title: Hypogonadism, decreased sexual desire, and long-term depression in middle-aged men.
abstract: BACKGROUND
  In middle-aged men, the associations between long-term depressive symptoms and circulating testosterone levels are poorly known, although it is known that testosterone levels decrease with age.
  
  
  METHODS
  A health questionnaire was mailed to a population-based sample from the National Population Register in 1998, 1999, and 2001. Based on their self-reported mental symptoms, a total of 116 men were selected for clinical examination in 2005. Half of them had high and the others low levels of adverse mental symptoms in all three previous follow-ups. A structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders-IV was performed. Depressive symptoms were assessed with the Beck Depression Inventory (BDI) and the Hamilton Depression Rating Scale (HDRS). The Aging Males' Symptoms scale was also compiled and testosterone levels were determined.
  
  
  RESULTS
  In the entire study sample, serum free testosterone levels correlated negatively with both BDI and HDRS scores. In the hypogonadism group (based on free testosterone, 19.8% of the sample), clinically significant depression (BDI score > or = 13) was more than three times as frequent as in the other men (34.8% vs. 10.4%), the odds ratio after multiple adjustments being 4.98 (95% confidence interval 1.66-14.95). A decrease in sexual desire was common in hypogonadism (36%). Nevertheless, it also associated with clinically significant depression, irrespective of free testosterone levels.
  
  
  CONCLUSIONS
  Long-term and current depressive symptoms, a decreased sexual desire, and low serum free testosterone levels are associated in middle-aged men. Hypogonadism per se and as a cause of decreased sexual desire may be a contributory and possibly treatable factor underlying male depression.
  
  
  CONCLUSIONS
  The findings highlight the need for hormonal status assessment in middle-aged depressive men.
authors.affiliation: Institute of Clinical Medicine, University of Kuopio, Kuopio, Finland. jukka.hintikka@kuh.fi
authors.forename: Jukka
authors.initials: J
authors.lastname: Hintikka
authors.forename: Leo
authors.initials: L
authors.lastname: Niskanen
authors.forename: Heli
authors.initials: H
authors.lastname: Koivumaa-Honkanen
authors.forename: Tommi
authors.initials: T
authors.lastname: Tolmunen
authors.forename: Kirsi
authors.initials: K
authors.lastname: Honkalampi
authors.forename: Soili M
authors.initials: SM
authors.lastname: Lehto
authors.forename: Heimo
authors.initials: H
authors.lastname: Viinamäki
mesh_terms: D000223:Adaptation, Psychological; D000367:Age Factors; D001143:Arousal; D016001:Confidence Intervals; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D007172:Erectile Dysfunction / Q000150:complications*; D005387:Finland / Q000453:epidemiology; D006305:Health Status Indicators; D006801:Humans; D007006:Hypogonadism / Q000150:complications*; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011594:Psychometrics; D012042:Registries; D012307:Risk Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000097:blood; D013997:Time Factors
chemical_list: D013739:Testosterone