title: Psychological and physical impact of anabolic-androgenic steroid dependence.
abstract: OBJECTIVE
  To contrast the characteristics of two groups of anabolic-androgenic steroid (AAS) users-those with versus those without AAS dependence.
  
  
  METHODS
  Subanalysis of data from the Anabolic 500, a cross-sectional survey.
  
  
  METHODS
  One hundred twelve male AAS-dependent users and 367 AAS-nondependent users who completed an online survey between February 19 and June 30, 2009.
  
  
  RESULTS
  Respondents were recruited from the Internet discussion boards of 38 fitness, bodybuilding, weightlifting, and steroid Web sites. The respondents provided online informed consent and completed the Anabolic 500, a 99-item Web-based survey. Self-reported data included demographics, exercise patterns, use of AAS and other performance-enhancing agents, adverse effects of AAS use, behavior consistent with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria for AAS dependence, history of illicit drug and alcohol use, history of sexual or physical abuse, and psychiatric conditions diagnosed according to the DSM-IV-TR. Behavior consistent with AAS dependence was identified in 23.4% of the survey participants. These AAS-dependent users were more excessive in their AAS use (e.g., higher doses, higher quantity of agents, longer duration of use), more likely to report a history of illicit heroin use in the last 12 months (5.4% vs 1.9%, p=0.049), and more likely to report a diagnosis of an anxiety disorder (16.1 vs 8.4%, p=0.020) or major depressive disorder (15.2% vs 7.4%, p=0.012) than AAS-nondependent users.
  
  
  CONCLUSIONS
  Data from the Anabolic 500 survey showed that almost one quarter of AAS users were dependent on these drugs. These AAS-dependent users had a higher rate of heroin use as well as anxiety and major depressive disorders compared with AAS-nondependent users. These findings can help clinicians and researchers better understand and address the potential illicit drug use and psychiatric comorbidities that may be present among AAS-dependent users.
authors.affiliation: Department of Pharmacy Practice, Touro University California College of Pharmacy, Vallejo, California 94592, USA. eric.ip@tu.edu
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Ip
authors.forename: Debbie H
authors.initials: DH
authors.lastname: Lu
authors.forename: Mitchell J
authors.initials: MJ
authors.lastname: Barnett
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Tenerowicz
authors.forename: Justin C
authors.initials: JC
authors.lastname: Vo
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Perry
mesh_terms: D000293:Adolescent; D000328:Adult; D045930:Anabolic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000728:Androgens / Q000008:administration & dosage / Q000009:adverse effects*; D001008:Anxiety Disorders / Q000150:complications; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000150:complications; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004305:Dose-Response Relationship, Drug; D006306:Health Surveys; D003932:Heroin / Q000008:administration & dosage; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D058573:Performance-Enhancing Substances / Q000008:administration & dosage / Q000009:adverse effects; D013256:Steroids / Q000008:administration & dosage / Q000009:adverse effects*; D019966:Substance-Related Disorders / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*; D055815:Young Adult
chemical_list: D045930:Anabolic Agents; D000728:Androgens; D058573:Performance-Enhancing Substances; D013256:Steroids; D003932:Heroin