According to information in the article, testosterone deficiency (hypogonadism) is a common condition in older men, occurring in 30 percent of men older than 55. Testosterone levels peak in early adulthood, and then decrease by approximately 1 percent per year after age 40. Symptoms of hypogonadism include decreased muscle mass and strength, decreased bone mineral density, diminished appetite, decreased libido, fatigue and irritability. Some symptoms overlap with those of depression, but the association between hypogonadism and depression is unclear.
Molly M. Shores, M.D., of Veterans Affairs Puget Sound Health Care System, Seattle, and colleagues examined the clinical records of 278 men (45 years or older) without depression to examine the relationship between testosterone level and the incidence of diagnosed depression over a two-year period.
The researchers found that over the study period, 21.7 percent of the hypogonadal men were diagnosed with depression, vs. 7.1 percent of men with normal testosterone levels. When the researchers adjusted for age, alcohol use disorders, prostate cancer, and other medical conditions, they found that men with hypogonadism were 4.2 times more likely to be diagnosed with depression. "Hypogonadal men showed an increased incidence of depressive illness and a shorter time to diagnosis of depression," the authors write. "Further prospective studies are needed to confirm these preliminary findings and to clarify the role of testosterone in the treatment of depressive illness in older men."
(Arch Gen Psychiatry. 2004;61:162-167. Available post-embargo at http://www.
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To contact Molly M. Shores, M.D., call Jeri Rowe at 206-764-2435.