Applewhite Briana, Olivola M, Tweed C, Wesemann U, Himmerich H
Department of Psychological Medicine, King's College London, London, UK.
Department of Brain and Behavioural Science, University of Pavia, Pavia, Italy.
BMJ Mil Health. 2024 May 22;170(3):255-266. doi: 10.1136/bmjmilitary-2022-002135.
Body dysmorphic disorder (BDD) and muscle dysmorphia (MD) are common but often underdiagnosed disorders. These disorders have rarely been explored in the context of military personnel by mental health researchers despite the emphasis on physical fitness in military populations. We conducted a comprehensive systematic literature review on scientific studies of BDD and MD and the accompanying symptoms within the military.
We used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and used PubMed, Web of Science and PsycINFO as databases with "body dysmorphic disorder," "muscle dysmorphia," "body image," "performance and image enhancing drugs," "anabolic steroid," military personnel," "soldiers," "navy," "air force," "army" and "armed forces" as search terms.
A total of 20 eligible articles reporting data of 42 952 study participants were used. According to the identified literature, prevalence rates of BDD in the military are ~10% in men and ~20% in women, whereas ~15% of men and ~5% of women may suffer from MD. Further identified related problems in military populations were excessive bodybuilding, the use of anabolic drugs, the intake of stimulants, weight and shape concerns, and weight-control behaviours.
BDD, MD, as well as the use of anabolic and stimulating drugs, are highly prevalent in military personnel. Despite the importance of these problems in the military, there are no military-specific treatment studies available. A pre-existing focus on physical appearance and fitness might contribute to the decision to pursue a professional military career. The military environment might be a maintaining factor of BDD or MD, but not the ultimate cause of the disorder in an affected individual.
躯体变形障碍（BDD）和肌肉变形障碍（MD）是常见但常被漏诊的疾病。尽管军事人群强调身体素质，但心理健康研究人员很少在军事人员背景下对这些疾病进行探讨。我们对军事领域中关于BDD、MD及其伴随症状的科学研究进行了全面的系统文献综述。
我们采用系统评价和Meta分析的首选报告项目指南，以PubMed、科学网和PsycINFO为数据库，使用“躯体变形障碍”“肌肉变形障碍”“身体意象”“提高成绩和形象的药物”“合成代谢类固醇”“军事人员”“士兵”“海军”“空军”“陆军”和“武装部队”作为检索词。
共纳入20篇符合条件的文章，报告了42952名研究参与者的数据。根据已确定的文献，军事人员中BDD的患病率在男性中约为10%，在女性中约为20%，而约15%的男性和5%的女性可能患有MD。在军事人群中进一步确定的相关问题包括过度健身、使用合成代谢药物、摄入兴奋剂、对体重和体型的关注以及体重控制行为。
BDD、MD以及合成代谢和刺激性药物的使用在军事人员中非常普遍。尽管这些问题在军事领域很重要，但目前尚无针对军事人员的治疗研究。先前对身体外貌和健康的关注可能促使人们决定投身军事职业。军事环境可能是BDD或MD的维持因素，但不是个体患病的根本原因。
