Abstract
Background: Testosterone (T) level declines progressively with age. Psychiatric symptoms
of T deficiency (e.g., dysphoria, fatigue, irritability, low libido) are also symptoms
of depression, and appear to be variably expressed.
Methods: We assessed independent measures of hypothalamic-pituitary-gonadal axis functioning,
i.e., total T level and androgen receptor (AR) CAG repeat length (CAG RL), a genetic
trait marker associated with AR function; and depression (diagnosed by above-threshold
score on the Center for Epidemiologic Studies-Depression Scale [CES-D]) in 1000 men
(mean age = 62.6 years; SD = 8.3) who participated in the Massachusetts Male Aging
Study.
Results: There were 110 (11%) men with “depression” (CES-D score ≥ 16) in the analysis
sample. Neither total T level nor CAG RL was associated with depression in bivariate
analyses. Among men with shorter CAG RLs, the percentage of men with depression was
21.6% in the lowest subgroup of total T (defined by quintiles) and 4.2% in the highest
subgroup of total T. This was confirmed in simple logistic regression models with
depression as the dependent variable and continuous total T as the predictor, run
separately within the three CAG RL subgroups: depression was significantly and inversely
associated with total T in men with shorter CAG RLs but not in men with moderate and
longer CAG RLs.
Conclusions: CAG isotype, a genetic trait marker of androgen receptor function, may
mediate the expression of the central nervous system effects of T deficiency in men.
Keywords
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Article info
Publication history
Accepted:
March 16,
2001
Received in revised form:
March 13,
2001
Received:
December 6,
2000
Identification
Copyright
© 2001 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
