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Herrera-Quintana L, Vázquez-Lorente H, Carneiro-Barrera A, Gutiérrez-Rojas L, Castillo MJ, Amaro-Gahete FJ. Is There a Relationship of Cortisol and Sex Steroid Hormones With Mental Health in Middle-Aged Adults? The FIT-AGEING Study. Endocr Pract 2024; 30:970-977. [PMID: 39032832 DOI: 10.1016/j.eprac.2024.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 06/24/2024] [Accepted: 07/11/2024] [Indexed: 07/23/2024]
Abstract
OBJECTIVE Mental health has emerged as a worldwide concern given the increasing incidence of anxiety and depression disorders in the last years. Cortisol and sex steroid hormones have been demonstrated to be important regulators of mental health processes in older adults. However, the evidence considering these integrated variables in apparently healthy middle-aged individuals has not been thoroughly addressed. The present study aimed to investigate the association of the plasma cortisol, testosterone, free testosterone, sex hormone-binding globulin (SHBG), and dehydroepiandrosterone sulfate (DHEAS) levels with mental health in middle-aged adults. METHODS This cross-sectional study included a cohort of 73 middle-aged adults aged 45 to 65 years (women, 53%). Plasma cortisol, testosterone, SHBG, and DHEAS were assessed using a competitive chemiluminescence immunoassay. Free testosterone was calculated from the total testosterone and SHBG. Self-reported depression severity, generic health-related quality of life, hope, satisfaction with life, and optimism-pessimism were evaluated using the Beck Depression Inventory-II (BDI-II), 36-Item Short-Form Health Survey, Adult Hope Scale, Satisfaction with Life Scale, and Life Orientation Test-Revised, respectively-with higher total scores of these scales indicating greater levels of these variables. RESULTS The testosterone and free testosterone levels were inversely associated with the BDI-II values in men (all P ≤ .042). The cortisol levels were positively related with the Satisfaction with Life Scale scores, whereas the testosterone, free testosterone, SHBG, and DHEAS levels were negatively correlated with the BDI-II values in women (all P ≤ .045). CONCLUSION In summary, these results suggest that the increased levels of steroid hormones-within the normal values-are associated with better mental health in middle-aged adults.
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Affiliation(s)
| | | | | | - Luis Gutiérrez-Rojas
- Department of Psychiatry and CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain
| | - Manuel J Castillo
- Department of Physiology, Faculty of Medicine, University of Granada, Granada, Spain
| | - Francisco J Amaro-Gahete
- Department of Physiology, Faculty of Medicine, University of Granada, Granada, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Biosanitaria, ibs.Granada, Granada, Spain.
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Boylu ME, Turan Ş, Güler EM, Boylu FB, Kılıç Ö, Koçyiğit A, Kırpınar İ. Changes in neuroactive steroids, neurotrophins and immunological biomarkers after monotherapy 8-week rTMS treatment and their relationship with neurocognitive functions in depression. Eur Arch Psychiatry Clin Neurosci 2024; 274:849-865. [PMID: 37980294 DOI: 10.1007/s00406-023-01704-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 10/15/2023] [Indexed: 11/20/2023]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) has proven effective in the treatment of major depression. The underlying mechanisms of action are still poorly understood. We aimed to evaluate the changes in the levels of neuroactive steroids, neurotrophins and immunological biomarkers before and after rTMS treatment and assess the relationship of this change between clinical response and cognitive functions after monotherapy rTMS treatment. Twenty-three patients with major depressive disorder (MDD) and 25 matched healthy controls were included in the study. The Hamilton Depression Rating Scale (HDRS), Trail Making Test A and B forms and Digit Span Test were administered. Biomarkers (BDNF, TNF-α, IL-1ß, NAS) were run in the peripheral blood at the end of the first month that rTMS was administered daily and at the end of the 2nd month when that rTMS was administered once a week. Appropriate conditions were provided so that the relevant biomarkers were not affected by the biorhythm. After rTMS monotherapy, an increase in BDNF and allopregnanolone, a decrease in TNF-α, IL-1ß, DHEA, and DHEA-S levels was found to be statistically significant. The scores on cognitive tests increased with the treatment. Positive significant correlations was found between BDNF levels and cognitive tests at the end of the first and second months. Our findings suggest that the effects of rTMS treatment may be related to the neuroendocrine, neurotrophin, and immunological mechanisms. rTMS treatment is found to have positive effects on cognitive functions in the short term.
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Affiliation(s)
- Muhammed Emin Boylu
- Faculty of Medicine, Psychiatry Department, Bezmialem Vakıf University, Istanbul, Türkiye.
- Council of Forensic Medicine, Expertise Department of Psychiatric Observation, Ministry of Justice, Istanbul, Türkiye.
| | - Şenol Turan
- Faculty of Medicine, Psychiatry Department, İstanbul University- Cerrahpaşa, Istanbul, Türkiye
| | - Eray Metin Güler
- Faculty of Medicine, Department of Medical Biochemistry, Bezmialem Vakıf University, Istanbul, Türkiye
| | - Fatma Betül Boylu
- Faculty of Medicine, Public Health Department, İstanbul University, Istanbul, Türkiye
| | - Özge Kılıç
- Faculty of Medicine, Psychiatry Department, Bezmialem Vakıf University, Istanbul, Türkiye
| | - Abdurrahim Koçyiğit
- Faculty of Medicine, Department of Medical Biochemistry, Bezmialem Vakıf University, Istanbul, Türkiye
| | - İsmet Kırpınar
- Faculty of Medicine, Psychiatry Department, Bezmialem Vakıf University, Istanbul, Türkiye
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Souza-Teodoro LH, Davies NM, Warren HR, Andrade LHSG, Carvalho LA. DHEA and response to antidepressant treatment: A Mendelian Randomization analysis. J Psychiatr Res 2024; 173:151-156. [PMID: 38531145 DOI: 10.1016/j.jpsychires.2024.02.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 02/02/2024] [Accepted: 02/21/2024] [Indexed: 03/28/2024]
Abstract
Treatment response is hard to predict and detailed mechanisms unknown. Lower levels of the dehydroepiandrosterone sulphate (DHEA(S)) - a precursor to testosterone and estrogen - have been associated to depression and to response to antidepressant treatment. Previous studies however may have been ridden by confounding and reverse causation. The aim of this study is to evaluate whether higher levels of DHEA(S) are causally linked to response to antidepressants using mendelian randomization (MR). We performed a Two-sample MR analysis using data the largest publicly available GWAS of DHEA(S) levels (n = 14,846) using eight common genetic variants associated to DHEA(S) (seven single nucleotide polymorphisms and one variant rs2497306) and the largest GWAS of antidepressant response (n = 5218) using various MR methods (IVW, MR Egger, Weighted mean, weighted mode, MR-PRESSO) and single SNP analysis. We further investigated for pleiotropy conducting a look up on PhenoScanner and GWAS Catalog. Results show no evidence for DHEA(S) gene risk score from any of MR methods, however, we found a significant association on individual variant analysis for rs11761538, rs17277546, and rs2497306. There was some evidence for heterogeneity and pleiotropy. This is the first paper to show some evidence for a causal association of genetically-predicted DHEA and improvement of depressive symptoms. The effect is not a simple linear effect, and we were unable to dissect whether the effect was direct effect of DHEA(S), mediated by DHEA(S) or on the pathway is not yet clear. Further studies using more refined instrumental variables will help clarify this association.
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Affiliation(s)
- L H Souza-Teodoro
- William Harvey Research Institute, Charterhouse Square, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, EC1M 6BQ, UK; Núcleo de Epidemiologia Psiquiatrica, Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo, Brazil
| | - N M Davies
- Division of Psychiatry, University College London, UK; K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Norway; Department of Statistical Sciences, University College London, London, UK
| | - H R Warren
- William Harvey Research Institute, Charterhouse Square, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, EC1M 6BQ, UK; NIHR Cardiovascular Biomedical Research Centre, Barts and the London Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - L H S G Andrade
- Núcleo de Epidemiologia Psiquiatrica, Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo, Brazil
| | - L A Carvalho
- William Harvey Research Institute, Charterhouse Square, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, EC1M 6BQ, UK.
