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Background Universities around the world are facing an epidemic of mental distress among their students. The problem is truly a public health issue, affecting many and with serious consequences. The global burden of disease-agenda calls for effective interventions with lasting effects that have the potential to improve the mental health of young adults. In this study we aimed to determine whether yoga, a popular and widely available mind-body practice, can improve student mental health. Methods We performed a randomised controlled trial with 202 healthy university students in the Oslo area. The participants were assigned to a yoga group or waitlist control group in a 1:1 ratio by a simple online randomisation program. The intervention group was offered 24 yoga sessions over 12 weeks. Measurements were taken at week 0 (baseline), week 12 (post-intervention), and week 24 (follow-up). The primary outcome was psychological distress assessed by the HSCL-25 questionnaire. Analysis was performed based on the intention to treat-principle. Results Between 24 January 2017, and 27 August 2017, we randomly assigned 202 students to a yoga intervention group ( n = 100), or waitlist control group ( n = 102). Compared with the control group, the yoga participants demonstrated a significant reduction in distress symptoms both at post-intervention (adjusted difference in the mean change −0.15, 95% CI −0.26 to −0.03, p = 0.0110) and follow-up (adjusted difference in the mean change −0.18, 95% CI −0.29 to −0.06, p = 0.0025). Sleep quality also improved at post-intervention and follow-up. No adverse events were reported. Conclusions Our findings suggest that yoga has a moderately large and lasting effect, at least for some months, reducing symptoms of distress and improving sleep quality among students. Further research should seek ways to enhance the effect, assess an even longer follow-up period, include active control groups, and consider performing similar studies in other cultural settings. Trial registration: ClinicalTrials.gov identifier: NCT04258540.

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Use of anabolic androgenic steroids (AAS) causes drastic changes in hormonal milieu and is associated with a range of medical and psychological consequences. Sleep pathology is a common side-effect of AAS use but few have studied these relations. This study examined the relationship between AAS use, psychological distress and sleep quality, and how phases of heavy use and abstinence influence sleep. The Pittsburgh-Sleep-Quality-Index (PSQI) and Jenkins Sleep Scale (JSS) were used to assess sleep quality, and psychological distress was measured with the Hopkins Symptoms Checklist (HSCL). Participants comprised men who have previous or current long-term use of AAS (n=68) and non-using weightlifting controls (WLC) (n=58), where a subgroup of participants (n= 22) was monitored over ~6 months during phases of AAS use and withdrawal. Group differences on PSQI and JSS were evaluated with Kruskal-Wallis H tests, and the mediating role of psychological distress was evaluated using structural equation modeling. Linear mixed models were used to assess the role of AAS use and withdrawal on sleep quality. Among the AAS group, 65% reported sleep problems as a side effect, and 43% had used sleep medication. PSQI scores showed significantly lower sleep quality in the AAS group compared to WLC (p<0.001) on all subscales except “sleep latency”. Furthermore, sleep quality was significantly poorer during withdrawal-phases than periods with AAS use (p<.001). Our findings provide key insight into sleep disturbances among men who use AAS, suggesting a link between sleep disturbances and hormone levels that deviate from physiologically normal levels in both directions.

Background: Anabolic-androgenic steroids (AAS) comprise testosterone and synthetic derivatives, primarily used in the bodybuilding and fitness communities to increase lean muscle mass. However, AAS can lead to several somatic and psychiatric side-effects. As a result of low perceived prevalence and stigma among female users, the relationship between AAS use and psychopathology in this population is not well-known.Methods: AAS using women (n=16) and weight-lifting controls (WLC) (n=16) completed questionnaires regarding AAS use, health and training information. Psychopathology was evaluated using the Millon Clinical Multiaxial Inventory-III (MCMI-III). Group differences on demographic variables and scores on MCMI-III scales were evaluated with Mann-Whitney U tests. The clinical cut-off was then applied to all MCMI-III scales and groups were compared using Fisher’s exact test. Results: AAS users demonstrated significantly greater psychopathology than WLC on several scales. Externalizing personality disorder scales were elevated among users relative to controls, such as borderline (p<0.001), antisocial (p=0.007) and sadistic (p=0.002), and in addition depressive (p=0.012), negativistic (p=0.001) and masochistic (p=0.029) personality disorders scales. Furthermore, all clinical syndromes were elevated among AAS users. AAS users thus demonstrated multi-pathology, and 56% (n=9) of the group met the clinical criteria for six or more disorders. Conclusion: Female AAS users experience in general increased levels of psychopathology compared to WLC. Clinicians should be aware of these traits and the challenges they present in providing care to female AAS users.