Dismorfia Muscular e Uso de Esteroides Androgénios‑Anabolizantes: Uma Revisão Sistemática
DOI:
https://doi.org/10.51338/rppsm.2020.v6.i1.97Palavras-chave:
Anabolizantes, Congéneres da Testosterona, Imagem Corporal, Perturbação Dismórfica CorporalResumo
Introdução: A dismorfia muscular (DM) é um subtipo de perturbação dismórfica corporal, que ocorre em indivíduos que, apesar de apresentarem um físico muscularmente desenvolvido, se consideram magros e fracos. Presentemente, supõe‑se que o uso de esteroides androgénios‑anabolizantes (EAAs) poderá ser um fator perpetuante desta perturbação, mas também que a DM poderá predispor ao uso de EAAs, fármacos utilizados frequentemente pelos seus efeitos na composição corporal, nomeadamente o aumento de massa muscular, mas com efeitos secundários vastos. Esta revisão sistemática pretendeu explorar a atual evidência acerca da associação entre a DM e o uso de EAAs.
Métodos: Revisão sistemática da literatura mais recente, com inclusão de artigos publicados entre junho 2009 e janeiro 2019.
Resultados: Foram incluídos 12 artigos, sendo que a maioria dos estudos estabeleceram uma associação entre as duas variáveis estudadas, sendo que os resultados oscilaram entre a ausência de diferenças estatisticamente significativas e uma forte associação, sendo o último o que mais frequentemente se encontrou.
Conclusão: A evidência existente da associação entre a DM e o uso de EAAS é ainda pouco consistente, podendo dever‑se à heterogeneidade das ferramentas utilizadas para comparação das mesmas variáveis. Assim, é importante que se estabeleça um modelo ótimo de recolha de informação mais sensível, e que se estabeleçam escalas de avaliação de DM melhor validadas, para que a recolha de dados e a sua análise possam ser as mais corretas possíveis.
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Referências
American Psychiatric Association. Obsessive compulsive and related disorders. In Diagnostic and Statistical Manual of Mental Disorders.5th ed. Chicago: APA; 2013.
Pope HG, Katz DL, Hudson JI. Anorexia nervosa and “reverse anorexia” among 108 male bodybuilders. Compr Psychiatry. 1993; 34:406‑9.
Pope HG, Gruber AJ, Choi P, Olivardia R, Phillips KA. Muscle dysmorphia: An underrecognized form of body dysmorphic disorder. Psychosomatics. 1997; 38:548‑57.
Murray SB, Nagata JM, Griffiths S, Calzo JP, Brown TA, Mitchison D, et al. The enigma of male eating disorders: A critical review and synthesis. Clin Psychol Rev. 2017; 57:1‑11.
Santos Filho CA dos, Tirico PP, Stefano SC, Touyz SW, Claudino AM. Systematic review of the diagnostic category muscle dysmorphia. Aust N Z J Psychiatry. 2016; 50:322‑33.
Foster A, Shorter G, Griffiths M. Muscle dysmorphia: could it be classified as an addiction to body image? J Behav Addict. 2015; 4:1–5.
Nye S. The Muscular Ideal: Psychological, Social and Medical Perspectives. Eat Disord. 2008; 17:95‑96.
McCreary DR, Hildebrandt TB, Heinberg LJ, Boroughs M, Thompson JK. A review of body image influences on men’s fitness goals and supplement use. Am J Mens Health. 2007; 1:307‑16.
Dawes J, Mankin T. Muscle dysmorphia. Strength Condit J. 2004; 26:24‑5.
Andersen A. The Adonis Complex: The Secret Crisis of Male Body Obsession. Am J Psychiatry. 2001; 158:1947‑8.
Hildebrandt T, Schlundt D, Langenbucher J, Chung T. Presence of muscle dysmorphia symptomology among male weightlifters. Compr Psychiatry. 2006; 47:127‑35.
Seleri S, Assunção M. Dismorfia muscular. Muscle Dysmorphia. 2002; 24(Supl III):80‑4.
Massada M, Ribeiro S, Ferreira V. Consumo de substâncias dopantes no desporto recreativo português
– um estudo em praticantes de musculação. Rev Med Desportiva Inf. 2011; 2:19‑21.
Anton M. Anabolic drugs consumption by adolescent students of physical education degree in Spain, Portugal and Italy: A survey. African J Pharm Pharmacol. 2014; 5: 654‑7.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta‑analyses:
the PRISMA statement. J Clin Epidemiol. 2009; 62:1006‑12.