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Tao L, Wu R, Song X, Xia M, Yao R. The associations between 2D:4D ratio and behavior problems among Chinese preschool children: A cross-sectional study. Early Hum Dev 2023; 186:105871. [PMID: 37797473 DOI: 10.1016/j.earlhumdev.2023.105871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Digit ratio (2D:4D) is considered a biomarker of prenatal androgen activity, the prenatal hormone exposure may affect children's psychology and behavior. OBJECTIVE The aim of this study was to analyze the associations between 2D:4D ratio and behavior problems in Chinese preschool children, and to provide ideas for early intervention of children's behavior problems. METHODS A total of 548 Chinese preschool children aged 3-6 years were recruited using a stratified cluster sampling method. The Child Behavior Checklist (CBCL) was used to assess the children's behavior. Basic information of the children and their parents was also collected, finger length was directly measured by electronic vernier caliper. RESULTS We found that sex and age of the child, mother's educational level, and whether the child was an only child were the influencing factors of behavior problems (P < 0.05). Right-handed 2D:4D was negatively correlated with parent-reported anxiety/depression (P < 0.05), father-reported aggression (P < 0.05) and attention problems (P < 0.01), that is, high levels of testosterone may increase the risk of anxiety and depression, our results were in contrast to previous studies. CONCLUSION The 2D:4D ratio may be related to behavior problems among Chinese preschool children, and prenatal testosterone exposure may be an important factor affecting behavior problems.
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Affiliation(s)
- Lan Tao
- Department of Child and Adolescents Health, School of Public Health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu 233030, Anhui, China
| | - Ruoyao Wu
- Fengxian District Center for Disease Control and Prevention, Jiefang E Rd, Shanghai 201400, China
| | - Xingxing Song
- Department of Child and Adolescents Health, School of Public Health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu 233030, Anhui, China
| | - Moyan Xia
- Department of Child and Adolescents Health, School of Public Health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu 233030, Anhui, China
| | - Rongyin Yao
- Department of Child and Adolescents Health, School of Public Health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu 233030, Anhui, China.
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Calva-González M, Villanueva-Solórzano PL, Crail-Meléndez ED, Loya-Murguia KM, Dehesa Hernandez IA, Robles-Ramirez F, Rodríguez-Hernández LA, Mondragón-Soto MG, Flores-Vázquez JG, Portocarrero-Ortiz LA. Neuropsychiatric Effects in Patients With Invasive Prolactinomas Treated With Cabergoline. Cureus 2023; 15:e39869. [PMID: 37404423 PMCID: PMC10315068 DOI: 10.7759/cureus.39869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2023] [Indexed: 07/06/2023] Open
Abstract
Background and objective Invasive prolactinoma accounts for 1-5% of all prolactinomas. Its mass and compromise of the diencephalon and frontal and temporal lobes may result in a range of neuropsychiatric symptoms that are often missed during initial evaluations. Cabergoline is a dopaminergic agonist used as the first-line treatment for these patients; however, its effect on neuropsychiatric symptoms in this particular setting remains unexplored. In this study, our primary objective was to describe the epidemiology of neuropsychiatric comorbidities in Mexican patients with invasive prolactinomas. The secondary aim of the study was to describe how these comorbidities are modified by treatment with cabergoline, through follow-up with standardized clinical scales. Methods This was a retrospective analytic study. Data were pulled from clinical records and evaluations of patients at baseline and at six-month follow-ups. Results A total of 10 patients were included in the study. None of them had any prior psychiatric diagnosis. At the initial evaluation, 70% were diagnosed with depression or anxiety. During follow-up, two patients developed neuropsychiatric symptoms; there was a significant reduction in tumor size but no difference was found in clinimetric scores for neuropsychiatric comorbidities. Conclusions Patients with giant prolactinomas may present with several neuropsychiatric symptoms throughout the course of their disease. Although there are several mechanisms involved, it is important to keep in mind that cabergoline may interfere with the dopaminergic pathways involved. This study was underpowered to determine the association but can serve as a pilot for further research on this topic.
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Affiliation(s)
- Metztli Calva-González
- Psychiatry, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, MEX
| | | | - Edgar D Crail-Meléndez
- Neuropsychiatry, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, MEX
| | - Kennya M Loya-Murguia
- Neuropsychiatry, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, MEX
| | | | - Fernando Robles-Ramirez
- Neuroradiology, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, MEX
| | | | - Michel G Mondragón-Soto
- Neurosurgery, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, MEX
- General Surgery, Centro Medico ABC, Mexico City, MEX
| | | | - Lesly A Portocarrero-Ortiz
- Neuroendocrinology, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, MEX
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Hemachandra C, Davis SR, Bell RJ, Sultana F, Islam RM. Endogenous dehydroepiandrosterone and depression in postmenopausal women: a systematic review of observational studies. Menopause 2023; 30:332-340. [PMID: 36649577 DOI: 10.1097/gme.0000000000002142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
IMPORTANCE The associations between endogenous dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEAS), and depression in older women are uncertain. However, DHEA supplements are widely available over the counter in some countries, and some people may be taking DHEA with the hope of positive mood effects. OBJECTIVE This systematic review aimed to investigate the association between endogenous DHEA/DHEAS blood concentrations and depression/depressive symptoms in community-dwelling postmenopausal women.Evidence Review: Searches were conducted in Ovid MEDLINE, EMBASE, PsycINFO, and Web of Science databases for observational studies with at least 100 community-dwelling participants until March 9, 2022. The bibliographies of retrieved articles were manually searched. The studies published in English and meeting the inclusion criteria were included in the review. The risk of bias was assessed with the modified Hoy tool for cross-sectional designs and the Joanna Briggs Institute modified critical appraisal checklist for cohort studies. FINDINGS Of the 30 articles retrieved for full-text review, 14 met the criteria for inclusion. Seven studies were cross-sectional, six were longitudinal, and one had both cross-sectional and longitudinal data. Five of eight cross-sectional studies found no association between DHEAS and depression, whereas three studies reported an inverse association. Similarly, most of the studies (n = 4) with longitudinal data reported no association, whereas two studies reported either an inverse association or mixed results for DHEAS and depression severity. No association between DHEA and depression was found irrespective of the study design. Heterogeneity of design was a barrier to meta-analysis and between study comparison. The majority of studies were limited by high risk of bias in at least one assessed domain. CONCLUSION AND RELEVANCE This systematic review does not support an association between endogenous DHEA/DHEAS and depression in postmenopausal women.
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Affiliation(s)
| | | | - Robin J Bell
- From the Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | - Rakibul M Islam
- From the Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Hemachandra C, Islam RM, Bell RJ, Sultana F, Davis SR. The association between testosterone and depression in postmenopausal women: A systematic review of observational studies. Maturitas 2023; 168:62-70. [PMID: 36493634 DOI: 10.1016/j.maturitas.2022.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/07/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The contribution of testosterone to depression in older women is uncertain. This review was conducted to investigate the association between endogenous testosterone blood concentrations and depression in postmenopausal women. METHODS We searched Ovid MEDLINE, EMBASE, PsycINFO, and Web of Science databases for observational studies with at least 100 community-dwelling participants. The results were categorised by study design, and the reporting of total, bioavailable and free testosterone findings is narrative. RESULTS The search strategy retrieved 28 articles for full-text review, of which eight met the criteria for inclusion; these described 6 cross-sectional and 2 longitudinal studies. Testosterone was measured by immunoassay in all of the included studies. No association was seen between total testosterone or free testosterone and depression in either the cross-sectional or the longitudinal studies. A significant association between bioavailable testosterone and incident depressive symptoms was limited to women at least 21 years postmenopause in one study. Most of the cross-sectional studies were not representative of national populations and lacked random selection. CONCLUSIONS This systematic review does not support an association between testosterone and depression in postmenopausal women. However, as the included studies had substantial methodological limitations, studies of community-based samples, employing validated instruments for depression and precise measurement of blood testosterone, are needed to address this knowledge gap.
