Mental health correlates of risky anabolic-androgenic steroid use in Australian alcohol and other drug treatment services

Anabolic-androgenic steroid (AAS) use is increasing globally yet remains poorly integrated into alcohol and other drug (AOD) service models. This study aimed to examine data from AOD service clients using AAS, seeking to understand the psychosocial correlates of risky use. We analyzed service intake data from 2022-2025, comprising adults (N = 18786) who reported prior use of AAS (N = 521; 92.7% male). Measures included demographics, primary drug of concern, mental health (depression, anxiety), impulsivity (Short UPPS-P), and substance-related risk (WHO ASSIST). A multinomial logistic regression was conducted to examine how depression, anxiety, and impulsivity traits predict levels of AAS-related risk. Methamphetamine (49.3%) and alcohol (23.2%) were the most common primary drugs of concern. AAS risk scores ranged from 2 to 39 (M = 10.60, SD = 9.34). Regression analysis (Nagelkerke R2 = 0.53, p p p Higher AAS-related risk is associated with poorer mental health and impulsivity. Mental health support is needed for AAS consumers presenting to AOD services.全球范围内，同化类固醇（Anabolic-androgenic steroid, AAS）的使用呈逐年上升趋势，但该类物质的危险性使用仍未被充分整合进酒精与其他药物（Alcohol and Other Drug, AOD）服务体系中。本研究旨在针对使用AAS的AOD服务对象展开数据分析，以探究其危险性使用行为的社会心理相关因素。我们分析了2022年至2025年的服务入组数据，纳入对象为报告曾使用AAS的成年人：总筛查成年人数为18786名，其中符合该亚组标准的样本量为521名，男性占比92.7%。评估指标涵盖人口统计学特征、主要关注药物类型、心理健康状况（抑郁、焦虑水平）、冲动性（简版UPPS-P量表（Short UPPS-P））以及物质使用相关风险（世界卫生组织ASSIST量表（WHO ASSIST））。采用多项逻辑回归模型，探究抑郁、焦虑及冲动性特质对AAS相关风险程度的预测作用。最常见的主要关注药物为甲基苯丙胺（占比49.3%）与酒精（占比23.2%）。AAS相关风险得分区间为2至39分（均值M=10.60，标准差SD=9.34）。回归分析结果显示（Nagelkerke R²=0.53，p<0.001），冲动性特质越强，AAS相关风险越高。研究结果表明，更高的AAS相关风险与较差的心理健康状况及冲动性特质存在显著关联。针对前往AOD服务机构的AAS使用者，需为其提供针对性的心理健康支持服务。