Pope H G, Katz D L, Hudson J I
Biological Psychiatry Laboratory, McLean Hospital, Belmont, MA 02178.
Compr Psychiatry. 1993 Nov-Dec;34(6):406-9. doi: 10.1016/0010-440x(93)90066-d.
Two disorders of body image encountered in a study of 108 bodybuilders are described. In a study of the psychiatric effects of anabolic steroids, structured interviews were administered to 55 bodybuilders who had used anabolic steroids and 53 non-user controls. Three (2.8%) of the subjects reported a history of anorexia nervosa--a rate far higher than the 0.02% rate typically reported among American men (P < .001). Nine (8.3%) of the subjects, two of whom were former anorexics, described a "reverse anorexia" syndrome, where they believed that they appeared small and weak even though they were actually large and muscular. Reverse anorexic subjects reported that they declined social invitations, refused to be seen at the beach, or wore heavy clothes even in the heat of summer because they feared that they looked too small. All nine reverse anorexia cases occurred among steroid users; none occurred among non-users (P < .003). Four subjects reported that their reverse anorexic symptoms contributed to their decision to start using steroids. Disorders of body image, including both anorexia nervosa and its reverse form, may occur frequently in men who lift weights regularly. Reverse anorexia may precipitate or perpetuate the use of anabolic steroids in some individuals.
本文描述了在一项对108名健美运动员的研究中遇到的两种身体意象障碍。在一项关于合成代谢类固醇对精神影响的研究中，对55名使用过合成代谢类固醇的健美运动员和53名未使用过的对照者进行了结构化访谈。三名受试者（2.8%）报告有神经性厌食症病史，这一比例远高于美国男性通常报告的0.02%（P <.001）。九名受试者（8.3%）描述了一种“反向厌食症”综合征，他们认为自己看起来瘦小虚弱，尽管实际上身材高大且肌肉发达。有反向厌食症的受试者报告说，他们会拒绝社交邀请，拒绝在海滩露面，甚至在炎炎夏日也穿着厚重的衣服，因为他们担心自己看起来太瘦小。所有九例反向厌食症病例均发生在使用类固醇的人群中，未使用者中无一例发生（P <.003）。四名受试者报告说，他们的反向厌食症症状促使他们决定开始使用类固醇。身体意象障碍，包括神经性厌食症及其反向形式，可能在经常举重的男性中频繁出现。反向厌食症可能会促使一些人开始使用合成代谢类固醇，或使他们持续使用。
