Kanayama Gen, Hudson James I, Pope Harrison G
Biological Psychiatry Laboratory, McLean Hospital/Harvard Medical School, 115 Mill Street, Belmont, MA 02478, United States.
Drug Alcohol Depend. 2009 Jun 1;102(1-3):130-7. doi: 10.1016/j.drugalcdep.2009.02.008. Epub 2009 Apr 1.
Anabolic-androgenic steroid (AAS) dependence has been a recognized syndrome for some 20 years, but remains poorly understood.
We evaluated three groups of experienced male weightlifters: (1) men reporting no history of AAS use (N=72); (2) nondependent AAS users reporting no history of AAS dependence (N=42); and (3) men meeting adapted DSM-IV criteria for current or past AAS dependence (N=20). We assessed demographic indices, lifetime history of psychiatric disorders by the Structured Clinical Interview for DSM-IV, variables related to AAS use, and results from drug tests of urine and hair.
Nondependent AAS users showed no significant differences from AAS nonusers on any variable assessed. Dependent AAS users, however, differed substantially from both other groups on many measures. Notably, they reported a more frequent history of conduct disorder than nondependent AAS users (odds ratio [95% CI]: 8.0 [1.7, 38.0]) or AAS nonusers (13.1 [2.8, 60.4]) and a much higher lifetime prevalence of opioid abuse and dependence than either comparison group (odds ratios 6.3 [1.2, 34.5] and 18.6 [3.0, 116.8], respectively).
Men with AAS dependence, unlike nondependent AAS users or AAS nonusers, showed a distinctive pattern of comorbid psychopathology, overlapping with that of individuals with other forms of substance dependence. AAS dependence showed a particularly strong association with opioid dependence - an observation that recalls recent animal data suggesting similarities in AAS and opioid brain reward mechanisms. Individuals with AAS dependence and individuals with "classical" substance dependence may possibly harbor similar underlying biological and neuropsychological vulnerabilities.
合成代谢雄激素类固醇（AAS）依赖作为一种公认的综合征已有约20年，但人们对其仍知之甚少。
我们评估了三组有经验的男性举重运动员：（1）报告无AAS使用史的男性（N = 72）；（2）报告无AAS依赖史的非依赖性AAS使用者（N = 42）；以及（3）符合经修订的DSM-IV当前或过去AAS依赖标准的男性（N = 20）。我们评估了人口统计学指标、通过DSM-IV结构化临床访谈得出的精神疾病终生史、与AAS使用相关的变量以及尿液和毛发药物检测结果。
在任何评估变量上，非依赖性AAS使用者与未使用AAS者均无显著差异。然而，依赖性AAS使用者在许多指标上与其他两组有很大不同。值得注意的是，他们报告品行障碍史的频率高于非依赖性AAS使用者（优势比[95%置信区间]：8.0 [1.7, 38.0]）或未使用AAS者（13.1 [2.8, 60.4]），且阿片类药物滥用和依赖的终生患病率远高于两个对照组（优势比分别为6.3 [1.2, 34.5]和18.6 [3.0, 116.8]）。
与非依赖性AAS使用者或未使用AAS者不同，AAS依赖的男性表现出一种独特的共病精神病理学模式，与其他形式物质依赖者的模式重叠。AAS依赖与阿片类药物依赖表现出特别强的关联——这一观察结果让人想起近期的动物数据，这些数据表明AAS和阿片类药物的脑奖赏机制存在相似性。AAS依赖者和“经典”物质依赖者可能存在相似的潜在生物学和神经心理学易损性。
