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Abumunaser I, Salawati E, Albogami S, Alzahrani T, Kabouha Q, Alzahrani J, Almalki A, Alzahrani N. Knowledge and Awareness About Anabolic-Androgenic Steroid Use as a Body Shape Enhancer and Its Side Effects Among Adult Gym Participants in Jeddah, Saudi Arabia. Cureus 2024; 16:e51747. [PMID: 38318561 PMCID: PMC10840593 DOI: 10.7759/cureus.51747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Anabolic steroids, often referred to as anabolic-androgenic steroids, are steroidal androgens that include testosterone and other naturally occurring androgens, as well as synthetic androgens that are chemically linked to testosterone and have similar actions. MATERIAL AND METHODS A cross-sectional study was conducted to evaluate the knowledge and awareness about anabolic-androgenic steroid (AAS) use and its side effects among adult gym participants in Jeddah. A total of 269 adults fulfilling the inclusion criteria were included. The questionnaire covered the demographics, attitudes, and behaviors associated with AAS use and consisted of single-response questions and four multiple-response questions. All statistical methods used were two-tailed with an alpha level of 0.05, considering significance if the p-value was less than or equal to 0.05. The overall awareness score was categorized as "poor" if the students' score was less than 60% of the overall score and "good" if the students' score was 60% or more. Descriptive analysis was done by prescribing frequency distributions and percentages for study variables, including the adult's personal data, reasons for going to the gym, and duration. RESULTS This study shows a prevalence of 6.3% of adults' use of AAS, which was higher than in some regions in Saudi Arabia. The largest age group that uses AAS, according to this study, is 26-45 years old. A total of 185 (68.8%) were males, and a total of 185 (68.8%) were university graduates. The most reported reasons for going to the gym included fitness (63.2%), muscle building (52.8%), entertainment (39.4%), and weight loss (37.9%). 94.4% of people think that anabolic steroids are harmful to the body, and 80.3% know that misuse of anabolic steroids may lead to problems with the kidneys and liver. 75.1% of male adults and 76.8% of university graduates had good knowledge and awareness. The internet is the most common source of information. CONCLUSION Our study provides clear evidence that there is a high awareness of AAS and its side effects and a high prevalence of its use among male gym participants in Jeddah. The use of AAS is a national problem that the authorities need to act on. There is a strong need for health policy reforms to reduce the rise of AAS use among young adults.
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Affiliation(s)
- Ibrahim Abumunaser
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Emad Salawati
- Family Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Sultan Albogami
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Taher Alzahrani
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Qusai Kabouha
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Jamaan Alzahrani
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Abdulmajeed Almalki
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Nawaf Alzahrani
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
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Vauhkonen PK, Laajala TD, Lindroos KM, Mäyränpää MI. Female doping: observations from a data lake study in the Hospital District of Helsinki and Uusimaa, Finland. BMC Womens Health 2023; 23:242. [PMID: 37161416 PMCID: PMC10170745 DOI: 10.1186/s12905-023-02399-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 04/28/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Doping is a well-recognized risk factor for several potentially severe health effects. Scientific literature concerning the need for medical treatment for such adversities is still sparse. This is especially true for women, due to lower doping use prevalence compared to men. Our study explored the nature of medical contacts and deviance in red blood cell parameters of female patients with doping use in Finnish specialized health care. METHODS This was a retrospective register study. The study sample was gathered from the Hospital District of Helsinki and Uusimaa, Finland (HUS) Datalake. An exhaustive search for doping related terms was performed to find patients with doping use documentation within free-text patient records. Medical record data was supplemented with laboratory data and medical diagnoses covering a total observation time of two decades. Statistical analysis included Fisher's Exact Test and one-way ANOVA. RESULTS We found 39 female patients with history of doping use and specialized health care contacts in the HUS-area between 2002-2020. At initial contact (i.e., the first documentation of doping use), the mean age of these patients was 33.6 years (min 18.1, max 63.5, SD 10.6). The most frequently used doping agents were anabolic androgenic steroids (AAS). The initial contacts were significantly more often acute in nature among patients with active doping use than among patients with only previous use (no use within one year; p = 0.002). Psychiatric and substance use disorder (SUD) morbidity was high (46.2% and 30.8%, respectively). Eight patients (20.5%) had received specialized health care for acute poisoning with alcohol or drugs, and nine (23.1%) for bacterial skin infections. Less than 45% of patients with active AAS use presented with off-range red blood cell parameters. CONCLUSIONS Our findings suggest that female patients with a history of doping use encountered in specialized health care may exhibit high psychiatric and SUD related morbidity. Also, majority of patients with AAS use had red blood cell parameters within-range. Further studies are required to assess the generalizability of these findings to patients within primary health care services, and to determine the usefulness of hematological parameters as indicators of AAS use in female patients.
