PSYCHIATRIC AND MEDICAL EFFECTS OF ANABOLIC-ANDROGENIC STEROID USE - A CONTROLLED-STUDY OF 160 ATHLETES

Background: We sought to expand on preliminary findings suggesting that anabolic-androgenic steroids produce psychiatric effects in some athletes who use them. Methods: We compared 88 athletes who were using steroids with 68 nonusers, using the Structured Clinical Interview for DSM-III-R to diagnose psychiatric syndromes occurring in association with steroid use (if applicable) and in the absence of steroid use. Demographic, medical, and laboratory measures were also performed. Results: Steroid users displayed more frequent gynecomastia, decreased mean testicular length, and higher cholesterol-high-density lipoprotein ratios than nonusers. Most strikingly, 23% of steroid users reported major mood syndromes-mania, hypomania, or major depression-in association with steroid use. Steroid users displayed mood disorders during steroid exposure significantly more frequently than in the absence of steroid exposure (P<.001) and significantly more frequently than nonusers (P<.01). Users rarely abused other drugs simultaneously with steroids. Conclusion: Major mood disturbances associated with anabolic-androgenic steroids may represent an important public health problem for athletes using steroids and sometimes for the victims of their irritability and aggression.