Anabolic androgenic steroid abuse and mood disorder: a case report.

Current data suggest that the use of anabolic androgenic steroids (AAS) has become quite common among athletes, bodybuilders, as well as adolescents and young adults who want to increase their muscle mass for aesthetic or athletic reasons. Commonly used anabolic steroids are the oral 17a alkyl derivatives of testosterone (methyl testosterone, oxymetholone, oxandrolone, stanozolol) and the intramuscular 17b-esterified agents such as nandrolone decaonate, nandrolone phenpropionate, testosterone cypionate and testosterone propionate (Blue and Lombardo, 1999). The abuse of AAS has been associated with various psychiatric manifestations: sleep disorders, anxiety, labile mood, mania, depression, irritability, aggression, violence, suicidal and homicidal ideation and behaviour, psychosis, confusion and delirium. Long-term abuse may lead to the development of a dependence syndrome and associated withdrawal symptoms on attempted discontinuation (Hall et al., 2005; NIDA, 2006). The case of a young man, a long-term steroid abuser with a prior history of psychotic depression and manifestations of a current manic episode, is presented. The patient was hospitalized in the D’ Acute Ward of the Psychiatric Hospital of Thessaloniki and he was diagnosed with a substance-induced mood disorder (with manic features), attributed to the use of AAS. A few months after his brief hospitalization and under obscure circumstances the patient committed suicide.