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Article ; Online: Reduced Quality of Life in Former Androgen Users: An Evolving Public-Health Concern.

Pope, Harrison G / Kanayama, Gen

The Journal of clinical endocrinology and metabolism

2023 Volume 109, Issue 5, Page(s) e1400–e1401

MeSH term(s)	Humans ; Androgens ; Quality of Life ; Testosterone ; Steroids
Chemical Substances	Androgens ; Testosterone (3XMK78S47O) ; Steroids
Language	English
Publishing date	2023-11-11
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	3029-6
ISSN	1945-7197 ; 0021-972X
ISSN (online)	1945-7197
ISSN	0021-972X
DOI	10.1210/clinem/dgad661
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Article ; Online: Body Image Disorders and Anabolic Steroid Withdrawal Hypogonadism in Men.

Pope, Harrison G / Kanayama, Gen

Endocrinology and metabolism clinics of North America

2022 Volume 51, Issue 1, Page(s) 205–216

Abstract: Hypogonadism commonly occurs during withdrawal from anabolic-androgenic steroid (AAS) use, particularly when users have been taking AAS for prolonged periods. Mounting evidence now suggests that AAS-induced hypogonadism may persist for months or even ... ...

Abstract	Hypogonadism commonly occurs during withdrawal from anabolic-androgenic steroid (AAS) use, particularly when users have been taking AAS for prolonged periods. Mounting evidence now suggests that AAS-induced hypogonadism may persist for months or even years after last AAS use, and in some cases may be partially or completely irreversible. Treatment with human chorionic gonadotropin and clomiphene may help to restore hypothalamic-pituitary-testicular axis function, and these substances are widely used illicitly by AAS users at the end of a course of AAS as so-called postcycle therapy. Many endocrinologists still have only limited experience in diagnosing and treating AAS-induced hypogonadism.
MeSH term(s)	Anabolic Agents/adverse effects ; Body Dysmorphic Disorders ; Humans ; Hypogonadism/chemically induced ; Hypogonadism/diagnosis ; Hypogonadism/drug therapy ; Male ; Substance-Related Disorders ; Testis ; Testosterone Congeners/adverse effects
Chemical Substances	Anabolic Agents ; Testosterone Congeners
Language	English
Publishing date	2022-02-08
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	92116-6
ISSN	1558-4410 ; 0889-8529
ISSN (online)	1558-4410
ISSN	0889-8529
DOI	10.1016/j.ecl.2021.11.007
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Article: Assessing the Prevalence of Doping Among Elite Athletes: An Analysis of Results Generated by the Single Sample Count Method Versus the Unrelated Question Method.

Ulrich, Rolf / Cléret, Léa / Comstock, R Dawn / Kanayama, Gen / Simon, Perikles / Pope, Harrison G

Sports medicine - open

2023 Volume 9, Issue 1, Page(s) 112

Abstract: In 2011, a group of researchers investigated the 12-month prevalence of doping at the 13th International Association of Athletics Federations World Championships in Athletics (WCA) in Daegu, South Korea, and also at the 12th Pan-Arab Games (PAG) in Doha, ...

Abstract	In 2011, a group of researchers investigated the 12-month prevalence of doping at the 13th International Association of Athletics Federations World Championships in Athletics (WCA) in Daegu, South Korea, and also at the 12th Pan-Arab Games (PAG) in Doha, Qatar. The prevalence of doping at each event was estimated using an established randomized response method, the Unrelated Question Model (UQM). The study, published in 2018, found that the prevalence of past-year doping was at least 30% at WCA and 45% at PAG. At both events, separate data sets were collected in addition to the UQM data using a new method, the single sample count (SSC). Recently, Petróczi et al. have reported 12-month doping prevalence estimates for these two events based on the SSC data. These investigators obtained substantially lower prevalence estimates using the SSC and suggested that the 2018 estimates based on the UQM may have been too high. However, in this communication, we point out several possible shortcomings in the methods of Petróczi et al. and show that their SSC data would be equally compatible with a high 12-month doping prevalence comparable to the UQM estimates published in 2018.
Language	English
Publishing date	2023-11-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2809942-4
ISSN	2198-9761 ; 2199-1170
ISSN (online)	2198-9761
ISSN	2199-1170
DOI	10.1186/s40798-023-00658-5
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Article ; Online: Assessing the Prevalence of Doping Among Elite Athletes

Rolf Ulrich / Léa Cléret / R. Dawn Comstock / Gen Kanayama / Perikles Simon / Harrison G. Pope

Sports Medicine - Open, Vol 9, Iss 1, Pp 1-

An Analysis of Results Generated by the Single Sample Count Method Versus the Unrelated Question Method

2023 Volume 7

Abstract: Abstract In 2011, a group of researchers investigated the 12-month prevalence of doping at the 13th International Association of Athletics Federations World Championships in Athletics (WCA) in Daegu, South Korea, and also at the 12th Pan-Arab Games (PAG) ...

