Background Millions of individuals worldwide have used anabolic-androgenic steroids (AAS) to gain muscle or improve athletic performance. Recently, in vitro investigations have suggested that supraphysiologic AAS doses cause apoptosis of neuronal cells. These findings raise the possibility, apparently still untested, that humans using high-dose AAS might eventually develop cognitive deficits. Methods We administered five cognitive tests from the computerized CANTAB battery (Pattern Recognition Memory, Verbal Recognition Memory, Paired Associates Learning, Choice Reaction Time, and Rapid Visual Information Processing) to 31 male AAS users and 13 non-AAS-using weightlifters age 29-55, recruited and studied in May 2012 in Middlesbrough, UK. Testers were blinded to participants’ AAS status and other historical data. Results Long-term AAS users showed no significant differences from nonusers on measures of response speed, sustained attention, and verbal memory. On visuospatial memory, however, AAS users performed significantly more poorly than nonusers, and within the user group, visuospatial performance showed a significant negative correlation with total lifetime AAS dose. These were large effects: on Pattern Recognition Memory, long-term AAS users underperformed nonusers by almost one standard deviation, based on normative population scores (adjusted mean difference in z-scores = 0.89; p = 0.036), and performance on this test declined markedly with increasing lifetime AAS dose (adjusted change in z-score = −0.13 per 100g of lifetime AAS dose; p = 0.002). These results remained stable in sensitivity analyses addressing potential confounding factors. Conclusions These preliminary findings raise the ominous possibility that long-term high-dose AAS exposure may cause cognitive deficits, notably in visuospatial memory.

Identifying a typology of men who use Anabolic Androgenic Steroids (AAS)http://researchonline.ljmu.ac.uk/8081/ Article LJMU has developed LJMU Research Online for users to access the research output of the University more effectively. Copyright © and Moral Rights for the papers on this site are retained by the individual authors and/or other copyright owners. Users may download and/or print one copy of any article(s) in LJMU Research Online to facilitate their private study or for non-commercial research. You may not engage in further distribution of the material or use it for any profit-making activities or any commercial gain.The version presented here may differ from the published version or from the version of the record. Please see the repository URL above for details on accessing the published version and note that access may require a subscription.

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The syndrome of anabolic-androgenic steroid (AAS) dependence, though well recognized, remains poorly studied. In this preliminary psychometric study, American and British investigators separately administered a structured diagnostic interview module, based on recently proposed criteria for AAS dependence, to 42 male AAS users in Middlesbrough, England. Another investigator, blinded to the diagnostic interview findings, assessed self-reported symptoms of "muscle-dysmorphia"; effects of AAS on various aspects of functioning; and maximum proportion of annual income spent on AAS. We also assessed demographic measures, history of other substance use, and performance on a hypothetical AAS-purchasing task. The interview module yielded very good interrater reliability (kappa = 0.76 and overall intraclass correlation = 0.79) and strong internal consistency (Cronbach's alpha = 0.77-0.87). Men diagnosed as AAS-dependent, when compared to nondependent men, reported significantly earlier onset of AAS use, longer duration and higher maximum doses of AAS used, more frequent use of other performance-enhancing drugs, and a somewhat larger maximum percentage of income spent on AAS. Dependent users also "bought" more AAS in the hypothetical purchase task, but rated significantly more negatively the effects of AAS on their mental health-findings all suggesting that the diagnosis of AAS dependence shows construct validity. As a group, AAS users showed high preoccupation with muscular appearance, but dependence per se was not significantly associated with this measure-suggesting that the diagnosis of AAS dependence shows some evidence of discriminant validity. Collectively, these findings suggest that AAS dependence may be diagnosed reliably, with preliminary evidence for construct and discriminant validity. KeywordsAnabolic-androgenic steroids; substance dependence; diagnostic interview; psychometrics; behavioral economicsCorrespondence should be addressed to Dr. Pope at McLean Hospital, Belmont, MA 02178; telephone 617-855-2911; fax 617-855-3585; hpope@mclean.harvard.edu. NIH Public Access Author ManuscriptExp Clin Psychopharmacol. Author manuscript; available in PMC 2011 June 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptThe anabolic-androgenic steroids (AAS) are a family of drugs comprising testosterone and its numerous synthetic analogs. AAS are widely used by men (and more rarely, women) to gain muscle and lose body fat (H. G. Pope & Brower, 2009). In the United States alone, at least two million individuals have likely used illicit AAS (Centers for Disease Control and Prevention (CDC), 2008; Johnston, O'Malley, Bachman, & Schulenberg, 2009; Kanayama, Hudson, & Pope, in press;McCabe, Brower, West, Nelson, & Wechsler, 2007), and epidemiologic data suggest that there are millions of other AAS users worldwide, particularly in British Commonwealth countries (Baker, Graham, & Davies, 2006;Handelsman & Gupta, 1997;Melia, Pipe, & Greenberg, 1996), Scandinavia (Nilsson, Baigi, Marklund, & Fridlu...

The study is intended to contribute to health policy and practice debate around the targeting of dedicated education, outreach and harm reduction for ethnic groups engaged in IPED use.