Baghurst T, Lirgg C. Characteristics of muscle dysmorphia in male football, weight training, and competitive natural and non‑natural bodybuilding samples. Body Image. 2009; 6:221‑7.
Catherine Walker D, Anderson DA, Hildebrandt T. Body checking behaviors in men. Body Image. 2009; 6:164‑70.
Longobardi C, Prino LE, Fabris MA, Settanni M. Muscle dysmorphia and psychopathology: Findings from an Italian sample of male bodybuilders. Psychiatry Res. 2017; 256:231‑6.
Griffiths S, Murray SB, Dunn M, Blashill AJ. Anabolic steroid use among gay and bisexual men living in Australia and New Zealand: Associations with demographics, body dissatisfaction, eating disorder psychopathology, and quality of life. Drug Alcohol Depend. 2017; 181:170‑6.
Hildebrandt T, Alfano L, Langenbucher JW. Body image disturbance in 1000 male appearance and performance enhancing drug users. J Psychiatr Res. 2010; 44:841‑6.
García CS, Ammendolia A, Procopio L, Papaianni MC, Sinopoli F, Bianco C, et al. Body uneasiness, eating disorders, and muscle dysmorphia in individuals who overexercise. J Strength Cond Res. 2010; 24:3098‑104.
Pope HG, Kanayama G, Hudson JI. Risk factors for illicit anabolic‑androgenic steroid use in male weightlifters:
A cross‑sectional cohort study. Biol Psychiatry. 2012; 71:254‑61.
Babusa B, Túry F. Muscle dysmorphia in Hungarian non‑competitive male bodybuilders. Eat Weight Disord. 2012; 17:e49‑53.
Hildebrandt T, Harty S, Langenbucher JW. Fitness supplements as a gateway substance for anabolic‑androgenic
steroid use. Psychol Addict Behav. 2012; 26:10.1037/a00227877.
Angoorani H, Halabchi F. The misuse of anabolic‑androgenic steroids among iranian recreational male body‑builders
and their related psycho‑socio‑demographic factors. Iran J Public Health. 2015; 44:1662‑9.
Murray SB, Griffiths S, Mond JM, Kean J, Blashill AJ. Anabolic steroid use and body image psychopathology in men: Delineating between appearance‑versus performance‑driven motivations. Drug Alcohol Depend. 2016; 165:198‑202.
Gonzalez‑Marti I, Fernández‑Bustos J, Onofre R, Contreras J, Sokolova M. Muscle dysmorphia: detection of the use‑abuse of anabolic androgenic steroids in a Spanish sample. Addiciones. 2017; 30:243–50.
Mayville SB, Williamson DA, White MA, Netemeyer RG, Drab DL. Development of the muscle appearance satisfaction scale: A self‑report measure for the assessment of muscle dysmorphia symptoms. Assessment. 2002; 9351‑60.
Rogol AD, Yesalis CE. Anabolic‑Androgenic Steroids and the Adolescent. Pediatr Ann. 2014; 21:175, 183, 186‑188.
Pope HG, Kanayama G, Athey A, Ryan E, Hudson JI, Baggish A. The lifetime prevalence of anabolic‑androgenic steroid use and dependence in Americans: Current best estimates. American Journal on Addictions. 2014. 23:371‑7.
Baker JS, Graham MR, Davies B. Steroid and prescription medicine abuse in the health and fitness community: A regional study. Eur J Intern Med. 2006; 17:479‑84.
Nilsson S, Baigi A, Marklund B, Fridlund B. The prevalence of the use of androgenic anabolic steroids by adolescents in a county of Sweden. Eur J Public Health. 2001; 11:195‑7.
Rachoń D, Pokrywka L, Suchecka‑Rachoń K. Prevalence and risk factors of anabolic‑androgenic steroids (AAS) abuse among adolescents and young adults in Poland. Soz Praventivmed. 2006; 51:392.
Melia P, Pipe A, Greenberg L. The use of anabolic‑androgenic steroids by Canadian students. Clin J Sport Med. 1996; 6:9‑14.
Handelsman DJ, Gupta L. Prevalence and risk factors for anabolic‑androgenic steroid abuse in Australian high school students. Int J Androl. 1997; 20:159‑64.
Galduróz JCF, Noto AR, Nappo SA, Carlini EA. Household survey on drug abuse in Brazil: Study involving the 107 major cities of the country ‑ 2001. Addict Behav. 2005; 30:545‑56.