OBJECTIVE: To determine the effectiveness of mindfulness-based programmes (MBPs) on the mental health of elite athletes. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Eight online databases (Embase, PsycINFO, SPORTDiscus, MEDLINE, Scopus, Cochrane CENTRAL, ProQuest Dissertations & Theses and Google Scholar), plus forward and backward searching from included studies and previous systematic reviews. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Studies were included if they were randomised controlled trials (RCTs) that compared an MBP against a control, in current or former elite athletes. RESULTS: Of 2386 articles identified, 12 RCTs were included in this systematic review and meta-analysis, comprising a total of 614 elite athletes (314 MBPs and 300 controls). Overall, MBPs improved mental health, with large significant pooled effect sizes for reducing symptoms of anxiety (hedges g=-0.87, number of studies (n)=6, p=0.017, I 2=90) and stress (g=-0.91, n=5, p=0.012, I 2=74) and increasing psychological well-being (g=0.96, n=5, p=0.039., I 2=89). Overall, the risk of bias and certainty of evidence was moderate, and all findings were subject to high estimated levels of heterogeneity. CONCLUSION: MBPs improved several mental health outcomes. Given the moderate degree of evidence, high-quality, adequately powered trials are required in the future. These studies should emphasise intervention fidelity, teacher competence and scalability within elite sport. PROSPERO REGISTRATION NUMBER: CRD42020176654.
Br J Sports Med
99 - 108
athletes, meta-analysis, psychiatry, psychology, sports, Humans, Mental Health, Mindfulness, Anxiety, Athletes, Sports