Çınaroğlu Metin, Yılmazer Eda
Psychology Department, İstanbul Nişantaşı University, İstanbul 34485, Türkiye.
Psychology Department, Beykoz University, İstanbul 34820, Türkiye.
Behav Sci (Basel). 2025 Sep 4;15(9):1206. doi: 10.3390/bs15091206.
Muscle dysmorphia (MD) is a body image disorder characterized by an obsessive preoccupation with muscularity and compulsive behaviors such as excessive exercise, rigid dieting, and frequent body checking. MD has been linked to obsessive-compulsive traits and the use of anabolic-androgenic steroids (AASs), yet these associations have not been comprehensively synthesized. This systematic review and meta-analysis examined the relationships between MD, obsessive-compulsive symptomatology, and AASs or performance-enhancing drug use. Following PRISMA 2020 guidelines and PROSPERO preregistration (CRD42025640206), we searched four major databases for peer-reviewed studies published between 2015 and 2025. Ten studies (five quantitative, five qualitative) met the inclusion criteria. Meta-analytic findings revealed a moderate positive correlation between MD symptom severity and obsessive-compulsive traits ( ≈ 0.24), and significantly higher MD symptoms among AAS users compared to non-users (Cohen's ≈ 0.45). Odds of MD were markedly higher in steroid-using populations. Thematic synthesis of qualitative studies highlighted compulsive training routines, identity conflicts, motivations for AAS use, and limited engagement with healthcare services. These findings suggest that MD exists at the intersection of obsessive-compulsive psychopathology and substance-related behavior, warranting integrated interventions targeting both dimensions. The study contributes to understanding MD as a complex, multi-faceted disorder with significant clinical and public health relevance.
肌肉畸形症（MD）是一种身体意象障碍，其特征是对肌肉发达程度的强迫性关注以及诸如过度锻炼、严格节食和频繁身体检查等强迫行为。MD与强迫特质以及合成代谢雄激素类固醇（AASs）的使用有关，但这些关联尚未得到全面综合。本系统评价和荟萃分析研究了MD、强迫症状与AASs或提高运动成绩药物使用之间的关系。遵循PRISMA 2020指南和PROSPERO预注册（CRD42025640206），我们在四个主要数据库中搜索了2015年至2025年发表的同行评审研究。十项研究（五项定量研究、五项定性研究）符合纳入标准。荟萃分析结果显示，MD症状严重程度与强迫特质之间存在中度正相关（≈0.24），与非使用者相比，AAS使用者的MD症状明显更高（科恩d≈0.45）。在使用类固醇的人群中，患MD的几率明显更高。定性研究的主题综合突出了强迫性训练习惯、身份冲突、使用AAS的动机以及与医疗服务的有限接触。这些发现表明，MD存在于强迫性精神病理学和物质相关行为的交叉点，需要针对这两个维度的综合干预。该研究有助于将MD理解为一种具有重大临床和公共卫生相关性的复杂、多方面的障碍。
