Training Patterns and Mental Health of Bodybuilders and Fitness Athletes During the First Lockdown of the COVID-19 Pandemic-A Cross-Sectional Study.

Background: Government restrictions during the first COVID-19 lockdown, such as the closure of gyms and fitness centers, drastically limited the training opportunities of bodybuilders and fitness athletes (BoFA) who rely on indoor training facilities. This provided a unique situation to investigate the effect of training limitations on the training patterns, training adaptive strategies and mental health of BoFAs. Objectives: The primary aim of this study was to investigate differences in the training patterns and the mental health of BoFA before and during the first COVID-19 lockdown. The secondary aim was to assess whether BoFA who exhibited features of muscle dysmorphia were affected differently from the group that did not. Methods: A cross-sectional study was conducted with 85 BoFAs by means of an online questionnaire asking about sports activity, intensity, subjective physical performance, and economic status, including primary or secondary occupations before (from memory) and during lockdown, current physical health problems and financial fears, symptoms of depression, sleep disorders, anxiety (trait and state), muscle dysmorphia, coping mechanisms and actions during the first lockdown in Switzerland. Results: Training patterns and mental health of BoFA were influenced by the COVID-19 pandemic and first lockdown. During lockdown, the physical activity on the BoFA dropped significantly from 2.3 ± 0.8 h per day to 1.6 ± 0.9 h per day (p < 0.001), the subjective training intensity decreased significantly from 85.7 ± 13.2% to 58.3 ± 28.3% (p < 0.001) and the subjective performance declined significantly from 83.4 ± 14.3% to 58.2 ± 27.8% (p < 0.001) of maximal performance. In comparison to those without risk for body dysmorphia, participants at risk rated their maximal performance significantly lower and scored significantly higher for depression, sleep disorders and anxiety. Conclusion: This study showed the significant changes on the training patterns of BoFA before and during the first COVID-19 lockdown and poor mental health scores of BoFA during the lockdown itself, with those at risk of muscle dysmorphia scoring statistically worse regarding mental health than those with no risk of muscle dysmorphia. To better understand the particularities of BoFA, further investigation is needed to understand their psychology and in particular the effect of training restrictions on it.

[Interdisciplinary and Psychiatric Treatment of Anabolic Androgenic Steroids Users]. / Interdisziplinäre und psychiatrisch-psychotherapeutische Behandlung bei Gebrauch von anabolen androgenen Steroiden.

Interdisciplinary and Psychiatric Treatment of Anabolic Androgenic Steroids Users Abstract. The prevalence of anabolic androgenic steroid (AAS; anabolic steroids) use in recreational sports is underestimated. Due to the influence of social media, an increase in AAS use in recreational sports and in the general population is to be expected. AAS use is associated with significant physical and mental health consequences, and the psychiatric consequences include the risk of developing addictive behaviour. The widespread stigmatization of AAS use also by professionals often undermines users' trust in physicians and drives them into the arms of so-called "gurus." The tightening of anti-doping practices in sports and an exclusively prohibitive stance have so far failed to convincingly curb the problem in recreational sports. Harm reduction strategies could help patients to get the help they need from primary care providers.

Interdisciplinary and Psychiatric Treatment of Anabolic Androgenic Steroids Users.

The prevalence of anabolic androgenic steroid (AAS; anabolic steroids) use in recreational sports is underestimated. Due to the influence of social media, an increase in AAS use in recreational sports and in the general population is to be expected. AAS use is associated with significant physical and mental health consequences, and the psychiatric consequences include the risk of developing addictive behaviour. The widespread stigmatization of AAS use also by professionals often undermines users' trust in physicians and drives them into the arms of so-called "gurus." The tightening of anti-doping practices in sports and an exclusively prohibitive stance have so far failed to convincingly curb the problem in recreational sports. Harm reduction strategies could help patients to get the help they need from primary care providers.

[Recognizing IPED Use in Clinical Practice]. / Somatische Folgen des IPED-Gebrauchs früh in der Hausarztpraxis erkennen.

