{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T13:49:34Z","timestamp":1785937774614,"version":"3.56.0"},"reference-count":61,"publisher":"Georg Thieme Verlag KG","issue":"14","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Sports Med"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Despite the public health benefits of cycling in the general population, mental\n                    health issues may be evident in high-performance and elite-level competitive\n                    domains. With prominent riders disclosing their experiences with psychiatric\n                    symptoms, distinctive socioenvironmental factors could exacerbate\n                    psychopathological vulnerabilities. This suggests a need for greater mental\n                    health awareness amongst stakeholders, supplemented by actions from\n                    international and national federations and regulators. To synthesise relevant\n                    observations about psychiatric concerns in high-performance and elite-level\n                    cycling, we conducted a keyword search of articles in APA PsycINFO, PubMed, and\n                    Scopus based on specified exclusion criteria. Thirteen papers were identified\n                    that examined mental health issues in high-performance and\/or\n                    elite-level cycling per classifications from the World Health\n                    Organization\u2019s International Classification of Diseases 11th Revision. A\n                    large proportion of articles illustrated eating disorder symptomatology, but\n                    others discussed attention deficit\/hyperactivity disorder, anxiety\n                    disorder, depression, sleep wake disorders, and substance use disorder. Existing\n                    literature underlines important considerations for all stakeholders within the\n                    cycling community around mental health initiatives and care provisions, which\n                    are currently lacking across the sport. Such programmes could incorporate\n                    consensus statements, psychiatric screening, psychoeducation, stigma-reducing\n                    policies, and athlete advocacy. These can help mitigate socioenvironmental risk\n                    factors and prioritise athlete wellbeing over performance-centred\n                    motivations.<\/jats:p>","DOI":"10.1055\/a-2145-6355","type":"journal-article","created":{"date-parts":[[2023,7,31]],"date-time":"2023-07-31T22:55:11Z","timestamp":1690844111000},"page":"1034-1042","source":"Crossref","is-referenced-by-count":15,"title":["A Review of Mental Health Issues in High-Performance and Elite-Level\n                    Cycling"],"prefix":"10.1055","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1769-5684","authenticated-orcid":false,"given":"Alexander","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Forensic Psychiatry, University of Bern, Bern,\n                    Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Buadze","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric\n                    University Hospital Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Colangelo","sequence":"additional","affiliation":[{"name":"Department of Forensic Psychiatry, University of Bern, Bern,\n                    Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Liebrenz","sequence":"additional","affiliation":[{"name":"Department of Forensic Psychiatry, University of Bern, Bern,\n                    Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,10,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1111\/j.1600-0838.2011.01299.x","article-title":"Health benefits of cycling: a systematic review","volume":"17","author":"P Oja","year":"2011","journal-title":"Scand J Med Sci Sports"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1289\/ehp.0901747","article-title":"Do the health benefits of cycling outweigh the risks?","volume":"118","author":"J Johan de Hartog","year":"2010","journal-title":"Environ Health Perspect"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"j1456","DOI":"10.1136\/bmj.j1456","article-title":"Association between active commuting and incident cardiovascular disease,\n                    cancer, and mortality: prospective cohort study","volume":"357","author":"C A Celis-Morales","year":"2017","journal-title":"BMJ"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1016\/j.trf.2019.05.018","article-title":"Psychosocial benefits and positive mood related to habitual bicycle use","volume":"64","author":"S Kaplan","year":"2019","journal-title":"Trans Res F: Traffic Psychol Behav"},{"key":"ref9","first-page":"293","volume-title":"\u2018Dishing out the pain\u2019 in professional cycling. 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