Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway.
Anabolic Androgenic Steroid Research Group, National Advisory Unit on SUD Treatment, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
J Psychiatr Res. 2022 Nov;155:295-301. doi: 10.1016/j.jpsychires.2022.09.023. Epub 2022 Sep 21.
Anabolic-androgenic steroids (AAS) are primarily used to improve physical appearance and increase lean muscle mass. Due to their masculinizing properties, the majority of people using AAS are men; however, AAS use among females may increase with changing body ideals trending towards a more muscular appearance. AAS use among males have been associated with risk-taking behavior, and increased prevalence of personality disorders and psychopathology. As a result of low perceived prevalence and stigma among females who use AAS, the relationship between AAS use and psychopathology in this population is not well-known. AAS using women (n = 16) and weight-lifting controls (WLC) (n = 16) completed questionnaires regarding AAS use, health and training information. Psychopathology was evaluated using the Millon Clinical Multiaxial Inventory-III (MCMI-III). Group differences on demographic variables and scores on MCMI-III scales were evaluated with Mann-Whitney U tests. The clinical cut-off was then applied to all MCMI-III scales and groups were compared using Fisher's exact test. AAS consumers demonstrated significantly greater psychopathology than WLC on several scales. Externalizing personality disorder scales were elevated among those who use AAS relative to controls, such as borderline (p < 0.001), antisocial (p = 0.007) and sadistic (p = 0.002), and in addition depressive (p = 0.012), negativistic (p = 0.001) and masochistic (p = 0.029) personality disorders scales. Furthermore, all clinical syndromes were elevated among AAS consumers. AAS consumers thus demonstrated multi-pathology, and 56% (n = 9) of the group met the clinical criteria for six or more disorders. Females who use AAS experience in general increased levels of psychopathology compared to WLC. Clinicians should be aware of these traits and the challenges they present in providing care to this population.
合成代谢雄激素类固醇（AAS）主要用于改善外貌和增加肌肉质量。由于其雄性化特性，大多数使用 AAS 的人是男性；然而，随着身体理想朝着更肌肉发达的外观发展，女性中 AAS 的使用可能会增加。男性使用 AAS 与冒险行为以及人格障碍和精神病理学的发病率增加有关。由于使用 AAS 的女性中普遍存在低感知患病率和耻辱感，因此该人群中 AAS 使用与精神病理学之间的关系尚不清楚。使用 AAS 的女性（n=16）和举重对照（WLC）（n=16）完成了关于 AAS 使用、健康和训练信息的问卷。使用 Millon 临床多轴量表-III（MCMI-III）评估精神病理学。使用 Mann-Whitney U 检验评估组间在人口统计学变量和 MCMI-III 量表得分上的差异。然后将临床截止值应用于所有 MCMI-III 量表，并使用 Fisher 确切检验比较组间差异。与 WLC 相比，AAS 使用者在多个量表上表现出明显更高的精神病理学。与对照组相比，使用 AAS 的人出现了更高的外向型人格障碍量表，如边缘型（p<0.001）、反社会型（p=0.007）和虐待型（p=0.002），此外还包括抑郁型（p=0.012）、消极型（p=0.001）和受虐型（p=0.029）人格障碍量表。此外，AAS 使用者的所有临床综合征都升高。因此，AAS 使用者表现出多系统病理学，56%（n=9）的组符合六个或更多障碍的临床标准。与 WLC 相比，使用 AAS 的女性总体上经历了更高水平的精神病理学。临床医生应该意识到这些特征以及在为该人群提供护理方面所带来的挑战。
