In many cases, there will be no significant findings in the physical examination. However, the player’s general appearance and behaviour can provide important clues regarding their overall well-being. They may be clearly distressed, tearful, agitated or have difficulty concentrating during your consultation. In these situations, it may be obvious that there is a problem. Other findings may be more subtle. For example, weight loss or weight gain might be present. Disorders of thinking can be recognised from the player’s speech. At one extreme, there may be pressure of speech (where the patient talks very quickly and jumps from topic to topic) while at the other extreme, they may not wish to communicate at all.

Consider a medical cause

A player who appears to be depressed may be hypothyroid and have associated clinical signs of this (bradycardia, hypotension or dry skin).

It is important to consider, and assess for, possible medical causes of low mood, anxiety or other psychiatric symptoms.