title: Plasma Testosterone and the Course of Major Depressive Disorder in Older Men and Women.
abstract: OBJECTIVE
  To investigate associations between testosterone levels and major depressive disorder (MDD) in older men and women.
  
  
  METHODS
  In a cross-sectional, 2-year prospective analyses within the Netherlands Study on Depression in Older persons cohort study, 469 participants comprised 350 patients with MDD and 119 nondepressed participants in the comparison group (mean age 70.5 ± 7.3 years; 166 [35.4%] men). MDD was assessed by the Composite International Diagnostic Interview. Baseline plasma total testosterone and sex hormone binding globulin (SHBG) were assessed to calculate free testosterone. The Inventory of Depressive Symptomatology was assessed every 6 months.
  
  
  RESULTS
  Whereas SHBG levels did not differ between the depressed/nondepressed groups (F(1,149) = 0.075, p = 0.78), men with MDD had lower mean total and free testosterone levels than the comparison group in the multivariate adjusted analyses (F(1,150) = 7.249, p = 0.008, Cohen's d = 0.51; and F(1,149) = 8.548, p = 0.004 Cohen's d = 0.55, respectively). This could be ascribed to lower testosterone in men with "pure" MDD and not in men with MDD and comorbid anxiety. Nine men (5.4%) had a total testosterone level < 8 nmol/L, of whom 8 suffered from MDD. In women, hormone levels showed no significant difference between the groups. In men (using all five measurement points during follow-up) baseline free testosterone was inversely associated with depression severity in the adjusted analyses (β = -0.15, t(151) = -2.15, p = 0.03).
  
  
  CONCLUSIONS
  Testosterone levels were lower in men with MDD compared with healthy men after adjustment for confounders, such as body mass index. No significant associations were found in women.
authors.affiliation: Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: e.j.giltay@lumc.com.
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Giltay
authors.affiliation: Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands; Department of Psychiatry, CAPRI-University of Antwerp, Antwerp, Belgium.
authors.forename: Roos C
authors.initials: RC
authors.lastname: van der Mast
authors.affiliation: Department of Psychiatry, Haga Ziekenhuis, The Hague, The Netherlands.
authors.forename: Esther
authors.initials: E
authors.lastname: Lauwen
authors.affiliation: Department of Clinical Chemistry, Endocrine Laboratory, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Annemieke C
authors.initials: AC
authors.lastname: Heijboer
authors.affiliation: Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Margot W M
authors.initials: MWM
authors.lastname: de Waal
authors.affiliation: GGZ InGeest, Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Hannie C
authors.initials: HC
authors.lastname: Comijs
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000097:blood* / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011446:Prospective Studies; D012737:Sex Factors; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism*; D013739:Testosterone / Q000097:blood*
chemical_list: D012738:Sex Hormone-Binding Globulin; D013739:Testosterone
keywords: Testosterone; anxiety disorders; major depressive disorder; older persons; sex hormone binding globulin