Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program, National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, Maryland, USA.
Center on Compulsive Behaviors, National Institutes of Health, Baltimore, Maryland, USA.
Hum Psychopharmacol. 2022 Jan;37(1):e2815. doi: 10.1002/hup.2815. Epub 2021 Sep 15.
The use of anabolic androgenic steroids (AASs) as performance and image enhancing drugs (PIEDs), once restricted to professional athletes, now includes amateurs and regular gym visitors. AAS use is associated with psychopathology, yet this relationship is complex and not fully understood. We aimed to assess the presence of AASs and other misused substances in athletes' biological samples and link toxicological to psychopathological findings.
A multicentre, cross-sectional study in fitness centres in Italy recruited 122 professional and amateur athletes training in several sports (84 men; age range = 18-45 years). Athletes completed questionnaires, interviews, and toxicology testing for AASs, other PIEDs, illicit drugs, and non-prescribed psychotropics. Toxicology was conducted in blood, urine, and hair.
Self-reported and toxicologically detected use rates of AASs and other misused substances showed slight-to-fair agreement (Fleiss' κ = 0.104-0.375). There was slight-to-moderate agreement among the three biological samples used for AAS testing (κ = 0.112-0.436). Thirty-one athletes (25.4%) tested positive for AASs. More sport hours/week, narcissistic or antisocial personality disorders, and higher nonplanning impulsiveness scores predicted AAS use (pseudo-R = 0.665). AAS users did not differ significantly from non-users in major psychopathology, but their Hypomania Checklist-32 score, which also predicted AAS use, was significantly higher (p < 0.001), suggesting increased odds for cyclothymic disorder or subthreshold hypomania.
Our results have implications for studying AAS users, as they identify a cluster of variables that may be relevant in future understanding of AAS use risks (e.g., personality disorders). Possible disagreements between AAS assessment methods should be considered when implementing harm reduction interventions, such as needle and syringe distribution, health education, and counselling, as well as surveillance programmes.
曾经仅限于职业运动员使用的合成代谢雄激素类固醇（AAS）作为表现和形象增强药物（PIED），现在包括业余运动员和普通健身房访客。AAS 使用与精神病理学有关，但这种关系很复杂，尚未完全理解。我们旨在评估运动员生物样本中 AAS 和其他滥用物质的存在，并将毒理学与精神病理学发现联系起来。
意大利健身中心的一项多中心、横断面研究招募了 122 名从事多项运动的专业和业余运动员（84 名男性；年龄范围 18-45 岁）。运动员完成了问卷、访谈和 AAS、其他 PIED、非法药物和非处方精神药物的毒理学检测。毒理学检测在血液、尿液和头发中进行。
自我报告和毒理学检测的 AAS 和其他滥用物质的使用率显示出轻微到适度的一致性（Fleiss' κ = 0.104-0.375）。用于 AAS 检测的三种生物样本之间存在轻微到中度的一致性（κ = 0.112-0.436）。31 名运动员（25.4%）检测出 AAS 阳性。每周运动时间更长、自恋或反社会人格障碍以及更高的非计划性冲动得分预测 AAS 使用（伪 R 2 = 0.665）。AAS 使用者与非使用者在主要精神病理学方面没有显著差异，但他们的躁狂清单-32 评分（也预测 AAS 使用）明显更高（p < 0.001），表明患有环性心境障碍或亚阈值轻躁狂的可能性更高。
我们的研究结果对研究 AAS 使用者具有启示意义，因为它们确定了一组可能与未来理解 AAS 使用风险相关的变量（例如，人格障碍）。在实施减少伤害干预措施（如针和注射器分发、健康教育和咨询）以及监测计划时，应考虑 AAS 评估方法之间可能存在的差异。