Abstract	Abstract In 2011, a group of researchers investigated the 12-month prevalence of doping at the 13th International Association of Athletics Federations World Championships in Athletics (WCA) in Daegu, South Korea, and also at the 12th Pan-Arab Games (PAG) in Doha, Qatar. The prevalence of doping at each event was estimated using an established randomized response method, the Unrelated Question Model (UQM). The study, published in 2018, found that the prevalence of past-year doping was at least 30% at WCA and 45% at PAG. At both events, separate data sets were collected in addition to the UQM data using a new method, the single sample count (SSC). Recently, Petróczi et al. have reported 12-month doping prevalence estimates for these two events based on the SSC data. These investigators obtained substantially lower prevalence estimates using the SSC and suggested that the 2018 estimates based on the UQM may have been too high. However, in this communication, we point out several possible shortcomings in the methods of Petróczi et al. and show that their SSC data would be equally compatible with a high 12-month doping prevalence comparable to the UQM estimates published in 2018.
Keywords	Doping ; Randomized response technique ; Unrelated question method ; Single sample count ; Elite athletes ; Sports medicine ; RC1200-1245
Subject code	310
Language	English
Publishing date	2023-11-01T00:00:00Z
Publisher	SpringerOpen
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Anabolic-Androgenic Steroid Use and Body Image in Men: A Growing Concern for Clinicians.

Kanayama, Gen / Hudson, James I / Pope, Harrison G

Psychotherapy and psychosomatics

2020 Volume 89, Issue 2, Page(s) 65–73

MeSH term(s)	Anabolic Agents/adverse effects ; Androgens/adverse effects ; Body Image/psychology ; Cardiovascular Diseases/prevention & control ; Humans ; Male ; Mood Disorders/prevention & control ; Mood Disorders/psychology ; Steroids/adverse effects ; Substance-Related Disorders/diagnosis ; Substance-Related Disorders/psychology
Chemical Substances	Anabolic Agents ; Androgens ; Steroids
Language	English
Publishing date	2020-02-17
Publishing country	Switzerland
Document type	Editorial
ZDB-ID	209490-3
ISSN	1423-0348 ; 0033-3190
ISSN (online)	1423-0348
ISSN	0033-3190
DOI	10.1159/000505978
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Article ; Online: Review Article: Anabolic-Androgenic Steroids, Violence, and Crime: Two Cases and Literature Review.

Pope, Harrison G / Kanayama, Gen / Hudson, James I / Kaufman, Marc J

The American journal on addictions

2021 Volume 30, Issue 5, Page(s) 423–432

Abstract: Background and objectives: Anabolic-androgenic steroid (AAS) use has become a major worldwide substance use disorder, affecting tens of millions of individuals. Importantly, it is now increasingly recognized that some individuals develop ... ...

Abstract	Background and objectives: Anabolic-androgenic steroid (AAS) use has become a major worldwide substance use disorder, affecting tens of millions of individuals. Importantly, it is now increasingly recognized that some individuals develop uncharacteristically violent or criminal behaviors when using AAS. We sought to summarize available information on this topic. Methods: We reviewed the published literature on AAS-induced behavioral effects and augmented this information with extensive observations from our clinical and forensic experience. Results: It is now generally accepted that some AAS users develop uncharacteristically violent or criminal behaviors while taking these drugs. Although these behaviors may partially reflect premorbid psychopathology, sociocultural factors, or expectational effects, accumulating evidence suggests that they are also attributable to biological effects of AAS themselves. The mechanism of these effects remains speculative, but preliminary data suggest a possible role for brain regions involved in emotional reactivity, such as the amygdala and regions involved in cognitive control, including the frontal cortex. For unknown reasons, these effects appear idiosyncratic; most AAS users display few behavioral effects, but a minority develops severe effects. Conclusion and scientific significance: Professionals encountering AAS users in clinical or forensic settings should be alert to the possibility of AAS-induced violence or criminality and should employ strategies to assess whether AAS is indeed a contributory factor in a given case. Further research is needed to elucidate the mechanism of AAS-induced violence and to explain why only a subset of AAS users appears vulnerable to these effects. (Am J Addict 2021;00:00-00).
MeSH term(s)	Anabolic Agents/adverse effects ; Crime ; Humans ; Steroids ; Substance-Related Disorders/epidemiology ; Testosterone Congeners ; Violence
Chemical Substances	Anabolic Agents ; Steroids ; Testosterone Congeners
Language	English
Publishing date	2021-04-19
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	1141440-6
ISSN	1521-0391 ; 1055-0496
ISSN (online)	1521-0391
ISSN	1055-0496
DOI	10.1111/ajad.13157
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Article ; Online: History and epidemiology of anabolic androgens in athletes and non-athletes.

