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

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Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Huddinge, 141 86 Stockholm, Sweden
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Centre for Ethics, Law and Mental Health, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
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Psychiatric Clinic, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
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Department of Forensic Psychiatry, National Board of Forensic Medicine, 422 49 Gothenburg, Sweden
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The Ambulance Medical Service in Stockholm (AISAB), Academic EMS, 121 63 Stockholm, Sweden
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Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, 171 77 Stockholm, Sweden
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Department of Medicine, Karolinska Institutet, S:t Görans Hospital, 122 19 Stockholm, Sweden
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Department of Neurobiology Care Sciences and Society, Karolinska Institutet, 171 77 Stockholm, Sweden
*
Author to whom correspondence should be addressed.
Medicina 2020, 56(6), 265; https://doi.org/10.3390/medicina56060265
Received: 15 April 2020 / Revised: 25 May 2020 / Accepted: 26 May 2020 / Published: 28 May 2020
(This article belongs to the Section Public Health)
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. View Full-Text
Keywords: anabolic androgenic steroids (AAS); adverse effects of psychiatric disorders; structured clinical interview diagnosis; comprehensive psychopathological rating scale; personality disorders anabolic androgenic steroids (AAS); adverse effects of psychiatric disorders; structured clinical interview diagnosis; comprehensive psychopathological rating scale; personality disorders
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Börjesson, A.; Möller, C.; Hagelin, A.; Vicente, V.; Rane, A.; Lehtihet, M.; Dahl, M.-L.; Gårevik, N.; Ekström, L. Male Anabolic Androgenic Steroid Users with Personality Disorders Report More Aggressive Feelings, Suicidal Thoughts, and Criminality. Medicina 2020, 56, 265.

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