ANABOLIC-ANDROGENIC STEROID ABUSE AND PSYCHOPATHOLOGY

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Case Example

Mr. A, an auto mechanic by trade, is a heavily muscled 26-year-old, single, black man who presented to an outpatient psychiatric clinic angrily demanding to see a doctor. During an initial evaluation, he complained of frequent homicidal thoughts of killing his last two employers who fired him because he threatened co-workers who he believed were “plotting” against him. He could not give supporting evidence for his claims. His girlfriend stated that he had grown increasingly hostile and

ANABOLIC STEROID ABUSE AND PERSONALITY PSYCHOPATHOLOGY

Some investigators have suggested that personality psychopathology may be a risk factor for anabolic steroid use and abuse. A relationship between personality psychopathology and anabolic steroid use has been reported in only two studies. Using a self-report inventory10 comprised of the 11 personality disorder categories of the DSM-III, Yates et al22 reported that anabolic-steroid users (n=20) and weight lifter controls (n=20) had a higher prevalence of cluster B (histrionic, narcissistic,

SUMMARY

Anabolic steroid abuse is a significant public health problem. There is evidence from both case reports and empirical studies that abuse of these drugs causes significant psychiatric and medical effects. There appears to be a relationship between increased dosages and severity of psychiatric symptomatology. Research is needed on the role of pathologic personality traits in the initiation and maintenance of anabolic steroid abuse.

ACKNOWLEDGMENT

The authors thank Sabine Chrisman, PhD, for her helpful editorial comments.

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      Other psychiatric presentations include the development of acute psychoses, exacerbation of tics and depression, and the development of acute confusional/delirious states.2,6–8 Extreme variability of symptom presentation exists because of differences in the dose consumed, agent used, duration of use, personality type of the abuser, and current or previous use of other recreational drugs.2,9–11 Studies in which steroid abusers have been used as their own comparison subjects, in the attempt to eliminate the variable of personality disorder, have shown differences in the degree of hostility, aggression, and severity of manic-like symptoms during periods of use and nonuse.4–8

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