DSM-5’E GÖRE KAS DİSMORFİSİNİN OBSESİF-KOMPULSİF SPEKTRUM VE MADDE BAĞIMLILIĞI PERSPEKTİFİNDEN KAVRAMSALLAŞTIRILMASI

Öz

Kas dismorfisi, DSM-5’te beden dismorfik bozukluğun alt türü olarak tanımlanan, obsesif-kompulsif spektrumla ilişkili ve aynı zamanda bağımlılık davranışlarıyla kesişen kompleks bir psikiyatrik bozukluktur. Bu bozukluk, bireyin yeterince kaslı olmadığına dair takıntılı düşüncelerle zihinsel olarak yoğun biçimde meşgul olması ve buna bağlı olarak aşırı egzersiz, katı diyet ve anabolik steroid kullanımı gibi zorlantılı davranışlar geliştirmesiyle karakterizedir. Son 15 yılda yapılan araştırmalar, kas dismorfisinin erkekler arasında daha yaygın olmakla birlikte kadınlar ve LGBTQ+ bireylerde de özgül biçimlerde ortaya çıkabildiğini göstermektedir. Bozukluk; majör depresyon, anksiyete, yeme bozuklukları ve madde kullanımı gibi psikiyatrik komorbiditelerle birlikte seyreder. Özellikle anabolik-androjenik steroid kullanımına yatkınlık, bu bozukluğu sadece beden imajı problemi olmaktan çıkararak bağımlılık eksenine yerleştirir. Medya, sosyal medya, fitness kültürü ve toplumsal cinsiyet rolleri gibi sosyokültürel faktörler kas dismorfisinin oluşumunda ve sürmesinde önemli rol oynamaktadır. Tedavide bilişsel davranışçı terapi ve SSRI temelli farmakoterapi etkinliğini kanıtlamış yöntemlerdir; ancak uzun vadeli başarı için multidisipliner ve bütüncül bir rehabilitasyon yaklaşımı şarttır. Bu derlemede, kas dismorfisinin tanı kriterleri, yaygınlık verileri, klinik özellikleri, eşlik eden riskler ve tedavi yaklaşımları güncel literatür ışığında kapsamlı biçimde değerlendirilmiştir.

Anahtar Kelimeler

• Kas dismorfisi
• beden dismorfik bozukluk
• obsesif-kompulsif spektrum
• anabolik steroid
• madde bağımlılığı

Conceptualizing Muscle Dysmorphia from the Perspective of the Obsessive-Compulsive Spectrum and Substance Use According to DSM-5

Öz

Muscle dysmorphia is a complex psychiatric disorder classified under body dysmorphic disorder (BDD) in the DSM-5 and conceptualized within the obsessive-compulsive spectrum while also overlapping with features of behavioral addiction. It is characterized by a persistent preoccupation with the belief of being insufficiently muscular, accompanied by compulsive behaviors such as excessive exercise, rigid dieting, and anabolic steroid use. Over the past 15 years, research has shown that while muscle dysmorphia is more prevalent among men, it can also manifest in women and LGBTQ+ individuals with specific patterns. The disorder frequently co-occurs with major depression, anxiety disorders, eating disorders, and substance use disorders. The tendency toward anabolic-androgenic steroid misuse positions muscle dysmorphia not merely as a body image concern but also as a form of substance-related pathology. Sociocultural factors—including media representations, social media influence, fitness culture, and gender role expectations—play a substantial role in its development and maintenance. Cognitive behavioral therapy and SSRI-based pharmacotherapy have demonstrated efficacy; however, sustainable treatment outcomes require a multidisciplinary and holistic rehabilitation approach. This review critically examines the diagnostic criteria, epidemiological trends, clinical features, associated risks, and current treatment strategies for muscle dysmorphia based on recent empirical literature.

Anahtar Kelimeler

• Muscle dysmorphia
• body dysmorphic disorder
• obsessive-compulsive spectrum
• anabolic steroids
• substance use

Kaynakça

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