Sports injury and stressor-related disorder in competitive athletes:a systematic review and a new framework

Background:For professional athletes,sports injury has been considered one of the most influential factors determining their athletic careers’duration and quality.High-intensity training and compet-itiveness of the sports competition are perhaps critical causes of sports-related stress.This article reviews the relevant research on sports injuries and stressor-related disorders.Further,it explores the following three issues in depth:(1)Do physical injuries caused by competitive sports lead to acute or posttraumatic stress disorder for athletes?What are the abnormal stress responses?(2)What diagnoses are currently available for sports injury related traumatic stress disorder?(3)What kinds of psychological rehabilitation are available for trauma-related symptoms in sports injury?How efficient are they in alleviating these symptoms?Methods:The study searched electronic databases,including PubMed,MEDLINE,CINAHL,etc.And reference lists of included papers were also screened.Two researchers selected the literature strictly according to the inclusion criteria and sorted them out.Based on the proved conclusions,the study established a new framework to manage traumatic stress disorders after the injury occurred.Results:16 articles were included in the study.(Q1:N=10;Q2:N=3;Q3:N=3)The findings of this review suggested that athletes who suffer from sports injuries are more likely to experience abnormal physiological or psychological stress responses,which may become a massive challenge for athletes to continue their sports careers at a competitive level.However,there is a minimal understanding of addressing sports injury-related traumatic stress disorder from a biological perspective.Thus,it is challenging to build a scientific basis for diagnosis,screening,and treatment.In addition,the current diagnostic tool for athletes stress disorder still heavily relies on subjective measurement,and the treatment plan is not different from that of the general population.Conclusions:It highlighted that sports-related stress disorder could be the greatest challenge to return to competition for injured athletes.The present study indicated the importance of systematically identifying the symptoms of sports-related stress disorder and improving the current diagnosis and treatment system.

Psychiatric hospitalization during the two SARS-CoV-2 pandemic waves:New warnings for acute psychotic episodes and suicidal behaviors

BACKGROUND The subsequent waves of the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)pandemic have represented a dramatic health emergency characterized by significant consequences on mental health.Diachronic variations in the incidence rates of acute relapse of psychiatric disorders may represent significant"sentinel events"for assessing the mental health response to an unprecedented stressful event.AIM To investigate the variation in psychiatric hospitalization rates and differences in sociodemographic and clinical-psychopathological peculiarities at Bologna"Maggiore"General Hospital Psychiatric Ward(GHPW)between the first two waves SARS-CoV-2 pandemic and the same periods of the previous 3 years.The secondary purpose of the study was to suggest a diachronic response pathway to stress by reporting additional literature data on coping strategies.METHODS This observational and retrospective study collected information on admission to the GHPW at the"Maggiore"Hospital in Bologna in the index periods defined as follows:the first period between February 24,2020 and April 30,2020(first epidemic wave)and the second period between October 8,2020,and January 7,2021(second pandemic wave).Absolute numbers and proportion of admitted patients,their sociodemographic and clinical-psychopathological characteristics were compared with the same parameters recorded in the two same periods of the previous 3 years.No strict inclusion or exclusion criteria were provided in the data collection to collect information on all patients requiring acute psychiatric hospitalization.RESULTS During the first wave,there was a significant reduction in hospitalization rates,although there was a simultaneous increase in compulsory hospitalizations and the acute relapse of schizophrenia spectrum and other psychotic disorders.During the second wave,hospitalization rates reached those recorded during the same period of the previous 3 years,mainly due to the rise of bipolar and related disorders,depressive disorders,anxiety disorders,trauma-and stressor-related disorders and suicidal behaviors.CONCLUSION The coping strategies adopted during the first wave of the SARS-CoV-2 pandemic protected the vulnerable population from the general risk of clinical-psychopathological acute relapse,even if they increased the susceptibility to run into schizophrenia spectrum and other psychotic disorder relapses.In the medium-long term(as in the second pandemic wave),the same strategies do not play protective roles against the stress associated with the pandemic and social restriction measures.Indeed,during the second wave of the SARS-CoV-2 pandemic,an increase in total hospitalization rate,suicidal behaviors and the incidence rate of bipolar and related disorders,depressive disorders,anxiety disorders,trauma-and stressorrelated disorders was observed.