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Affiliation(s)
- Chandima Hemachandra
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Level 1, 553 St Kilda Road, Melbourne, Victoria 3004, Australia
| | - Rakibul M Islam
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Level 1, 553 St Kilda Road, Melbourne, Victoria 3004, Australia
| | - Robin J Bell
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Level 1, 553 St Kilda Road, Melbourne, Victoria 3004, Australia
| | - Farhana Sultana
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Level 1, 553 St Kilda Road, Melbourne, Victoria 3004, Australia
| | - Susan R Davis
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Level 1, 553 St Kilda Road, Melbourne, Victoria 3004, Australia; Department of Endocrinology and Diabetes, Alfred Health, Melbourne, Vic 3004, Australia.
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Sun Y, Zhao J, Rong J. Dissecting the molecular mechanisms underlying the antidepressant activities of herbal medicines through the comprehensive review of the recent literatures. Front Psychiatry 2022; 13:1054726. [PMID: 36620687 PMCID: PMC9813794 DOI: 10.3389/fpsyt.2022.1054726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
Depression is clinically defined as a mood disorder with persistent feeling of sadness, despair, fatigue, and loss of interest. The pathophysiology of depression is tightly regulated by the biosynthesis, transport and signaling of neurotransmitters [e.g., serotonin, norepinephrine, dopamine, or γ-aminobutyric acid (GABA)] in the central nervous system. The existing antidepressant drugs mainly target the dysfunctions of various neurotransmitters, while the efficacy of antidepressant therapeutics is undermined by different adverse side-effects. The present review aimed to dissect the molecular mechanisms underlying the antidepressant activities of herbal medicines toward the development of effective and safe antidepressant drugs. Our strategy involved comprehensive review and network pharmacology analysis for the active compounds and associated target proteins. As results, 45 different antidepressant herbal medicines were identified from various in vivo and in vitro studies. The antidepressant mechanisms might involve multiple signaling pathways that regulate neurotransmitters, neurogenesis, anti-inflammation, antioxidation, endocrine, and microbiota. Importantly, herbal medicines could modulate broader spectrum of the cellular pathways and processes to attenuate depression and avoid the side-effects of synthetic antidepressant drugs. The present review not only recognized the antidepressant potential of herbal medicines but also provided molecular insights for the development of novel antidepressant drugs.
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Affiliation(s)
- Yilu Sun
- Department of Chinese Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- School of Chinese Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Jia Zhao
- Department of Chinese Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- School of Chinese Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Jianhui Rong
- School of Chinese Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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Souza-Teodoro LH, Andrade LHS, Carvalho LA. Could be dehydroepiandrosterone (DHEA) a novel target for depression? JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Syrogiannouli L, Wildisen L, Meuwese C, Bauer DC, Cappola AR, Gussekloo J, den Elzen WPJ, Trompet S, Westendorp RGJ, Jukema JW, Ferrucci L, Ceresini G, Åsvold BO, Chaker L, Peeters RP, Imaizumi M, Ohishi W, Vaes B, Völzke H, Sgarbi JA, Walsh JP, Dullaart RPF, Bakker SJL, Iacoviello M, Rodondi N, Del Giovane C. Incorporating Baseline Outcome Data in Individual Participant Data Meta-Analysis of Non-randomized Studies. Front Psychiatry 2022; 13:774251. [PMID: 35273528 PMCID: PMC8902696 DOI: 10.3389/fpsyt.2022.774251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background In non-randomized studies (NRSs) where a continuous outcome variable (e.g., depressive symptoms) is assessed at baseline and follow-up, it is common to observe imbalance of the baseline values between the treatment/exposure group and control group. This may bias the study and consequently a meta-analysis (MA) estimate. These estimates may differ across statistical methods used to deal with this issue. Analysis of individual participant data (IPD) allows standardization of methods across studies. We aimed to identify methods used in published IPD-MAs of NRSs for continuous outcomes, and to compare different methods to account for baseline values of outcome variables in IPD-MA of NRSs using two empirical examples from the Thyroid Studies Collaboration (TSC). Methods For the first aim we systematically searched in MEDLINE, EMBASE, and Cochrane from inception to February 2021 to identify published IPD-MAs of NRSs that adjusted for baseline outcome measures in the analysis of continuous outcomes. For the second aim, we applied analysis of covariance (ANCOVA), change score, propensity score and the naïve approach (ignores the baseline outcome data) in IPD-MA from NRSs on the association between subclinical hyperthyroidism and depressive symptoms and renal function. We estimated the study and meta-analytic mean difference (MD) and relative standard error (SE). We used both fixed- and random-effects MA. Results Ten of 18 (56%) of the included studies used the change score method, seven (39%) studies used ANCOVA and one the propensity score (5%). The study estimates were similar across the methods in studies in which groups were balanced at baseline with regard to outcome variables but differed in studies with baseline imbalance. In our empirical examples, ANCOVA and change score showed study results on the same direction, not the propensity score. In our applications, ANCOVA provided more precise estimates, both at study and meta-analytical level, in comparison to other methods. Heterogeneity was higher when change score was used as outcome, moderate for ANCOVA and null with the propensity score. Conclusion ANCOVA provided the most precise estimates at both study and meta-analytic level and thus seems preferable in the meta-analysis of IPD from non-randomized studies. For the studies that were well-balanced between groups, change score, and ANCOVA performed similarly.