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Affiliation(s)
- Paula Katriina Vauhkonen
- Forensic Medicine Unit, Finnish Institute for Health and Welfare, P.O. Box 30 (Mannerheimintie 166), 00271, Helsinki, Finland.
- Faculty of Medicine, University of Helsinki, P.O. Box 63 (Haartmaninkatu 3), 00014, Helsinki, Finland.
| | - Teemu Daniel Laajala
- Department of Mathematics and Statistics, University of Turku, Yliopistonmäki (Vesilinnantie 5), 20014, Turku, Finland
| | - Katarina Mercedes Lindroos
- Forensic Medicine Unit, Finnish Institute for Health and Welfare, P.O. Box 30 (Mannerheimintie 166), 00271, Helsinki, Finland
| | - Mikko Ilari Mäyränpää
- Department of Pathology, University of Helsinki, P.O. Box 21 (Haartmaninkatu 3), 00014, Helsinki, Finland
- Helsinki University Hospital, P.O. Box 340, FI-00029, Helsinki, Finland
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Jørstad ML, Scarth M, Torgersen S, Pope HG, Bjørnebekk A. Clustering psychopathology in male anabolic-androgenic steroid users and nonusing weightlifters. Brain Behav 2023:e3040. [PMID: 37150843 DOI: 10.1002/brb3.3040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/14/2023] [Accepted: 04/20/2023] [Indexed: 05/09/2023] Open
Abstract
INTRODUCTION Prior research has demonstrated that personality disorders and clinical psychiatric syndromes are common among users of anabolic-androgenic steroids (AAS). However, the prevalence, expression, and severity of psychopathology differ among AAS users and remain poorly understood. In this study, we examine the existence of potential clinically coherent psychopathology subgroups, using cluster procedures. METHODS A sample of 118 male AAS users and 97 weightlifting nonusers was assessed using the Millon Clinical Multiaxial Inventory-III (MCMI-III), measuring personality disorders and clinical syndromes. Group differences in MCMI-III scales were assessed using Wilcoxon-Mann-Whitney tests and Fisher's exact test. Agglomerative hierarchical clustering was used to identify clusters based on MCMI-III scale scores from the whole sample. RESULTS AAS users displayed significantly higher scores on all personality disorder (except narcissistic) and clinical syndrome scales compared to nonusing weightlifters. The clustering analysis found four separate clusters with different levels and patterns of psychopathology. The "no psychopathology" cluster was most common among nonusing weightlifters, while the three other clusters were more common among AAS users: "severe multipathology," "low multipathology," and "mild externalizing." The "severe multipathology" cluster was found almost exclusively among AAS users. AAS users also displayed the highest scores on drug and alcohol dependence syndromes. CONCLUSIONS AAS users in our sample demonstrated greater psychopathology than the nonusing weightlifters, with many exhibiting multipathology. This may pose a significant challenge to clinical care for AAS users, particularly as there appears to be significant variation in psychopathology in this population. Individual psychiatric profiles should be taken into consideration when providing treatment to this group. SIGNIFICANT OUTCOMES As a group, AAS users displayed markedly greater psychopathology than nonusing weightlifters. Multipathology was common among AAS users. Four different subgroups of personality profiles were identified with distinct patterns of pathology and severity. LIMITATIONS The cross-sectional nature of the study precludes inferences about causality. The study is limited by possible selection bias, as participants choosing to be involved in research may not be entirely representative for the group as a whole. The study is vulnerable to information bias, as the results are based on self-report measures and interviews.
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Affiliation(s)
- Marie Lindvik Jørstad
- Anabolic Androgenic Steroid Research Group, National Advisory Unit on SUD Treatment, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Morgan Scarth
- 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
| | | | - Harrison Graham Pope
- Biological Psychiatry Laboratory, McLean Hospital, Belmont, Massachusetts, USA
- Harvard Medical School, Department of Psychiatry, Boston, Massachusetts, USA
| | - Astrid Bjørnebekk
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Thevis M, Kuuranne T, Geyer H. Annual banned-substance review-Analytical approaches in human sports drug testing 2021/2022. Drug Test Anal 2023; 15:5-26. [PMID: 36369629 DOI: 10.1002/dta.3408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/10/2022] [Indexed: 11/13/2022]
Abstract
Also in 2021/2022, considerable efforts were invested into advancing human sports drug testing programs, recognizing and taking into account existing as well as emerging challenges in anti-doping, especially with regard to substances and methods of doping specified in the World Anti-Doping Agency's 2022 Prohibited List. In this edition of the annual banned-substance review, literature on recent developments published between October 2021 and September 2022 is summarized and discussed. Focus is put particularly on enhanced analytical approaches and complementary testing options in human doping controls, appreciating the exigence and mission in anti-doping and, equally, the contemporary "new normal" considering, for example, the athlete's exposome versus analytical sensitivity and applicable anti-doping regulations for result interpretation and management.
