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Key Words: androgens, anabolic-androgenic steroids, substance use, quality of life, hypogonadism, men

Background Doping in sports compromises fair play and endangers health. To deter doping among elite athletes, the World Anti-Doping Agency (WADA) oversees testing of several hundred thousand athletic blood and urine samples annually, of which 1–2% test positive. Measures using the Athlete Biological Passport suggest a higher mean prevalence of about 14% positive tests. Biological testing, however, likely fails to detect many cutting-edge doping techniques, and thus the true prevalence of doping remains unknown. Methods We surveyed 2167 athletes at two sporting events: the 13th International Association of Athletics Federations Word Championships in Athletics (WCA) in Daegu, South Korea in August 2011 and the 12th Quadrennial Pan-Arab Games (PAG) in Doha, Qatar in December 2011. To estimate the prevalence of doping, we utilized a “randomized response technique,” which guarantees anonymity for individuals when answering a sensitive question. We also administered a control question at PAG assessing past-year use of supplements. Results The estimated prevalence of past-year doping was 43.6% (95% confidence interval 39.4–47.9) at WCA and 57.1% (52.4–61.8) at PAG. The estimated prevalence of past-year supplement use at PAG was 70.1% (65.6–74.7%). Sensitivity analyses, assessing the robustness of these estimates under numerous hypothetical scenarios of intentional or unintentional noncompliance by respondents, suggested that we were unlikely to have overestimated the true prevalence of doping. Conclusions Doping appears remarkably widespread among elite athletes, and remains largely unchecked despite current biological testing. The survey technique presented here will allow future investigators to generate continued reference estimates of the prevalence of doping.

Epidemiological data offer conflicting views of the natural course of binge-eating disorder (BED), with large retrospective studies suggesting a protracted course and small prospective studies suggesting a briefer duration. We thus examined changes in BED diagnostic status in a prospective, community-based study that was larger and more representative with respect to sex, age of onset, and body mass index (BMI) than prior multi-year prospective studies. Probands and relatives with current DSM-IV BED ( = 156) from a family study of BED ('baseline') were selected for follow-up at 2.5 and 5 years. Probands were required to have BMI > 25 (women) or >27 (men). Diagnostic interviews and questionnaires were administered at all timepoints. Of participants with follow-up data ( = 137), 78.1% were female, and 11.7% and 88.3% reported identifying as Black and White, respectively. At baseline, their mean age was 47.2 years, and mean BMI was 36.1. At 2.5 (and 5) years, 61.3% (45.7%), 23.4% (32.6%), and 15.3% (21.7%) of assessed participants exhibited full, sub-threshold, and no BED, respectively. No participants displayed anorexia or bulimia nervosa at follow-up timepoints. Median time to remission (i.e. no BED) exceeded 60 months, and median time to relapse (i.e. sub-threshold or full BED) after remission was 30 months. Two classes of machine learning methods did not consistently outperform random guessing at predicting time to remission from baseline demographic and clinical variables. Among community-based adults with higher BMI, BED improves with time, but full remission often takes many years, and relapse is common.

A growing body of evidence, almost entirely from North America, has found that male testosterone levels are positively associated with mating effort (male-male competition and mate-seeking behaviour), while lower testosterone levels have been associated with affiliative pair bonding and paternal care. To expand the cross-cultural scope of this research, here we investigate variation in salivary testosterone levels among Chinese men in relation to marital and parenting variables. One hundred and twenty-six men drawn from a Beijing university setting between the ages of 21 and 38 completed a questionnaire and provided both morning and late afternoon saliva samples from which testosterone levels were measured. The 66 unmarried men had slightly higher levels of testosterone than the 30 married non-fathers, but this difference was not statistically significant. However, the 30 fathers exhibited significantly lower testosterone levels than both unmarried men and married non-fathers. Among married non-fathers, marital relationship quality was not significantly related to testosterone levels. Among married fathers, men with children aged less than 4 years of age did not have lower testosterone levels than men with older children. These data are the first outside of North America to show lower testosterone levels among fathers, and lend support to the theoretical view that male testosterone levels differ according to mating and parenting effort.