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Affiliation(s)
| | - Lea Wildisen
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Christiaan Meuwese
- Department of Intensive Care Medicine, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Douglas C. Bauer
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Departments of Medicine and Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Anne R. Cappola
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, United States
| | - Jacobijn Gussekloo
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
| | - Wendy P. J. den Elzen
- Atalmedial Diagnostics Centre, Amsterdam, Netherlands
- Department of Clinical Chemistry, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, Netherlands
| | - Stella Trompet
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, Netherlands
| | - Rudi G. J. Westendorp
- Department of Public Health and Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - J. Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
- Netherlands Heart Institute, Utrecht, Netherlands
| | - Luigi Ferrucci
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, United States
| | - Graziano Ceresini
- Unit of Internal Medicine and Onco-Endocrinology, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Bjørn O. Åsvold
- Department of Public Health and Nursing, K.G. Jebsen Center for Genetic Epidemiology, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Endocrinology, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Layal Chaker
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Robin P. Peeters
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Misa Imaizumi
- Department of Clinical Studies, Radiation Effects Research Foundation, Nagasaki, Japan
| | - Waka Ohishi
- Department of Clinical Studies, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Bert Vaes
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Henry Völzke
- Institute for Community Medicine, Clinical-Epidemiological Research, University Medicine Greifswald, Greifswald, Germany
| | - Josè A. Sgarbi
- Division of Endocrinology and Metabolism, Department of Medicine, Faculdade de Medicina de Marilia, São Paulo, Brazil
| | - John P. Walsh
- Medical School, The University of Western Australia, Crawley, WA, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Robin P. F. Dullaart
- Department of Internal Medicine, University Medical Center, University of Groningen, Groningen, Netherlands
| | - Stephan J. L. Bakker
- Department of Internal Medicine, University Medical Center, University of Groningen, Groningen, Netherlands
| | - Massimo Iacoviello
- Cardiology Unit, University Hospital Policlinico Consorziale of Bari, Bari, Italy
| | - Nicolas Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Cinzia Del Giovane
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
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11
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Chronister BN, Gonzalez E, Lopez-Paredes D, Suarez-Torres J, Gahagan S, Martinez D, Barros J, Jacobs DR, Checkoway H, Suarez-Lopez JR. Testosterone, estradiol, DHEA and cortisol in relation to anxiety and depression scores in adolescents. J Affect Disord 2021; 294:838-846. [PMID: 34375211 PMCID: PMC8992006 DOI: 10.1016/j.jad.2021.07.026] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 06/16/2021] [Accepted: 07/11/2021] [Indexed: 11/22/2022]
Abstract
Background Adrenal and sex hormone dysregulation have been independently associated with increased depression and anxiety. Cortisol can modify production of sex hormones and hormone-mood associations. This study evaluated associations and interplay of sex and adrenal hormones with depression and anxiety. Methods We assessed 545 Ecuadorian adolescents (11-17y, 50.4% female, ESPINA) for depression and anxiety symptoms using standardized scales. Testosterone, cortisol, dehydroepiandrosterone (DHEA), and estradiol (boys only) were measured in saliva. We performed logistic regression modeling to calculate odds ratios (OR) of elevated depression or anxiety (scores ≥60) comparing participants with low (<10th percentile) and elevated hormones (≥90th percentile) to normal concentrations (10th-90th percentile). Effect modification by cortisol and testosterone was assessed. Models adjusted for demographic, anthropometric, and circadian measures. Results In all participants, elevated testosterone (OR [95%CI:]=1.78 [0.98, 3.23]) and cortisol (OR=1.69 [0.95, 2.99]) were marginally associated with elevated anxiety scores. In boys, elevated estradiol was associated with elevated depression (OR=4.75 [1.95, 11.56]) and anxiety scores (OR=2.43 [1.01, 5.84]). In linear regression, estradiol was positively associated with depression (difference/10% hormone increase (β=0.45 [0.15, 0.75]) and anxiety scores (β=0.42 [0.13, 0.72]). Higher cortisol levels strengthened the depression association with estradiol in boys (β=0.54 [0.12, 0.96]), and with testosterone (β= -0.19 [-0.35, -0.03]) and DHEA (β= -0.12 [-0.22, -0.02]) in girls. Testosterone also modified associations. Limitations This was a cross-sectional analysis. Discussion Elevated testosterone, cortisol, and estradiol (≥90th percentile) were associated with altered mood. Cortisol and testosterone were considerable effect modifiers to the associations of most hormones with depression and anxiety.
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Affiliation(s)
- Briana Nc Chronister
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; School of Public Health, San Diego State University, San Diego, CA 92182, USA
| | - Eduardo Gonzalez
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | | | | | - Sheila Gahagan
- Department of Pediatrics, University of California San Diego, La Jolla, CA 92093, USA
| | | | | | - David R Jacobs
- School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA
| | - Harvey Checkoway
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Jose R Suarez-Lopez
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
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12
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Chen CV, Jordan CL, Breedlove SM. Testosterone works through androgen receptors to modulate neuronal response to anxiogenic stimuli. Neurosci Lett 2021; 753:135852. [PMID: 33785380 DOI: 10.1016/j.neulet.2021.135852] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 03/08/2021] [Accepted: 03/23/2021] [Indexed: 11/28/2022]
Abstract
Testosterone (T) exerts anxiolytic effects through functional androgen receptors (ARs) in rodents. T treatment of castrated mice reduces anxiety-like behavior in wild-type (WT) males, but not males with a spontaneous mutation that renders AR dysfunctional (testicular feminization mutation, Tfm). Using Cre-LoxP technology we created males carrying induced dysfunctional AR allele (induced TFM; iTfm) to determine the brain regions responsible for T-induced anxiolysis. Adult WT and iTfm mice were castrated and T treated. Castrated WTs given a blank capsule (WT + B) served as additional controls. Mice were later exposed to the anxiogenic light/dark box, sacrificed and their brains processed for immediate early gene cFos immunoreactivity. Analyses revealed that T treatment increased cFos-expressing neurons in the basolateral amygdala (blAMY) of WT males, but not in iTfm males, which did not differ from WT + B mice. In contrast, WT + T males displayed fewer cFos + cells than iTfm + T or WT + B groups in the suprachiasmatic nucleus of the hypothalamus (SCN). No effects of genotype or hormone were seen in cFos expression in the hippocampus, medial prefrontal cortex, paraventricular nucleus of the hypothalamus, oval and anterodorsal bed nucleus of the stria terminalis, or dorsal periaqueductal grey. AR immunohistochemistry indicated that ∼65 % of cells in the blAMY and SCN were AR + in WT males, so AR could act directly within neurons in these regions to modulate the animals' response to anxiogenic stimuli. Because absence of a functional AR did not affect cFos response to mild stress in the other brain regions, they are unlikely to mediate androgen's anxiolytic effects.
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Affiliation(s)
- Chieh V Chen
- Texas A&M University, Psychiatry Department, Clinical Building 1 Suite 1100, 8441 Riverside Parkway, Bryan, TX 77807, United States; Michigan State University, United States.
| | - Cynthia L Jordan
- Psychology Department, 293 Farm Lane, Giltner Room 108, East Lansing, MI 48824, United States; Neuroscience Program, 293 Farm Lane, Giltner Room 108, East Lansing, MI 48824, United States
| | - S Marc Breedlove
- Psychology Department, 293 Farm Lane, Giltner Room 108, East Lansing, MI 48824, United States; Neuroscience Program, 293 Farm Lane, Giltner Room 108, East Lansing, MI 48824, United States
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13
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Wildisen L, Feller M, Del Giovane C, Moutzouri E, Du Puy RS, Mooijaart SP, Collet TH, Poortvliet RKE, Kearney P, Quinn TJ, Klöppel S, Bauer DC, Peeters RP, Westendorp R, Aujesky D, Gussekloo J, Rodondi N. Effect of Levothyroxine Therapy on the Development of Depressive Symptoms in Older Adults With Subclinical Hypothyroidism: An Ancillary Study of a Randomized Clinical Trial. JAMA Netw Open 2021; 4:e2036645. [PMID: 33566107 PMCID: PMC7876592 DOI: 10.1001/jamanetworkopen.2020.36645] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
IMPORTANCE Previous trials on the effect of levothyroxine on depressive symptom scores in patients with subclinical hypothyroidism were limited by small sample sizes (N = 57 to 94) and potential biases. OBJECTIVE To assess the effect of levothyroxine on the development of depressive symptoms in older adults with subclinical hypothyroidism in the largest trial on this subject and to update a previous meta-analysis including the results from this study. DESIGN, SETTING, AND PARTICIPANTS This predefined ancillary study analyzed data from participants in the Thyroid Hormone Replacement for Untreated Older Adults with Subclinical Hypothyroidism (TRUST) trial, a double-blind, randomized, placebo-controlled, parallel-group clinical trial conducted from April 2013 to October 31, 2016. The TRUST trial included adults aged 65 years or older diagnosed with subclinical hypothyroidism, defined as the presence of persistently elevated thyroid-stimulating hormone (TSH) levels (4.6-19.9 mIU/L) with free thyroxine (T4) within the reference range. Participants were identified from clinical and general practitioner laboratory databases and recruited from the community in Switzerland, the Netherlands, Ireland, and the UK. This ancillary study included a subgroup of 472 participants from the Netherlands and Switzerland; after exclusions, a total of 427 participants (211 randomized to levothyroxine and 216 to placebo) were analyzed. This analysis was conducted from December 1, 2019, to September 1, 2020. INTERVENTIONS Randomization to either levothyroxine or placebo. MAIN OUTCOMES AND MEASURES Depressive symptom scores after 12 months measured with the Geriatric Depression Scale (GDS-15), with higher scores indicating more depressive symptoms (minimal clinically important difference = 2). RESULTS A total of 427 participants with subclinical hypothyroidism (mean [SD] age, 74.52 [6.29] years; 239 women [56%]) were included in this analysis. The mean (SD) TSH level was 6.57 (2.22) mIU/L at baseline and decreased after 12 months to 3.83 (2.29) mIU/L in the levothyroxine group; in the placebo group, it decreased from 6.55 (2.04) mIU/L to 5.91 (2.66) mIU/L. At baseline, the mean (SD) GDS-15 score was 1.26 (1.85) in the levothyroxine group and 0.96 (1.58) in the placebo group. The mean (SD) GDS-15 score at 12 months was 1.39 (2.13) in the levothyroxine and 1.07 (1.67) in the placebo group with an adjusted between-group difference of 0.15 for levothyroxine vs placebo (95% CI, -0.15 to 0.46; P = .33). In a subgroup analysis including participants with a GDS-15 of at least 2, the adjusted between-group difference was 0.61 (95% CI, -0.32 to 1.53; P = .20). Results did not differ according to age, sex, or TSH levels. A previous meta-analysis (N = 278) on the association of levothyroxine with depressive symptoms was updated to include these findings, resulting in an overall standardized mean difference of 0.09 (95% CI, -0.05 to 0.22). CONCLUSIONS AND RELEVANCE This ancillary study of a randomized clinical trial found that depressive symptoms did not differ after levothyroxine therapy compared with placebo after 12 months; thus, these results do not provide evidence in favor of levothyroxine therapy in older persons with subclinical hypothyroidism to reduce the risk of developing depressive symptoms. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01853579.