Kanayama, Gen / Pope, Harrison G

Molecular and cellular endocrinology

2017 Volume 464, Page(s) 4–13

Abstract: The use of androgens, frequently referred to as anabolic-androgenic steroids (AAS), has grown into a worldwide substance abuse problem over the last several decades. Testosterone was isolated in the 1930s, and numerous synthetic androgens were quickly ... ...

Abstract	The use of androgens, frequently referred to as anabolic-androgenic steroids (AAS), has grown into a worldwide substance abuse problem over the last several decades. Testosterone was isolated in the 1930s, and numerous synthetic androgens were quickly developed thereafter. Athletes soon discovered the dramatic anabolic effects of these hormones, and AAS spread rapidly through elite athletics and bodybuilding from the 1950s through the 1970s. However it was not until the 1980s that widespread AAS use emerged from the elite athletic world and into the general population. Today, the great majority of AAS users are not competitive athletes, but instead are typically young to middle-aged men who use these drugs primarily for personal appearance. AAS abuse has now become particularly prevalent in regions such as Scandinavia, the United States, Brazil, and British Commonwealth countries, but remains rare in countries such as China, Korea, and Japan - a pattern that reflects cultural differences in attitudes towards male muscularity.
MeSH term(s)	Anabolic Agents/history ; Androgens/history ; Athletes ; History, 20th Century ; History, 21st Century ; Humans ; Substance-Related Disorders/epidemiology
Chemical Substances	Anabolic Agents ; Androgens
Language	English
Publishing date	2017-03-01
Publishing country	Ireland
Document type	Historical Article ; Journal Article ; Review
ZDB-ID	187438-x
ISSN	1872-8057 ; 0303-7207
ISSN (online)	1872-8057
ISSN	0303-7207
DOI	10.1016/j.mce.2017.02.039
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Article ; Online: Competitive Bodybuilding: Fitness, Pathology, or Both?

Steele, Ian H / Pope, Harrison G / Kanayama, Gen

Harvard review of psychiatry

2019 Volume 27, Issue 4, Page(s) 233–240

Abstract: The sport of competitive bodybuilding requires an intense regimen of weightlifting and dieting, often aided with muscle-building or fat-burning drugs, and culminating in an on-stage posing competition. Despite these rigorous demands, competitive ... ...

Abstract	The sport of competitive bodybuilding requires an intense regimen of weightlifting and dieting, often aided with muscle-building or fat-burning drugs, and culminating in an on-stage posing competition. Despite these rigorous demands, competitive bodybuilding is popular, with thousands of competitions performed annually around the world. Although many studies have addressed the psychological features of various sports and the athletes who compete in them, few have examined the psychological aspects of bodybuilding. Even fewer studies have specifically examined competitive bodybuilders, as opposed to the much larger group of "recreational" bodybuilders who do not compete. The limited available literature suggests that competitive bodybuilders may show an increased risk for four categories of psychopathology: muscle dysmorphia, eating disorders, abuse of appearance- and performance-enhancing drugs, and exercise dependence. However, in each of these categories, one must carefully distinguish between the planned and dedicated behaviors required for success in the sport, as opposed to frankly pathological behaviors that impair social or occupational function, cause subjective distress, or lead to adverse health consequences. Future work should attempt to better assess the nature and prevalence of these conditions among competitive bodybuilders, with perhaps greatest attention to the issue of drug use.
MeSH term(s)	Behavior, Addictive/psychology ; Body Dysmorphic Disorders/diagnosis ; Body Dysmorphic Disorders/psychology ; Body Image/psychology ; Competitive Behavior ; Feeding and Eating Disorders/diagnosis ; Feeding and Eating Disorders/psychology ; Humans ; Psychopathology ; Substance-Related Disorders/diagnosis ; Substance-Related Disorders/psychology ; Weight Lifting/psychology
Language	English
Publishing date	2019-06-20
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1174775-4
ISSN	1465-7309 ; 1067-3229
ISSN (online)	1465-7309
ISSN	1067-3229
DOI	10.1097/HRP.0000000000000211
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Article: History and epidemiology of anabolic androgens in athletes and non-athletes

