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Psychiatric side effects induced by supraphysiological doses of combinations of anabolic steroids correlate to the severity of abuse
Eur Psychiatry. 2005 Dec 12; [Epub ahead of print]
Objective – The objective of our study was to evaluate the psychological consequences of real-world anabolic androgenic steroids use in athletes abusing such agents, in comparison with a placebo and control group of comparable athletes, while correlating the severity of abuse with the side effects observed. The hypothesis tested by the study was that the use of anabolic androgenic steroids induces a wide range of psychological side effects whose impact and emergence is dependent upon the severity of the abuse.
Design – The study includes a substantial group of anabolic androgenic steroids abusing athletes and two more groups demographically similar to the first, one composed of athletes not using any substance and a placebo group. All athletes were stratified according to the severity of anabolic androgenic steroids abuse.
Psychometric instruments were applied to all athletes in specific time intervals, dependent to the anabolic androgenic steroids abusers' regimens, providing us with a final psychological profile that was to be compared to the pre-study profile.
All results were comparable (within and between groups) for statistically significant differences and correlated to the severity of the abuse. Homogeneity of all groups was safeguarded by random doping controls, monitoring of drug levels and analysis of all self obtained drugs by method of liquid chromatography/mass spectrometry.
All athletes were provided with a common exercise and dietary regime, so common training and nutritional conditions were achieved.
Methods – We studied a cohort of 320 body-building, amateur and recreational athletes, of whom 160 were active users of anabolic androgenic steroids (group C), 80 users administering placebo drugs (group B) and 80 not abusing any substance (Group A).
Group C athletes were stratified according to AAS abuse parameters, thus providing us with three subgroups of "light, medium and heavy abuse".
Athletes of groups A and B were included in a "no abuse" subgroup. The psychometric instruments used were the Symptoms Check List-90 (SCL-90) and the Hostility and Direction of Hostility Questionnaire (HDHQ).
The SCL-90 is a 90-item self-report system inventory is designed to reflect the psychological symptom patterns of community, medical and psychiatric respondents. It is divided into 10 subscales, containingnine dimensions of psychiatric symptomatology: Somatization, Obsessive–Compulsiveness, Interpersonal Sensitivity, Depression, Anxiety, Hostility, Phobic Anxiety, Paranoid Ideation and Psychoticism and includes three symptomatic indices: General Symptomatic Index (G.S.I.), Positive Symptomatic Total (P.S.T.) and Positive Symptom Distress Level (P.S.D.L.)
The psychometric evaluations took place within a time interval of 13 months. Statistical analysis wasperformed by using the Mann–Whitney/Wilcoxon two-sample non-parametric test (Kruskal–Wallis test for two groups) for data that were not normally distributed and Linear regression analysis was used to ascertain the correlation between severity of use and escalation of side effects.
Results – The study showed a statistically significant increase in all psychometric subscales recorded in group C, and no statistically significant difference in group C and A. There was a significant increase in the scorings of group C for all subscales of SCL-90 and HDHQ.
Correlation of abuse severity and side effects showed that there was a statistical significant increase in D values of all SCL-90 and HDHQ subscales that escalated from light abuse to medium and heavy abuse/consumption patterns.
Conclusions – The results of the study suggest that the wide range of psychiatric side effects induced by the use of anabolic androgenic steroids is correlated to the severity of abuse and the force of these side effects intensifies as the abuse escalates.