Purpose: Findings of recent reviews show that the prevalence of mental health symptoms and disorders among both current and former elite athletes appears to be substantial and similar to the prevalence in the general population. The aim of the current systematic review was to determine the prevalence of distress, anxiety and depression symptoms, sleep disorders, nutrition disorders, and substance use in elite active athletes. Methods: The searches for articles were conducted in July 2024, in scientific journals indexed in the PsycNet, PubMed, SportDiscus, Scopus and ScienceDirect databases, with a search period from 1st January 2020 to July 31, 2024. Results: A total of 1505 potentially relevant citations were retrieved, the review included 28 articles. The prevalence of psychological distress in both male and female athletes is approximately 17%. Moderate to severe generalized anxiety occurs in 5-9% of male athletes and 12-25% of female athletes. In the case of depression, the results are therefore more diverse, depending not only on cultural factors, but also on the measurement tool. A higher prevalence of depression was shown in female athletes. A high risk of eating disorders was found in several to a dozen or so percent of athletes. At least a dozen or so percent of athletes have sleep problems, and these difficulties occur more often in women. The prevalence of alcohol misuse varies greatly depending on the study group (15-77%), usually higher in men than in women. Conclusions: The prevalence of mental disorders among elite athletes is higher in women than men and at least as high as in the general population. It does not differ significantly from that determined in earlier reviews and varies depending on cultural factors and sport practiced.
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