Low Testosterone Levels Associated With Depression

Feb 29, 2008
Older men with lower free testosterone levels in their
blood appear to have higher prevalence of depression,
according to a report in the March issue of Archives of
General Psychiatry, one of the JAMA/Archives journals.
Depression affects between 2 percent and 5 percent of the
population at any given time, according to background
information in the article. Women are more likely to be
depressed than men until age 65, when sex differences
almost disappear. Several studies have suggested that sex
hormones might be responsible for this phenomenon.

Osvaldo P. Almeida, M.D., Ph.D., F.R.A.N.Z.C.P., of the
University of Western Australia , Perth , and colleagues
studied 3,987 men age 71 to 89 years. Between 2001 and
2004, the men completed a questionnaire reporting
information about demographics and health history. They
underwent testing for depression and cognitive (thinking,
learning and memory) difficulties, and information about
physical health conditions was obtained from a short survey
and an Australian health database. The researchers
collected blood samples from the participants and recorded
levels of total testosterone and free testosterone, which
is not bound to proteins.

A total of 203 of the participants (5.1 percent) met
criteria for depression; these men had significantly lower
total and free testosterone levels then men who were not
depressed. After controlling for other factors—such as
education level, body mass index and cognitive scores—men
in the lowest quintile (20 percent) of free testosterone
concentration had three times the odds of having depression
compared to men in the highest quintile.

The mechanism by which low hormone levels might affect
depression risk has not been identified, but might involve
changes in the levels of neurotransmitters or hormones in
the brain, the authors note.

“A randomized controlled trial is required to determine
whether reducing prolonged exposure to low free
testosterone is associated with a reduction in the
prevalence of depression in elderly men,” the authors
write. “If so, older men with depression may benefit from
systematic screening of free testosterone concentration,
and testosterone supplementation may contribute to the
successful treatment of hypogonadal [with low hormone
levels] older men with depression.”

Arch Gen Psychiatry. 2008; 65[3]:283-289.