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Meta-Analysis
. 2015 Jan;13(1):101-21.
doi: 10.2174/1570159X13666141210222725.

Anabolic-androgenic steroid use and psychopathology in athletes. A systematic review

Daria Piacentino  1 , Georgios D Kotzalidis  1 , Antonio Del Casale  2 , Maria Rosaria Aromatario  3 , Cristoforo Pomara  4 , Paolo Girardi  5 , Gabriele Sani  6
Affiliations
Meta-Analysis

Anabolic-androgenic steroid use and psychopathology in athletes. A systematic review

Daria Piacentino et al. Curr Neuropharmacol. 2015 Jan.

Abstract

The use of anabolic-androgenic steroids (AASs) by professional and recreational athletes is increasing worldwide. The underlying motivations are mainly performance enhancement and body image improvement. AAS abuse and dependence, which are specifically classified and coded by the DSM-5, are not uncommon. AAS-using athletes are frequently present with psychiatric symptoms and disorders, mainly somatoform and eating, but also mood, and schizophrenia-related disorders. Some psychiatric disorders are typical of athletes, like muscle dysmorphia. This raises the issue of whether AAS use causes these disorders in athletes, by determining neuroadaptive changes in the reward neural circuit or by exacerbating stress vulnerability, or rather these are athletes with premorbid abnormal personalities or a history of psychiatric disorders who are attracted to AAS use, prompted by the desire to improve their appearance and control their weights. This may predispose to eating disorders, but AASs also show mood destabilizing effects, with longterm use inducing depression and short-term hypomania; withdrawal/discontinuation may be accompanied by depression. The effects of AASs on anxiety behavior are unclear and studies are inconsistent. AASs are also linked to psychotic behavior. The psychological characteristics that could prompt athletes to use AASs have not been elucidated.

Keywords: Anabolic-androgenic steroids; doping; mood disorders; psychopathology; psychosis.

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Figures

Fig. (1)
Fig. (1)
PRISMA flowchart of systematic review inclusion and exclusion.
See this image and copyright information in PMC

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