The abuse of anabolic steroids is associated with a number of serious psychiatric adverse effects.
Adverse psychiatric effects in a person who abuses anabolic steroids:
(1) depression
(2) mania or hypomania
(3) violent outbursts with physical aggression ("steroid rage", "roid rage")
(4) sexual aggression with sexual assault and rape
(5) physical and/or psychological dependency, which may be associated with withdrawal (see Chapter 32)
Risk factors:
(1) high doses of anabolic steroids for prolonged periods of time
(2) concurrent drug abuse (unusual in competitive athletes)
(3) recent stressors such as serious injury or recent competitive loss
(4) cover-up by coaches or others (reduces the chances of an early intervention)
