Association between mental health status and substance use risk taking behavior among young Egyptian athletes using anabolic androgenic steroids (AAS)

Background: This paper aimed for exploring the prevalence of psychological abnormalities (depression, anxiety, stress and eating disorders), along with assessing risk-taking behavior (sharing needles and illicit drug abuse) among androgenic anabolic steroids (AAS) users and non-users in young Egyptian recreational athletes. Methods: Face-to-face surveys were conducted at fitness-related sites. Inclusion criteria were age ≥ 18 years and exercise frequency ≥ twice weekly. Depression, anxiety and stress scale (DASS-21) inventory was used for depression, anxiety and stress assessments. Eating disorder Screen for Primary care (ESP) was the questionnaire used to assess eating disorders. Substance use risk-taking behavior was assessed by direct questions. In a separate analysis, AAS users were compared to AAS-naïve individuals. Results: In total, 418 participants completed the questionnaire. Of these, 40.47% (136/336) of AAS users and 24.39% (20/82) of AAS non-users had a history of polysubstance use. AAS users had significantly higher odds of exhibiting depressive traits, anxiety traits and nearly twice the odds of engaging in substance use risk-taking behaviors, compared to AAS nonusers. Conclusions: This cross-sectional study underpins AAS being strongly associated with depression, anxiety and substance-use risk taking behavior disorders. These associations reported herein justifies further needed research to clarify if these associations arise before, in parallel to, or a secondary subsequence to the use of AAS.