Recognizing IPED Use in Clinical Practice Abstract. The non-medical use of image- and performance-enhancing drugs (IPEDs) is widespread in the fitness and bodybuilding scene. The reasons for IPED use are often hedonistic in nature and they are used in so-called "cycles" over several weeks. The most common side effects are: testicular atrophy, acne, hypersexuality, hypertension, gynecomastia, lipid metabolism disorders, mood swings, hair loss, and policythemia. Common consequences following IPED use are: decreased libido, oligo- or azoospermia, and erectile dysfunction. To reduce undesirable side effects and consequences, IPED users often take medications for self-treatment; occasionally IPED users also mention such medications and ask for them in the general medical practice.

[IPED Use in Recreational Sports]. / IPED-Gebrauch im Freizeitsport.

IPED Use in Recreational Sports Abstract. Abtract: IPED consumers seek medical advice when uncertain as to their use. Due to shame or fear of stigmatization IPED consumers are often reluctant to talk about their drug use; they fear prejudice and a lack of experience when caring for this specific patient group. In order to strengthen trust, a non-judgmental, non-stigmatizing and supportive attitude is essential. The interaction should primarily lead to an understanding of why AAS are being used, what the patient's concerns are, and why medical help is being sought, without judgment or condemnation of the behavior. If no motivation to abstain from drug use is found during the consultation, harm reduction should be sought and the consequences of use addressed. Regular talks and active harm reduction can increase the confidence in evidence-based treatment to achieve personal motivation to abstain under medical supervision.

Recognizing IPED Use in Clinical Practice.

The non-medical use of image- and performance-enhancing drugs (IPEDs) is widespread in the fitness and bodybuilding scene. The reasons for IPED use are often hedonistic in nature and they are used in so-called "cycles" over several weeks. The most common side effects are: testicular atrophy, acne, hypersexuality, hypertension, gynecomastia, lipid metabolism disorders, mood swings, hair loss, and policythemia. Common consequences following IPED use are: decreased libido, oligo- or azoospermia, and erectile dysfunction. To reduce undesirable side effects and consequences, IPED users often take medications for self-treatment; occasionally IPED users also mention such medications and ask for them in the general medical practice.

IPED in Recreational Sports.

IPED consumers seek medical advice when uncertain as to their use. Due to shame or fear of stigmatization IPED consumers are often reluctant to talk about their drug use; they fear prejudice and a lack of experience when caring for this specific patient group. In order to strengthen trust, a non-judgmental, non-stigmatizing and supportive attitude is essential. The interaction should primarily lead to an understanding of why AAS are being used, what the patient's concerns are, and why medical help is being sought, without judgment or condemnation of the behavior. If no motivation to abstain from drug use is found during the consultation, harm reduction should be sought and the consequences of use addressed. Regular talks and active harm reduction can increase the confidence in evidence-based treatment to achieve personal motivation to abstain under medical supervision.

Monitoring of direct alcohol markers in alcohol use disorder patients during withdrawal treatment and successive rehabilitation.

Direct and indirect biomarkers are widely applied for the determination of alcohol consumption. They help to assess past or present alcohol consumption. Depending on the window of detection and sensitivity of the investigated marker, punctual alcohol consumption may remain undetected. In this study, different sampling strategies for the intermediary long-term marker phosphatidylethanol (PEth) are evaluated and compared to the determination of the short-term markers ethyl glucuronide (EtG) and ethyl sulfate (EtS) in urine. Samples from 19 patients undergoing alcohol use disorder treatment were collected during the withdrawal treatment and successive rehabilitation (33 ± 26 days (range: 3-74 days)). With liquid chromatography-tandem mass spectrometry (LC-MS/MS) EtG and EtS in urine, PEth in blood, PEth in dried blood spot (DBS) from venous blood, and PEth in DBS from capillary blood were quantified and compared. The use of volumetric capillary DBS, prepared from 20 µL of blood, provided the same results as the use of venous DBS (95% ± 10%, R2 0.9899 for PEth 16:0/18:1). Capillary DBS sampling has the advantage that it can be performed without venipuncture. The use of PEth in DBS proved to prevent post-sampling degradation, providing a longer detection in comparison to PEth in liquid blood, which only showed 67% ± 24% of the PEth DBS 16:0/18:1 concentration. When compared with EtG and EtS in urine, PEth monitoring proved to be advantageous for the detection of relapse situations, as the accumulation of PEth in blood prolongs the detectability. In conclusion, volumetric capillary DBS sampling for PEth is a simple and useful tool for compliance monitoring, and avoids hematocrit issues.