This editorial examines the issue of "cheating" (broadly defined) in sports from youth through professional sports. We describe possible underlying causes focusing on the development of a "personality disorder" and psychiatric/psychodynamic needs (e.g. a pathological need to be the best). We detail treatment and management from a medical-psychiatric perspective as well as implications for coaches, teams, leagues and professional organizations (e.g. soccer, bicycling, etc). Cheating behavior exists in other fields, for example, politics, law among others and some of the management principles mentioned here may apply there.
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