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May 1994

Psychiatric and Medical Effects of Anabolic-Androgenic Steroid UseA Controlled Study of 160 Athletes

Arch Gen Psychiatry. 1994;51(5):375-382. doi:10.1001/archpsyc.1994.03950050035004

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.