title: Testosterone and its effects on human male adolescent mood and behavior: a systematic review.
abstract: OBJECTIVE
  During human puberty, there is an approximate 30-fold increase in testosterone production in boys. This increase is often linked to changes in mood and behavior in adolescence such as aggression, an increase in risk taking, and depression. The aim of this systematic review was to determine what evidence exists on the effects of endogenous testosterone on behavior and mood in males during adolescence.
  
  
  METHODS
  The following databases were searched: MEDLINE, Pre-MEDLINE, Education Resources Information Centre, PsycINFO, EMBASE, Scopus, and Web of Science. Only human studies were included. The study is community based, and the participants were healthy male adolescents within the age range of 9-18 years. Studies were required to have a validated mood and/or behavior assessment contemporaneous with a timed testosterone measurement.
  
  
  RESULTS
  A total of 27 studies met the inclusion criteria of which only one was a longitudinal study. The remaining 26 studies were cross sectional in their analysis. As a variety of measurement tools were used, no meta-analysis was possible. Most studies focused on aggression. The one longitudinal study looking at testosterone and aggression showed little relationship with concurrent changes in aggression. Most of the cross-sectional studies of adolescent males observed relationships between aggression and testosterone levels. With respect to other behaviors and moods and/or affect, no consistent relationships with testosterone were observed in cross-sectional studies.
  
  
  CONCLUSIONS
  This systematic review concludes that there are insufficient longitudinal data of high methodological quality to currently confirm that changing testosterone levels during puberty are significantly associated with mood and behavior in adolescent males. To discount these findings is to risk apportioning blame inappropriately and missing other important diagnoses in adolescent males.
authors.affiliation: Department of Endocrinology, Royal North Shore Hospital, St. Leonards, New South Wales, Australia.
authors.forename: Sally Anne
authors.initials: SA
authors.lastname: Duke
authors.affiliation: Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Westmead, New South Wales, Australia; Discipline of Pediatrics and Child Health, Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia.
authors.forename: Ben W R
authors.initials: BW
authors.lastname: Balzer
authors.affiliation: Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Westmead, New South Wales, Australia; Discipline of Pediatrics and Child Health, Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia. Electronic address: kate.steinbeck@health.nsw.gov.au.
authors.forename: Katharine S
authors.initials: KS
authors.lastname: Steinbeck
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000502:physiology*; D000339:Affect / Q000502:physiology*; D006801:Humans; D008297:Male; D011627:Puberty / Q000502:physiology*; D013739:Testosterone / Q000502:physiology*
chemical_list: D013739:Testosterone
keywords: Adolescence; Affect; Behavior; Mood; Puberty; Risk taking; Self-image; Testosterone; aggression