. Reproductive Sciences, 27(3), 888-894.

Vella, S. A., Swann, C., Batterham, M., Boydell, K. M., Eckermann, S., Ferguson, H., & Deane, F. P. (2021). An intervention for mental health literacy and resilience in organized sports. Medicine and science in sports and exercise, 53(1), 139.

White, K. (2016). Evidence-based practice. Translation of Evidence into Nursing and Health Care. 2nd ed. New York: Springer Publishing Company.

Zhu, X. (2020). Systematic reviews and meta-analysis. Routledge Handbook of Adapted Physical Education.



How to Cite

FARIAS, E. R. .; SILVA, M. F. L. da . Mental stress in elite athletes: A systematic review. Research, Society and Development, [S. l.], v. 10, n. 7, p. e55710716838, 2021. DOI: 10.33448/rsd-v10i7.16838. Disponível em: Acesso em: 28 may. 2023.



Health Sciences