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Affiliation(s)
- Lea Wildisen
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Martin Feller
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Cinzia Del Giovane
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Elisavet Moutzouri
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Robert S. Du Puy
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
| | - Simon P. Mooijaart
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Tinh-Hai Collet
- Service of Endocrinology, Diabetology, Nutrition, and Therapeutic Education, Geneva University Hospitals, Geneva, Switzerland
| | | | | | - Terence J. Quinn
- Institute of Cardiovascular Medicine, University of Glasgow, Glasgow, Scotland
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry, University of Bern, Bern, Switzerland
| | - Douglas C. Bauer
- Departments of Medicine and Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Robin P. Peeters
- Department of Medicine, Erasmus Medical Center, Rotterdam, the Netherland
| | - Rudi Westendorp
- Department of Public Health and Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Drahomir Aujesky
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jacobijn Gussekloo
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Nicolas Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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14
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So SY, Savidge TC. Sex-Bias in Irritable Bowel Syndrome: Linking Steroids to the Gut-Brain Axis. Front Endocrinol (Lausanne) 2021; 12:684096. [PMID: 34093447 PMCID: PMC8170482 DOI: 10.3389/fendo.2021.684096] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 05/03/2021] [Indexed: 12/12/2022] Open
Abstract
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that is more common in females. Despite its high global incidence, the disease mechanism is still unclear and therapeutic options remain limited. The sexual dimorphism in IBS incidence suggests that sex steroids play a role in disease onset and symptoms severity. This review considers sex steroids and their involvement in IBS symptoms and the underlying disease mechanisms. Estrogens and androgens play important regulatory roles in IBS symptomology, including visceral sensitivity, gut motility and psychological conditions, possibly through modulating the gut-brain axis. Steroids are regulators of hypothalamic-pituitary-adrenal activity and autonomic nervous system function. They also modulate gut microbiota and enteric nervous systems, impacting serotonin and mast cell signaling. Sex steroids also facilitate bidirectional cross-talk between the microbiota and host following bacterial transformation and recycling of steroids by the intestine. The sex-specific interplay between sex steroids and the host provides neuroendocrinology insight into the pathophysiology, epigenetics and treatment of IBS patients.
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Affiliation(s)
- Sik Yu So
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, United States
- Texas Children’s Microbiome Center, Department of Pathology, Texas Children’s Hospital, Houston, TX, United States
| | - Tor C. Savidge
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, United States
- Texas Children’s Microbiome Center, Department of Pathology, Texas Children’s Hospital, Houston, TX, United States
- *Correspondence: Tor C. Savidge,
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15
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Ceylan Y, Gunlusoy B, Koskderelioglu A, Gedizlioglu M, Degirmenci T. The depressive effects of androgen deprivation therapy in locally advanced or metastatic prostate cancer: a comparative study. Aging Male 2020; 23:733-739. [PMID: 30924381 DOI: 10.1080/13685538.2019.1586869] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
AIM To investigate association of androgen deprivation therapy (ADT) with depression and the effect of depression on cognitive functions in men with locally advanced or metastatic prostate cancer. METHODS A total of 144 patients were evaluated in a prospective, comparative study. Group1 consisted of 72 patients with locally advanced or metastatic prostate cancer who received complete ADT treatment continuously for 12 months and group2 (control group) consisted of 72 patients who underwent radical prostatectomy without any additional treatment. MoCA (The Montreal Cognitive Assessment) and HAM-D (Hamilton depression rating scale) tests were used to assess the effects of ADT on depression and cognitive functions. RESULTS According to post-treatment results of MoCA test, patients had lower mean total scores in both the groups. The deficits were especially prominent in the areas of language ability and short-term memory capacity. In the comparison of two groups according to HAM-D tests, the scores were significantly higher in group1 at baseline-6 month, at baseline-12 month and at 6-12 month follow-up period (p = .003, p < .001, p = .023).There was a relationship between depression and deterioration of language and memory functions at 6th (p < .001, p = .002) and 12th months (p < .001, p = .046). Attention function was deteriorated in these patients at 6th (p < .001) and 12th months (p < .001). CONCLUSIONS ADT causes increase in depression and the deterioration of cognitive functions. ADT should be given carefully to these older group of patients with concomitant morbidities.
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Affiliation(s)
- Yasin Ceylan
- Urology, University of Health Sciences Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - Bulent Gunlusoy
- Urology, University of Health Sciences Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - Asli Koskderelioglu
- bNeurology, University of Health Sciences Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - Muhtesem Gedizlioglu
- Neurology, University of Health Sciences Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - Tansu Degirmenci
- Urology, University of Health Sciences Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
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16
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Chen CY, Chen JH, Ree SC, Chang CW, Yu SH. Associations between estradiol and testosterone and depressive symptom scores of the Patient Health Questionnaire-9 in ovariectomized women: a population-based analysis of NHANES data. Ann Gen Psychiatry 2020; 19:64. [PMID: 33292309 PMCID: PMC7672831 DOI: 10.1186/s12991-020-00315-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 11/05/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Women are well known to be susceptible to developing affective disorders, yet little attention has been given to effects of ovariectomy-reduced hormones and links with depression. This population-based cross-sectional study aimed to investigate possible associations between ovariectomy-reduced hormones and depression symptom scores of the Patient Health Questionnaire-9 (PHQ-9) in ovariectomized women. METHODS Data of PHQ-9 scores, demographics and comorbidities of ovariectomized women were extracted from the U.S. National Health and Nutrition Examination Survey (NHANES) database (2013-2016) and were analyzed retrospectively. RESULTS Among ovariectomized women in the NHANES database, serum estradiol levels were significantly positively associated with PHQ-9 scores (ß = 0.014, 95% CI: 0.001, 0.028, P = 0.040), whereas serum testosterone was negatively associated with PHQ-9 scores (ß = -0.033, 95% CI: - 0.048, - 0.018, P < 0.001) after adjusting for confounders. Further stratified analyses revealed that serum estradiol was positively associated with PHQ-9 only among women with history of estrogen use. Serum testosterone levels were negatively associated with PHQ-9 among women with or without prior estrogen use but this was only observed among women aged < = 60 years (ß = - 0.057, - 0.076, - 0.038, P < 0.001). CONCLUSIONS Serum estradiol and testosterone are associated with PHQ-9 scores indicative for depression in ovariectomized women. The associations are modified by age and history of estrogen use. Future prospective studies are warranted to confirm these findings, carefully addressing possible confounding of age-related dementia.