Kanayama, Gen / Harrison G. Pope

Molecular and Cellular Endocrinology. 2017,

2017

Abstract	The use of androgens, frequently referred to as anabolic-androgenic steroids (AAS), has grown into a worldwide substance abuse problem over the last several decades. Testosterone was isolated in the 1930s, and numerous synthetic androgens were quickly developed thereafter. Athletes soon discovered the dramatic anabolic effects of these hormones, and AAS spread rapidly through elite athletics and bodybuilding from the 1950s through the 1970s. However it was not until the 1980s that widespread AAS use emerged from the elite athletic world and into the general population. Today, the great majority of AAS users are not competitive athletes, but instead are typically young to middle-aged men who use these drugs primarily for personal appearance. AAS abuse has now become particularly prevalent in regions such as Scandinavia, the United States, Brazil, and British Commonwealth countries, but remains rare in countries such as China, Korea, and Japan â a pattern that reflects cultural differences in attitudes towards male muscularity.
Keywords	athletes ; attitudes and opinions ; cultural differences ; drugs ; epidemiology ; males ; men ; sports ; steroids ; strength training ; substance abuse ; synthetic androgens ; testosterone ; Brazil ; China ; Japan ; Korean Peninsula ; Scandinavia ; United States
Language	English
Size	p. .
Publishing place	Elsevier B.V.
Document type	Article
Note	Pre-press version
ZDB-ID	187438-x
ISSN	1872-8057 ; 0303-7207
ISSN (online)	1872-8057
ISSN	0303-7207
DOI	10.1016/j.mce.2017.02.039
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Associations of anabolic-androgenic steroid use with other behavioral disorders: an analysis using directed acyclic graphs.

Kanayama, Gen / Pope, Harrison G / Hudson, James I

Psychological medicine

2018 Volume 48, Issue 15, Page(s) 2601–2608

Abstract: Background: Anabolic-androgenic steroid (AAS) use is known to be associated with other psychiatric disorders, such as body image disorders, conduct disorder/sociopathy, and other substance use disorders (SUD) - but the causal pathways among these ... ...

Abstract	Background: Anabolic-androgenic steroid (AAS) use is known to be associated with other psychiatric disorders, such as body image disorders, conduct disorder/sociopathy, and other substance use disorders (SUD) - but the causal pathways among these conditions remain poorly delineated. Methods: We created a directed acyclic graph to diagram hypothesized relationships among AAS use and dependence, body image disorder (BID), conduct disorder/sociopathy, and other SUD. Using proportional hazards models, we then assessed potentially causal relationships among these variables, using a dataset of 233 male weightlifters, of whom 102 had used AAS. Results: BID and conduct disorder/sociopathy both strongly contributed to the development of AAS use, but did not appear to contribute further to the progression from AAS use to AAS dependence. Other SUD beginning prior to first AAS use - whether broadly defined or restricted only to opioids - failed to show an effect on AAS use or progression to AAS dependence. Conversely, AAS use contributed significantly to the subsequent first-time development of opioid use disorders but did not significantly increase the risk for first-time development of non-opioid SUD, taken as a whole. Conclusions: Our analysis suggests that AAS use and other SUD are mutually attributable to underlying conduct disorder/sociopathy. SUD do not appear to represent a 'gateway' to subsequent AAS use. AAS use may represent a gateway to subsequent opioid use disorder, but probably not to other SUD.
MeSH term(s)	Adult ; Antisocial Personality Disorder/epidemiology ; Body Dysmorphic Disorders/epidemiology ; Comorbidity ; Conduct Disorder/epidemiology ; Data Interpretation, Statistical ; Humans ; Male ; Substance-Related Disorders/epidemiology ; Testosterone Congeners ; Young Adult
Chemical Substances	Testosterone Congeners
Language	English
Publishing date	2018-03-01
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	217420-0
ISSN	1469-8978 ; 0033-2917
ISSN (online)	1469-8978
ISSN	0033-2917
DOI	10.1017/S0033291718000508
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