Differential prevalence of depressive and narcissistic traits in competing and non-competing bodybuilders in relation to muscle dysmorphia levels.

Background: Muscle dysmorphia is considered a subtype of Body dysmorphic disorder with an high prevalence in Bodybuilders. Observational and experimental data suggest a differential prevalence for depressive and narcissistic-like traits between people involved into agonistic or non-agonistic bodybuilding activity. Method: Here we assessed symptoms related to muscle dysmorphia (Muscle Dysmorphic Disorder Inventory), depression (Back Depression Inventory), and narcissism (Narcissistic Personality Inventory) (among others dimensions) in 260 subjects representing non-training subjects (controls), competing and non-competing bodybuilders. Given the large variability within the sample, a data-driven classification approach allowed excluding outliers as well competing/non-competing subjects not showing any clinically significant features, therefore restricting the analysis to a core group of subjects (n = 178). Results. Results showed a significant difference in depression and narcissism levels between competing and non-competing bodybuilders (NPI, F = 34.186, p < 0.01; BDI, F = 10.298, p < 0.05), with higher level of narcissism detected in the former ones while a slight depressive symptomatology has been identified in the latter ones. Post-hoc comparisons (p < 0.05 Bonferroni corrected) showed significant differences between agonistic/non-agonistic subjects and controls. Conclusions: Our results suggest a potential interaction between muscle dysmorphic symptoms, narcissism and depression, with a stronger association between narcissistic trait and the development of more severe muscle dysmorphic conditions expressed by competing body-builders.