Prevalence, mental health and substance use of anabolic steroid users: a population-based study on young individuals

Abstract

Aims: The use of anabolic androgen steroids to enhance performance is not a modern phenomenon. However, the majority of today’s anabolic androgen steroid users are not competitive athletes, but individuals who want to look leaner and muscular. This study aimed to examine the prevalence of anabolic androgen steroid use among young individuals and assess whether their mental health, lifestyle and substance use differ from non-anabolic androgen steroid users. Methods: A population-based study conducted in secondary schools, mean age was 17.3 years. A total of 10,259 participants (50% young women, 1% reported gender as ‘other’, 49% young men) answered questions on mental health, anabolic androgen steroid use, substance use and sports participation. Statistical analysis included descriptive statistics, t-test, χ2 and logistic regression. Results: The prevalence of anabolic androgen steroid use was 1.6%, and 78% of users were young men. Anabolic androgen steroid users had more anger issues, anxiety, depression, and their self-esteem was lower than among non-anabolic androgen steroid users ( P<0.05). A larger proportion of anabolic androgen steroid users, 30%, had attempted suicide compared to 10% of non-users (χ2 (1, 9580) = 57.5, P<0.001). Proportionally, anabolic androgen steroid users were more likely to take medicine for mental health problems and misuse substances than non-users. Participation in non-organised sports, increased anger and body image were associated with increased odds of using anabolic androgen steroids. Conclusions: Anabolic androgen steroid use is a public health threat. It had an alarming effect on the life of individuals who report having used anabolic androgen steroids. Authorities, healthcare workers, parents and others working with young people need to be informed of the signs and risks of anabolic androgen steroid use to reduce future negative implications.

Aggression and criminality in androgen abusers

“…Of the 13 included studies, 4 are case studies [9 ▪▪ ,12–14], 4 are cross-sectional studies [15 ▪ –18 ▪ ], and two are meta-analyses of randomized controlled trials (RCTs) [19 ▪▪ ,20 ▪▪ ]. Additionally, two are systematic reviews on the effects of androgen therapy on aggression in transgender men [21 ▪ ] and the side effects of nandrolone decanoate [22], whereas one is a double-blind placebo-controlled RCT [23 ▪ ].…”

“…The studies included a total of 12 556 persons constituting 6661 men, 5154 women, 664 transgender men, and ‘other’ ( n = 77). Only four studies [16 ▪ ,17 ▪ ,20 ▪▪ ,22] sampled women. Androgen abuse duration ranged from a few months [9 ▪▪ ] to 11 years [14] in the case reports, 1.33 [16 ▪ ] to 14.1 [18 ▪ ] years in the cross-sectional studies [15 ▪ ,17 ▪ ], one-time to 28 weeks in the meta-analyses of RCTs [19 ▪▪ ,20 ▪▪ ], and a one-time administration in the RCT [23 ▪ ].…”

Clustering psychopathology in male anabolic–androgenic steroid users and nonusing weightlifters

“…Also of note, it has been reported that among AAS users who sought help to quit AAS use, most did so as a result of mental health problems, with depression and anxiety being the most prominent effects described (Havnes et al, 2019). It has also been reported that AAS users are more prone to suicide or suicidal ideation than nonusers (Gestsdottir et al, 2021;Patel et al, 2021;Petersson et al, 2006;Thiblin et al, 1999), and that this risk increases if personality disorders are present (Borjesson et al, 2020).…”

Unsafe Behaviors and Anabolic Steroid Use

“…Mental health issues are a concern among AAS users. AAS users are reported to have more anxiety, depression, and anger issues than non-AAS users (Ip et al 2011;Gestsdottir et al 2020). Further, AAS-dependent users have higher rates of anxiety, depression, conduct disorder, body dysmorphic disorder, and muscle dysmorphia compared to non-AAS-dependent users or non-AAS users (Ip et al 2012a;Kanayama et al 2009a).…”

“…This also held true for older AAS users (40 years old), where rates of an anxiety disorder were over four times greater among AAS users than non-AAS users (12.0% vs. 2.6%, p¼0.046) (Ip et al 2015). Gestdottier and colleagues reported AAS users were more likely to meet criteria for anxiety (14.6% vs. 12.7%, p<0.001), depression (27.8% vs. 24.8%, p¼0.002), and anger issues (11.0% vs. 8.9%, p<0.001) than non-AAS users (Gestsdottir et al 2020). Female AAS users had higher rates of bulimia nervosa (25.0% vs. 3.5%, p¼0.01) and attention-deficit/hyperactivity disorder (ADHD) (16.7% vs. 2.2%, p¼0.04) than female non-AAS users (Ip et al 2010).…”