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Affiliation(s)
- Ching-Yen Chen
- Department of Psychiatry, Chang Gung Hospital, Keelung, Taiwan.,Faculty of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jian-Hong Chen
- Department of Psychiatry, Chang Gung Hospital, Keelung, Taiwan.,Faculty of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shao-Chun Ree
- Department of Psychiatry, Chang Gung Hospital, Keelung, Taiwan.,Faculty of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chun-Wei Chang
- Department of Psychiatry, Fu Jen Catholic University Hospital, New Taipei, Taiwan.,School of Medicine, Fu Jen Catholic University, New Taipei, Taiwan
| | - Sheng-Hsiang Yu
- Department of Psychology, Fo Guang University, No. 160, Linwei Rd., Jiaoxi, Yilan, 26247, Taiwan.
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17
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Wildisen L, Del Giovane C, Moutzouri E, Beglinger S, Syrogiannouli L, Collet TH, Cappola AR, Åsvold BO, Bakker SJL, Yeap BB, Almeida OP, Ceresini G, Dullaart RPF, Ferrucci L, Grabe H, Jukema JW, Nauck M, Trompet S, Völzke H, Westendorp R, Gussekloo J, Klöppel S, Aujesky D, Bauer D, Peeters R, Feller M, Rodondi N. An individual participant data analysis of prospective cohort studies on the association between subclinical thyroid dysfunction and depressive symptoms. Sci Rep 2020; 10:19111. [PMID: 33154486 PMCID: PMC7644764 DOI: 10.1038/s41598-020-75776-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 10/20/2020] [Indexed: 01/07/2023] Open
Abstract
In subclinical hypothyroidism, the presence of depressive symptoms is often a reason for starting levothyroxine treatment. However, data are conflicting on the association between subclinical thyroid dysfunction and depressive symptoms. We aimed to examine the association between subclinical thyroid dysfunction and depressive symptoms in all prospective cohorts with relevant data available. We performed a systematic review of the literature from Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library from inception to 10th May 2019. We included prospective cohorts with data on thyroid status at baseline and depressive symptoms during follow-up. The primary outcome was depressive symptoms measured at first available follow-up, expressed on the Beck's Depression Inventory (BDI) scale (range 0-63, higher values indicate more depressive symptoms, minimal clinically important difference: 5 points). We performed a two-stage individual participant data (IPD) analysis comparing participants with subclinical hypo- or hyperthyroidism versus euthyroidism, adjusting for depressive symptoms at baseline, age, sex, education, and income (PROSPERO CRD42018091627). Six cohorts met the inclusion criteria, with IPD on 23,038 participants. Their mean age was 60 years, 65% were female, 21,025 were euthyroid, 1342 had subclinical hypothyroidism and 671 subclinical hyperthyroidism. At first available follow-up [mean 8.2 (± 4.3) years], BDI scores did not differ between participants with subclinical hypothyroidism (mean difference = 0.29, 95% confidence interval = - 0.17 to 0.76, I2 = 15.6) or subclinical hyperthyroidism (- 0.10, 95% confidence interval = - 0.67 to 0.48, I2 = 3.2) compared to euthyroidism. This systematic review and IPD analysis of six prospective cohort studies found no clinically relevant association between subclinical thyroid dysfunction at baseline and depressive symptoms during follow-up. The results were robust in all sensitivity and subgroup analyses. Our results are in contrast with the traditional notion that subclinical thyroid dysfunction, and subclinical hypothyroidism in particular, is associated with depressive symptoms. Consequently, our results do not support the practice of prescribing levothyroxine in patients with subclinical hypothyroidism to reduce the risk of developing depressive symptoms.
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Affiliation(s)
- Lea Wildisen
- grid.5734.50000 0001 0726 5157Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland ,grid.5734.50000 0001 0726 5157Graduate School for Health Sciences, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland
| | - Cinzia Del Giovane
- grid.5734.50000 0001 0726 5157Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland
| | - Elisavet Moutzouri
- grid.5734.50000 0001 0726 5157Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland ,grid.5734.50000 0001 0726 5157Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 15, 3010 Bern, Switzerland
| | - Shanthi Beglinger
- grid.5734.50000 0001 0726 5157Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland ,grid.5734.50000 0001 0726 5157Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 15, 3010 Bern, Switzerland
| | - Lamprini Syrogiannouli
- grid.5734.50000 0001 0726 5157Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland
| | - Tinh-Hai Collet
- grid.8515.90000 0001 0423 4662Service of Endocrinology, Diabetes and Metabolism, Department of Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Anne R. Cappola
- grid.25879.310000 0004 1936 8972Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Pennsylvania School of Medicine, 3400 Civic Center Boulevard, Philadelphia, PA 19104 USA
| | - Bjørn O. Åsvold
- grid.5947.f0000 0001 1516 2393K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Postboks 8905 MTFS, 7491 Trondheim, Norway ,grid.52522.320000 0004 0627 3560Department of Endocrinology, St. Olavs Hospital, Trondheim University Hospital, Postbox 3250 Torgarden, 7006 Trondheim, Norway
| | - Stephan J. L. Bakker
- grid.4830.f0000 0004 0407 1981Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Bu B. Yeap
- grid.1012.20000 0004 1936 7910Medical School, University of Western Australia Perth, The University of Western Australia (M582), 35 Stirling Highway, Crawley, WA 6009 Australia
| | - Osvaldo P. Almeida
- grid.1012.20000 0004 1936 7910Medical School, University of Western Australia Perth, The University of Western Australia (M582), 35 Stirling Highway, Crawley, WA 6009 Australia
| | - Graziano Ceresini
- grid.411482.aDepartment of Medicine and Surgery, Unit of Internal Medicine and Onco-Endocrinology, University Hospital of Parma, Via Gramsci, 14 - 43126 Parma, Italy
| | - Robin P. F. Dullaart
- grid.4830.f0000 0004 0407 1981Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Luigi Ferrucci
- grid.419475.a0000 0000 9372 4913Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, 251 Bayview Boulevard, Suite 100, Baltimore, MD 21224 USA
| | - Hans Grabe
- grid.5603.0Institute for Community Medicine, Clinical-Epidemiological Research, University Medicine Greifswald, Walter Rathenau Str. 48, 17475 Greifswald, Germany
| | - J. Wouter Jukema
- grid.10419.3d0000000089452978Department of Cardiology, Leiden University Medical Center, Postbus 9600, 2300 RC Leiden, The Netherlands
| | - Matthias Nauck
- grid.5603.0Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany ,grid.452396.f0000 0004 5937 5237DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
| | - Stella Trompet
- grid.10419.3d0000000089452978Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Henry Völzke
- grid.5603.0Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstrasse 1-2, 17489 Greifswald, Germany
| | - Rudi Westendorp
- grid.5254.60000 0001 0674 042XDepartment of Public Health and Center for Healthy Aging, University of Copenhagen, Gothersgade 160, 1123 København K, Mærsk Tower, Copenhagen, Denmark
| | - Jacobijn Gussekloo
- grid.10419.3d0000000089452978Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands ,grid.10419.3d0000000089452978Department of Public Health and Primary Care, Leiden University Medical Center, LUMC Education Building, Hippocratespad 21, 2333 ZD Leiden, the Netherlands
| | - Stefan Klöppel
- grid.5734.50000 0001 0726 5157University Hospital of Old Age Psychiatry, University of Bern, Murtenstrasse 21, 3008 Bern, Switzerland
| | - Drahomir Aujesky
- grid.5734.50000 0001 0726 5157Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 15, 3010 Bern, Switzerland
| | - Douglas Bauer
- grid.266102.10000 0001 2297 6811Departments of Medicine and Epidemiology and Biostatistics, University of California, San Francisco, 550 16th St., Box 0560, San Francisco, CA 94158 USA
| | - Robin Peeters
- grid.5645.2000000040459992XDepartment of Medicine, Erasmus Medical Center, Postbus 2040, 3000 CA Rotterdam, The Netherlands
| | - Martin Feller
- grid.5734.50000 0001 0726 5157Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland ,grid.5734.50000 0001 0726 5157Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 15, 3010 Bern, Switzerland
| | - Nicolas Rodondi
- grid.5734.50000 0001 0726 5157Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland ,grid.5734.50000 0001 0726 5157Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 15, 3010 Bern, Switzerland
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Walther A, Tsao C, Pande R, Kirschbaum C, Field E, Berkman L. Do dehydroepiandrosterone, progesterone, and testosterone influence women's depression and anxiety levels? Evidence from hair-based hormonal measures of 2105 rural Indian women. Psychoneuroendocrinology 2019; 109:104382. [PMID: 31374371 PMCID: PMC6842697 DOI: 10.1016/j.psyneuen.2019.104382] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 06/16/2019] [Accepted: 07/16/2019] [Indexed: 01/19/2023]
Abstract
Depressive and anxiety disorders substantially contribute to the global burden of disease, particularly in poor countries. Higher prevalence rates for both disorders among women indicate sex hormones may be integrated in the pathophysiology of these disorders. The Kshetriya Gramin Financial Services study surveyed a random sample of 4160 households across 876 villages in rural Tamil Nadu, India. An interviewer-administered questionnaire was conducted to quantify depressive (K6-D) and anxiety (K6-A) symptoms. Alongside, hair samples for sex hormone profiling were collected from a subsample of 2105 women aged 18-85 years. Importantly, 5.9%, 14.8%, and 46.3% of samples contained non-detectable hormone levels for dehydroepiandrosterone, progesterone, and testosterone, respectively. Our primary analysis imputes values for the non-detectable sample and we check robustness of results when non-detectable values are dropped. In this cohort of women from rural India, higher depressive symptomatology is associated with lower levels of dehydroepiandrosterone and higher depressive and anxiety symptoms are associated with higher levels of testosterone. Progesterone shows no clear association with either depressive or anxiety symptoms. These results support a potential protective effect of higher endogenous dehydroepiandrosterone levels. An important caveat on the potential negative effect of hair testosterone levels on women's mental health is that the testosterone analysis is sensitive to how non-detectable values are treated.
