Male Anabolic Androgenic Steroid Users with Personality Disorders Report More Aggressive Feelings, Suicidal Thoughts, and Criminality

Abstract

Background and objectives: Anabolic androgenic steroids (AAS) are mainly used for aesthetic and performance-enhancing reasons. Their use is a growing public health problem and concern for society because of their adverse effects. The primary aim of this study was to identify psychiatric and personality disorders and to measure anxiety and depression in AAS users. Materials and Methods: Fifty-six males who actively contacted the Anti-Doping Hot-Line and wished to stop using AAS were included. Structured Clinical Interviews Diagnosis-I and -II were used to diagnose psychiatric and personality disorders. The Brief Scale for Anxiety and Montgomery Asberg Depression Rating Scale (subscales from the Comprehensive Psychopathological Rating Scale) were used to measure changes in anxiety and depression. Structured Clinical Interviews Diagnosis-I and -II were performed at one time point. Anxiety and depression were measured at inclusion and after six months. Urine samples were collected for an analysis of AAS and drugs of abuse. Results: All participants reported some adverse effects that they associated with AAS use. In total, 56% and 52% of the cohort fulfilled the criteria for Structured Clinical Interviews Diagnosis-I and -II diagnoses, respectively. A significantly increased risk of reporting aggressive feelings/behaviors (Odds Ratio (OR) = 4.9; Confidence Interval (CI) 0.99–25, p = 0.04), suicidal thoughts/attempts (OR = 4.6, CI 95; 0.99–21, p = 0.04) and criminality (OR = 6.5, CI 1–39, p = 0.03) was found among individuals with AAS use fulfilling the criteria for personality disorders compared with those without such AAS use. The Brief Scale for Anxiety score decreased from the median of 15 at inclusion to 10 at the follow-up visit six months later (p = 0.01, n = 19). Conclusions: Our findings indicate that among individuals with AAS use, those with a personality disorder report more aggressive behaviors, suicidal thoughts/suicidal attempts, and criminality than those without a personality disorder.

Men´s experiences of using anabolic androgenic steroids

“…Male AAS users have been shown to neglect the side effects of AAS and short-term gains generally outweigh long-term risks (Grogan et al, 2006 ; Kimergård, 2014 ). The majority of AAS users continue their use despite side effects (Ip et al, 2011 ) but they are concerned about harmful effects on health (Börjesson et al, 2020 ; Parkinson & Evans, 2006 ).…”

“…Typical AAS-induced physical side effects in men include sexual problems most commonly erectile dysfunction and decreased libido, acne and gynaecomastia. An association has been seen with a variety of psychiatric complications (Börjesson et al, 2020 ; Eklof et al, 2003 ; Pope & Katz, 1994 ; Pope et al, 2014 ). Typical psychiatric side effects include depression, sleep disorders and mood disturbances (Sjoqvist et al, 2008 ).…”

Testosterone Use and Abuse : Methodological Aspects in Forensic Toxicology and Clinical Diagnostics

“…[4][5][6][85][86][87] These side-effects appear to be idiosyncratic, maybe explained by other factors, such as use of narcotics, social background and diagnosis of personality disorder. 88 Recent evidence also suggests that supraphysiological doses of AAS may cause neurotoxicity and might be a risk factor for dementia. 89 Approximately 30% of AAS users develop a dependence syndrome, characterized by withdrawal symptoms and continued AAS use for years despite adverse side effects and social consequences.…”

Effective treatment and prevention of attempted suicide, anxiety, and aggressiveness with fluoxetine, despite proven use of androgenic anabolic steroids

“…The use of AAS and fluoxetine by the patient was monitored by analysis of urinary samples to minimize confounding factors related to the self‐reported use of substances, such as memory and disclosure bias 11,12 . Naturalistic observation of AAS use, such as this study, is additionally challenged by the use of substances of unknown composition from illicit markets, 13 therefore highlighting the importance of complementing self‐reported data with the analysis of biological samples 14 …”

“…11,12 Naturalistic observation of AAS use, such as this study, is additionally challenged by the use of substances of unknown composition from illicit markets, 13 therefore highlighting the importance of complementing self-reported data with the analysis of biological samples. 14…”