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Affiliation(s)
- Mario Thevis
- Center for Preventive Doping Research-Institute of Biochemistry, German Sport University Cologne, Cologne, Germany.,European Monitoring Center for Emerging Doping Agents, Cologne, Germany
| | - Tiia Kuuranne
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Genève and Lausanne, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Epalinges, Switzerland
| | - Hans Geyer
- Center for Preventive Doping Research-Institute of Biochemistry, German Sport University Cologne, Cologne, Germany.,European Monitoring Center for Emerging Doping Agents, Cologne, Germany
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Windfeld‐Mathiasen J, Christoffersen T, Strand NAW, Dalhoff K, Andersen JT, Horwitz H. Psychiatric morbidity among men using anabolic steroids. Depress Anxiety 2022; 39:805-812. [PMID: 36281632 PMCID: PMC10092709 DOI: 10.1002/da.23287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/21/2022] [Accepted: 10/02/2022] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE The purpose of this study was to investigate the psychiatric morbidity among men with abuse of anabolic steroids. METHODS The design is a retrospectively matched cohort study. Five hundred and fourty-five males, who tested positive for anabolic steroids in Danish fitness centers during the period January 3, 2006 to March 1, 2018, were matched with 5450 randomly chosen male controls. Data was cross-referenced with seven national registers pertaining to information about education, employment status, and psychiatric comorbidity. Main outcomes and measures were prescription of psychopharmacological treatment. RESULTS The incidence of treatment with anxiolytics (HR: 2.34, 95% CI: 1.62-3.38) and antipsychotics (HR: 2.69, 95% CI: 1.99-3.63) displayed a remarkable increase in the years following doping sanction, compared to the control group. The prevalence of antidepressant use was already markedly elevated several years before doping sanction, but also displayed a higher incidence in the years following sanction (HR: 1.65, 95% CI: 1.28-2.13). The associations remained highly significant after controlling for socioeconomic factors. CONCLUSION Anabolic steroids use is strongly associated with psychiatric morbidity.
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Affiliation(s)
| | - Thea Christoffersen
- Department of Clinical PharmacologyBispebjerg and Frederiksberg HospitalCopenhagenDenmark
| | | | - Kim Dalhoff
- Department of Clinical PharmacologyBispebjerg and Frederiksberg HospitalCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Jon Trærup Andersen
- Department of Clinical PharmacologyBispebjerg and Frederiksberg HospitalCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Henrik Horwitz
- Department of Clinical PharmacologyBispebjerg and Frederiksberg HospitalCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
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Amaral JMX, Kimergård A, Deluca P. Prevalence of anabolic steroid users seeking support from physicians: a systematic review and meta-analysis. BMJ Open 2022; 12:e056445. [PMID: 35788077 PMCID: PMC9255415 DOI: 10.1136/bmjopen-2021-056445] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To estimate the overall prevalence of androgenic-anabolic steroids (AAS) users seeking support from physicians. Secondary objectives are to compare this prevalence in different locations and among subpopulations of AAS users, and to discuss some of the factors that could have influenced the engagement of AAS users with physicians. DESIGN Systematic review and meta-analysis. DATA SOURCES MEDLINE, PsycINFO, Web of Science and SciELO were searched in January 2022. ELIGIBILITY CRITERIA Quantitative and qualitative studies reporting the number of AAS users who sought support from physicians, with no restrictions of language or time of publication. DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted data and assessed the quality of studies, including publication bias. A random-effects meta-analysis was performed to estimate the overall prevalence of AAS users seeking support from physicians, followed by pooled prevalence rates by studies' location and the subpopulation of AAS users. RESULTS We identified 36 studies published between 1988 and 2021, involving 10 101 AAS users. The estimated overall prevalence of AAS users seeking support from physicians is 37.12% (95% CI 29.71% to 44.52%). Higher prevalence rates were observed in studies from Australia (67.27%; 95% CI 42.29% to 87.25%) and among clients of the needle and syringe exchange programme (54.13%; 95% CI 36.41% to 71.84%). The lowest prevalence was observed among adolescent AAS users (17.27%; 95% CI 4.80% to 29.74%). CONCLUSION Our findings suggest that about one-third of AAS users seek support from physicians, with remarkable differences between locations and subpopulations of AAS users. Further studies should investigate the factors influencing the engagement of AAS users with physicians. PROSPERO REGISTRATION NUMBER CRD42020177919.
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Affiliation(s)
| | - Andreas Kimergård
- Addictions, King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - Paolo Deluca
- Addictions, King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
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