Anabolic androgenic steroids and suicide

Area of Science:

• Forensic Psychiatry
• Psychopharmacology
• Toxicology

Background:

• Anabolic androgenic steroids (AAS) are synthetic variations of testosterone used for performance enhancement and physique alteration.
• Concerns exist regarding the potential psychiatric and behavioral side effects of AAS use, including aggression and mood disturbances.
• Suicide is a significant public health issue, and understanding contributing factors is crucial for prevention.

Observation:

• This study examined eight medicolegal cases of suicide in males aged 21-33 with a history of AAS use (current or discontinued).
• Five suicides occurred during current AAS use, and two occurred within 2-6 months of AAS withdrawal.
• Observed psychiatric symptoms included depression (associated with withdrawal in five cases), hypomania-like symptoms, and recent acts of violence during AAS use.

Findings:

• Long-term AAS use was associated with the development of depressive syndromes in four individuals.
• Acts of violence linked to AAS use exacerbated personal and professional problems, potentially precipitating suicide.
• While AAS-related psychiatric symptoms were noted, all cases also presented with independent risk factors for suicidality.

Implications:

• The findings suggest that psychiatric symptoms and interpersonal conflicts arising from long-term AAS use may contribute to completed suicide in susceptible individuals.
• This highlights the importance of considering AAS use in the differential diagnosis of psychiatric disturbances and suicidal behavior.
• Further research is warranted to elucidate the complex interplay between AAS, psychiatric health, and suicide risk.