Combining pharmacotherapy with psychotherapeutic management for the treatment of psychiatric disorders among athletes

Abstract

Abstract: Introduction: Previous literature has highlighted athletes as a population that is particularly vulnerable to a range of psychiatric symptoms and disorders. Although psychotherapy and pharmacological interventions have been demonstrated as clinically effective for athletes in isolation, the potential for a combination of such approaches (integrative treatment) as superior to either modality is of increasing interest and importance. Specifically, the athlete population may benefit from an integrative approach since it faces unique factors and implications for treatment, including but not limited to doping regulations, performance modulation secondary to psychiatric medication, and particular barriers to adherence (e.g., personality factors, athlete-specific schedules, stigma). Methods: To retrieve relevant articles for our review, we searched five electronic databases (PubMed (MEDLINE), SportDiscus via EBSCO, PSycINFO viaProQuest, Scopus and Cochrane). Athletes were defined as those competing at professional, Olympic, or collegiate/university levels. Results: We seek to highlight clinically relevant factors, conceptual models, rationales and examples of an integrative approach so as to set the stage for future literature aiming to investigate such a topic on both theoretical and experimental levels. Conclusion: Ultimately, our review seeks to provide a rationale for systematically assessing factors for and against combination therapy for each athlete, a risk benefit analysis aimed at providing a clinically effective and parsimonious intervention strategy, which may include the use of one or multiple intervention modalities. Such a strategy will ideally facilitate positive outcomes for athletes’ personal functioning which may consequently maintain or augment their athletic performance, initiating a positive feedback loop of optimal functioning.