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Affiliation(s)
- A Walther
- Biological Psychology, TU Dresden, Germany.
| | - C Tsao
- Princeton University, USA
| | - R Pande
- Department of Economics, Yale University, USA
| | | | - E Field
- Economics Department, Duke Trinity College of Arts & Sciences, USA
| | - L Berkman
- Center for Population and Development Studies, Harvard University, USA
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The Effects of 12 Weeks of a Combined Exercise Program on Physical Function and Hormonal Status in Elderly Korean Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214196. [PMID: 31671514 PMCID: PMC6862258 DOI: 10.3390/ijerph16214196] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 10/22/2019] [Accepted: 10/27/2019] [Indexed: 12/23/2022]
Abstract
Aging causes a decline in physical function and hormonal balance. Exercise can improve these parameters. However, the beneficial effects of a combined exercise program (Korean dance and yoga) on physical function and hormonal status in elderly women remain unknown. This study aims to investigate the effects of a 12-week combined exercise program on balance, flexibility, muscle strength, and hormonal status in elderly Korean women. Twenty-five healthy elderly women were recruited and randomly divided into the control (CON) and exercise (EXE) groups. The EXE group underwent the combined exercise program (60 min/day and 3 times/week) for 12 weeks. The two groups did not differ in body weight, lean body mass, fat mass, body fat percentage, or body mass index at baseline or in the changes following the experimental conditions. A significant time × group interaction was detected for anterior and posterior dynamic balance, static balance, and growth hormone (GH). After the combined exercise program, anterior dynamic balance, posterior dynamic balance, static balance, flexibility, muscle strength, GH, dehydroepiandrosterone-sulfate, and estrogen significantly increased in the EXE group compared to the CON group. In conclusion, the combined exercise program contributed to improvements in overall health, including physical function and hormonal status, in elderly Korean women.
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Owens SJ, Purves-Tyson TD, Webster MJ, Shannon Weickert C. Evidence for enhanced androgen action in the prefrontal cortex of people with bipolar disorder but not schizophrenia or major depressive disorder. Psychiatry Res 2019; 280:112503. [PMID: 31446215 DOI: 10.1016/j.psychres.2019.112503] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/30/2019] [Accepted: 07/31/2019] [Indexed: 01/24/2023]
Abstract
Anxiety and depressive disorders are more prevalent in hypogonadal men. Low testosterone levels are associated with greater negative symptoms and impaired cognition in men with schizophrenia. Thus, androgens may contribute to brain pathophysiology in psychiatric disorders. We investigated androgen-related mRNAs in post-mortem dorsolateral prefrontal cortex of psychiatric disorders. We also assessed androgen receptor (AR) CAG trinucleotide repeat length, a functional AR gene variant associated with AR gene expression, receptor activity, and circulating testosterone. AR CAG repeat length was determined from genomic DNA and AR and 5α-reductase mRNAs measured using quantitative PCR in schizophrenia, bipolar disorder and control cases [n = 35/group; Stanley Medical Research Institute (SMRI) Array collection]. Layer-specific AR gene expression was determined using in situ hybridisation in schizophrenia, bipolar disorder, major depressive disorder and control cases (n = 15/group; SMRI Neuropathology Consortium). AR mRNA was increased in bipolar disorder, but was unchanged in schizophrenia, relative to controls. AR and 5α-reductase mRNAs were significantly positively correlated in bipolar disorder. AR CAG repeat length was significantly shorter in bipolar disorder relative to schizophrenia. AR mRNA expression was highest in cortical layers IV and V, but no layer-specific diagnostic differences were detected. Together, our results suggest enhanced cortical androgen action in people with bipolar disorder.
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Affiliation(s)
- Samantha J Owens
- Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick NSW 2031, Australia; School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney NSW 2052, Australia.
| | - Tertia D Purves-Tyson
- Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick NSW 2031, Australia; School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney NSW 2052, Australia
| | - Maree J Webster
- Laboratory of Brain Research, Stanley Medical Research Institute, MD 20815, USA
| | - Cynthia Shannon Weickert
- Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick NSW 2031, Australia; School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney NSW 2052, Australia; Department of Neuroscience & Physiology, Upstate Medical University, Syracuse, NY 13210, USA.
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21
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Impact of adrenal hormones, reproductive aging, and major depression on memory circuitry decline in early midlife. Brain Res 2019; 1721:146303. [PMID: 31279842 DOI: 10.1016/j.brainres.2019.146303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 06/12/2019] [Accepted: 06/18/2019] [Indexed: 11/24/2022]
Abstract
Dehydroepiandrosterone-sulfate (DHEAS) is an adrenal androgen that is, in part, aromatized to estradiol. It continues to be produced after menopause and provides estrogenicity after depletion of ovarian hormones. Estradiol depletion contributes to memory circuitry changes over menopause, including changes in hippocampal (HIPP) and dorsolateral- and ventrolateral-prefrontal cortex (DLPFC; VLPFC) function. Further, major depressive disorder (MDD) patients have, in general, lower levels of estradiol and lower DHEAS than healthy controls, thus potentially a higher risk of adverse menopausal outcomes. We investigated whether higher DHEAS levels after menopause is associated with better memory circuitry function, especially in women with MDD. 212 adults (ages 45-55, 50% women) underwent clinical and fMRI testing. Participants performed a working memory (WM) N-back task and an episodic memory verbal encoding (VE) task during fMRI scanning. DHEAS levels were significantly associated with memory circuitry function, specifically in MDD postmenopausal women. On the WM task, lower DHEAS levels were associated with increased HIPP activity. On the VE task, lower DHEAS levels were associated with decreased activity in the HIPP and VLPFC. In contrast, there was no association between DHEAS levels and memory circuitry function in MDD pre/perimenopausal women, men, and non-MDD participants regardless of sex and reproductive status. In fact, MDD postmenopausal women with higher levels of DHEAS were similar to MDD pre/perimenopausal women and men. Thus, memory circuitry deficits associated with MDD and a lower ability of the adrenal gland to produce DHEAS after menopause may contribute to a lower ability to maintain intact memory function with age.
