Stress levels faced by top-level esports players are equal to those experienced by professional athletes.
That's according to a new study from the University of Chichester, which looked at the psychological impact of major esports contests on those taking part.
The study, titled Identifying Stressors and Coping Strategies of Elite Esports Competitors, will be published in the International Journal of Gaming and Computer-Mediated Simulations.
It highlights 51 stress factors similar to those faced by professional football and rugby players when competing in major sporting events. These included communication problems with teammates, and worries of competing in front of a large audience.
When stressed, players resorted to aggressive comments to teammates - or avoided communicating at all - which lead to a poorer performance.
"Esports has become a multimillion-pound business attracting audiences worldwide, but there is little research into the psychological factors that influence players," co-author Dr Phil Birch said.
"We have discovered that gamers are exposed to significant stress when competing in top-flight contests. By isolating these stressors, we can help esports players develop effective coping strategies to deal with such stressors and optimise performance while playing at the highest level."
Rams Singh, a former Quake 3 Arena pro and now a course leader of Chichester's esports degree, said it was "essential [esports] remains grounded in traditional academia to help us understand immersive gaming and its impact on mind and body".
"This study is important for the industry. We must understand how we can best support the health of our gamers and keep them performing at the top level - just as any other professional athlete."