Objective Recent reports from our laboratory and others suggest that the menopausal transition may represent a window of vulnerability for eating disorders in women. Here, we present new findings regarding this issue. Methods We surveyed 230 women aged 40–60 years using an anonymous questionnaire focused on eating-disorder and body-image symptomatology. We then compared groups of respondents based on (a) menopausal stage as assessed by World Health Organization (WHO) criteria and (b) menopausal symptomatology as assessed by the Menopause Rating Scale (MRS). Results WHO-defined menopausal stage (premenopausal, perimenopausal, and postmenopausal) showed no significant associations with eating and body-image measures. However, MRS scores showed strong associations with most measures of the Eating Disorder Examination Questionnaire, as well as with questions regarding satisfaction with body image. These associations remained little changed even when removing the four psychological items from the MRS score and examining only the association of the MRS somato-vegetative and urogenital items with these outcome variables. Discussion Our data augment existing evidence that the menopausal transition may be associated with eating and body-image disturbances. However, reported menopausal stage , which is difficult to define reliably, may be less informative than menopausal symptoms as a predictor of disordered eating and associated symptoms. Level of evidence V—descriptive survey study.

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. Key points A prior study of the prevalence of past-year doping and dietary supplement use among elite athletes, conducted at two international sporting events, used two randomized response techniques—the unrelated question method (UQM) and the single sample count (SSC)—to ensure the anonymity of the participants and thus encourage honest responses. The UQM analysis, published in 2018, found the prevalence of past-year doping to be at least 30% and 45% at the two events, respectively, and the prevalence of past-year dietary supplement use at the second event about 70%—a figure congruent with other studies of supplement use among elite athletes. However, the SSC analysis, published in 2022, yielded rates of only 21.2% and 10.6% for doping and only 8.6% for dietary supplements. In a reanalysis of the SSC data, using a slightly different model that considers both cheating and underreporting due to cognitive limitations, we show that the SSC data can yield much higher prevalence estimates, very similar to those of the UQM.

No abstract available Copyright © 2010 S. Karger AG, Basel [PUBLICATION ABSTRACT]

The prevalence of body image disorders and anabolic-androgenic steroid (AAS) use is increasing, despite the evidence of their serious adverse health effects and despite the passage of laws regulating their sales. Here we review the evolution of the dual emerging epidemics of body image disorders and AAS use, adverse health effects of AASs, and the need for an integrated health policy and regulatory response. We searched for studies published prior to June 2018. Quality of evidence was low to moderate because of its observational nature; heterogeneity of eligibility criteria; variable doses; reliance on retrospective self-reported data in many studies; and variable quality of outcome ascertainment. Most AAS users are nonathlete young men, who use these substances to look lean and more muscular. Some of these men suffer from \"muscle dysmorphia,\" a form of body dysmorphic disorder. AASs has been associated with cardiovascular disorders, psychiatric disorders, AAS-withdrawal hypogonadism, infertility, neurotoxic effects, musculoskeletal injuries, liver toxicity, and needle-borne infections. Potential adverse effects may be compounded by the use of other substances (e.g., opioids) and high-risk behaviors. Unregulated Internet sales of AASs and selective androgen receptor modulators, which are easily purchased without a prescription, are of concern because of their potential to fuel the epidemic among adolescents and the military. Integrated nationwide efforts are necessary to raise public awareness of this epidemic, to study long-term health effects of AASs and treatment strategies, and to reform regulations to stem the epidemics of AAS use and body image disorders.

Glutamatergic abnormalities may underlie bipolar disorder (BD). The glutamate-modulating drug riluzole may be efficacious in bipolar depression, but few in vivo studies have examined its effect on glutamatergic neurotransmission. We conducted an exploratory study of the effect of riluzole on brain glutamine/glutamate (Gln/Glu) ratios and levels of N -acetylaspartate (NAA). We administered open-label riluzole 100–200 mg daily for 6 weeks to 14 patients with bipolar depression and obtained imaging data from 8-cm 3 voxels in the anterior cingulate cortex (ACC) and parieto-occipital cortex (POC) at baseline, day 2, and week 6 of treatment, using two-dimensional J -resolved proton magnetic resonance spectroscopy at 4 T. Imaging data were analyzed using the spectral-fitting package, LCModel; statistical analysis used random effects mixed models. Riluzole significantly reduced Hamilton Depression Rating Scale (HAM-D) scores ( d =3.4; p <0.001). Gln/Glu ratios increased significantly by day 2 of riluzole treatment (Cohen's d =1.2; p =0.023). NAA levels increased significantly from baseline to week 6 ( d =1.2; p =0.035). Reduction in HAM-D scores was positively associated with increases in NAA from baseline to week 6 in the ACC ( d =1.4; p =0.053), but was negatively associated in the POC ( d =9.6; p <0.001). Riluzole seems to rapidly increase Gln/Glu ratios—suggesting increased glutamate–glutamine cycling, which may subsequently enhance neuronal plasticity and reduce depressive symptoms. Further investigation of the Gln/Glu ratio as a possible early biomarker of response to glutamate-modulating therapies is warranted.