Psychiatric and medical effects of anabolic-androgenic steroid use. A controlled study of 160 athletes

Arch Gen Psychiatry. 1994 May;51(5):375-82. doi: 10.1001/archpsyc.1994.03950050035004.


Background: We sought to expand on preliminary findings suggesting that anabolic-androgenic steroids produce psychiatric effects in some athletes who use them.

Methods: We compared 88 athletes who were using steroids with 68 nonusers, using the Structured Clinical Interview for DSM-III-R to diagnose psychiatric syndromes occurring in association with steroid use (if applicable) and in the absence of steroid use. Demographic, medical, and laboratory measures were also performed.

Results: Steroid users displayed more frequent gynecomastia, decreased mean testicular length, and higher cholesterol-high-density lipoprotein ratios than nonusers. Most strikingly, 23% of steroid users reported major mood syndromes--mania, hypomania, or major depression--in association with steroid use. Steroid users displayed mood disorders during steroid exposure significantly more frequently than in the absence of steroid exposure (P < .001) and significantly more frequently than nonusers (P < .01). Users rarely abused other drugs simultaneously with steroids.

Conclusion: Major mood disturbances associated with anabolic-androgenic steroids may represent an important public health problem for athletes using steroids and sometimes for the victims of their irritability and aggression.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Anabolic Agents* / adverse effects
  • Atrophy
  • Cholesterol, HDL / blood
  • Comorbidity
  • Depressive Disorder / chemically induced
  • Depressive Disorder / epidemiology
  • Doping in Sports
  • Dose-Response Relationship, Drug
  • Gynecomastia / chemically induced
  • Gynecomastia / epidemiology
  • Humans
  • Male
  • Mental Disorders / chemically induced*
  • Mental Disorders / epidemiology
  • Methyltestosterone* / adverse effects
  • Prevalence
  • Sports Medicine
  • Substance Withdrawal Syndrome / epidemiology
  • Substance Withdrawal Syndrome / etiology
  • Substance-Related Disorders / complications*
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / epidemiology
  • Testis / drug effects
  • Testis / pathology
  • Testosterone* / adverse effects
  • Weight Lifting


  • Anabolic Agents
  • Cholesterol, HDL
  • Testosterone
  • Methyltestosterone