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Grubac Z, Sutulovic N, Ademovic A, Velimirovic M, Rasic-Markovic A, Macut D, Petronijevic N, Stanojlovic O, Hrncic D. Short-term sleep fragmentation enhances anxiety-related behavior: The role of hormonal alterations. PLoS One 2019; 14:e0218920. [PMID: 31269081 PMCID: PMC6609147 DOI: 10.1371/journal.pone.0218920] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 06/13/2019] [Indexed: 01/25/2023] Open
Abstract
Introduction The neuroendocrine background of acute sleep fragmentation in obstructive sleep apnea and sleep fragmentation involvement in psychiatric comorbidities, common in these patients, are still largely unknown. The aim of this study was to determine the effects of short-term experimental sleep fragmentation on anxiety -like behavior and hormonal status in rats. Methods Male rats were adapted to treadmill (ON and OFF mode with belt speed set on 0.02m/s and 0.00m/s) and randomized to: 1) treadmill control (TC, only OFF mode); 2) motion, activity control (AC, 10min ON and 30min OFF mode) and 3) sleep fragmentation (SF, 30s ON and 90s OFF mode) group. Six hours later, the animals were tested in the open field, elevated plus maze and light/dark test (n = 8/group). Testosterone, estradiol, progesterone and corticosterone were determined in separate animal cohort immediately upon sleep fragmentation (n = 6/group). Results SF rats showed decreased rearings number, decreased time spent in the central area and increased thigmotaxic index compared to TC and AC rats in the open field test. Similarly, increased anxiety upon sleep fragmentation was observed in the elevated plus maze and the light/dark test. Significantly lower testosterone, estradiol and progesterone levels were determined in SF in comparison to AC and TC groups, while there was no significant difference in the levels of corticosterone. Conclusion Short term sleep fragmentation enhances anxiety-related behavior in rats, which could be partly mediated by the observed hormonal changes presented in the current study in form of testosterone, estradiol and progesterone depletion.
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Affiliation(s)
- Zeljko Grubac
- Laboratory of Neurophysiology, Institute of Medical Physiology “Richard Burian”, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Nikola Sutulovic
- Laboratory of Neurophysiology, Institute of Medical Physiology “Richard Burian”, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Anida Ademovic
- Laboratory of Neurophysiology, Institute of Medical Physiology “Richard Burian”, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milica Velimirovic
- Institute of Clinical and Medical Biochemistry, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Aleksandra Rasic-Markovic
- Laboratory of Neurophysiology, Institute of Medical Physiology “Richard Burian”, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Djuro Macut
- Clinic of Endocrinology, Diabetes and Metabolic Disease, CCS, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Natasa Petronijevic
- Institute of Clinical and Medical Biochemistry, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Olivera Stanojlovic
- Laboratory of Neurophysiology, Institute of Medical Physiology “Richard Burian”, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Dragan Hrncic
- Laboratory of Neurophysiology, Institute of Medical Physiology “Richard Burian”, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- * E-mail: ,
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Fiacco S, Walther A, Ehlert U. Steroid secretion in healthy aging. Psychoneuroendocrinology 2019; 105:64-78. [PMID: 30314729 DOI: 10.1016/j.psyneuen.2018.09.035] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/25/2018] [Accepted: 09/26/2018] [Indexed: 01/16/2023]
Abstract
Nowadays, people spend a considerable amount of their lives as older adults, but this longer lifespan is often accompanied by an increase in chronic conditions and disease, resulting in reduced quality of life and unprecedented societal and economic burden. Healthy aging is therefore increasingly recognized as a healthcare priority. Physical and mental adaptations to changes over the life course, and the maintenance of well-being, represent pivotal challenges in healthy aging. To capture the complexity of healthy aging, we propose a specific phenotype based on body composition, cognition, mood, and sexual function as indicators of different dimensions of healthy aging. With increasing age, sex hormones as well as glucocorticoids undergo significant alterations, and different patterns emerge for women and men. This review describes age-related patterns of change for women and men, and sheds light on the underlying mechanisms. Furthermore, an overview is provided of the challenges for healthy aging resulting from these age-related steroid alterations. While clinical practice guidelines recommend hormonal treatment only in the case of consistently low hormone levels and symptoms of hormone deficiency, physical exercise and a healthy lifestyle emerge as preventive strategies which can counter age-related hormonal changes and at best prevent chronic conditions.
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Affiliation(s)
- Serena Fiacco
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Andreas Walther
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; Biopsychology, TU Dresden, Dresden, Germany
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland.
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24
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Brzozowska MM, Kepreotis S, Tsang F, Fuentes- Patarroyo SX. Improvement in cognitive impairment following the successful treatment of endogenous Cushing's syndrome-a case report and literature review. BMC Endocr Disord 2019; 19:68. [PMID: 31253144 PMCID: PMC6599300 DOI: 10.1186/s12902-019-0401-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 06/23/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Endogenous Cushing's syndrome, a rare endocrine disorder, characterised by chronic cortisol hypersecretion, results in neuropsychiatric disturbances and in cognitive deficits, which are only partially reversible after the biochemical remission of the disease. CASE PRESENTATION We report a case of a woman with a profound cognitive deficit and a gradual functional decline caused by Cushing's disease of at least 10 years duration. The neurosurgical resection of her 2 mm adrenocorticotropic hormone (ACTH) secreting pituitary microadenoma resulted in a successful resolution of the patient's hypercortisolism and a significant recovery of her neurocognitive function. The patient's progress was evaluated using serial clinical observations, functional assessments, Mini-Mental Status exams and through the formal neuropsychological report. Furthermore, the patient's recovery of her neurocognitive function was reflected by a sustained improvement in the patient's specific structural brain abnormalities on radiological imaging. CONCLUSIONS This report illustrates the importance of early detection and treatment of Cushing's syndrome in order to prevent neurocognitive impairment and neuropsychiatric disorders which are associated with an endogenous cortisol hypersecretion. The long term adverse effects of severe hypercortisolaemia on brain function and the pathophysiological mechanisms responsible for the structural and functional changes in brain anatomy due to glucocorticoid excess are reviewed.
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Affiliation(s)
- Malgorzata Monika Brzozowska
- Endocrinology Department, Sutherland Hospital, Sydney, NSW Australia
- Faculty of Medicine, University of New South Wales, Kensington, NSW Australia
- Garvan institute of Medical Research, Darlinghurst, NSW Australia
| | - Sacha Kepreotis
- Endocrinology Department, Sutherland Hospital, Sydney, NSW Australia
| | - Fiona Tsang
- Endocrinology Department, Sutherland Hospital, Sydney, NSW Australia
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Asadikaram G, Khaleghi E, Sayadi A, Foulady S, Ghasemi MS, Abolhassani M, Garrusi B, Nematollahi MH. Assessment of hormonal alterations in major depressive disorder: A clinical study. Psych J 2019; 8:423-430. [PMID: 31106520 DOI: 10.1002/pchj.290] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 03/12/2019] [Accepted: 04/04/2019] [Indexed: 11/07/2022]
Abstract
Major depressive disorder (MDD) is a severe mood disorder that may lead to use of drugs, alcohol, and even suicide in acute cases. It has been shown that neurotransmitters and hormones have the same receptors and pathways in the mood area of the brain. Therefore, metabolic and biochemical changes are expected in MDD and, in such diseases, understanding the hormonal alterations would be extremely helpful in the management or treatment with hormone replacement therapy. We evaluated levels of cortisol, adrenocorticotropic hormone (ACTH), testosterone, thyroid-stimulating hormone (TSH), thyroxine (T4), triiodothyronine (T3), free thyroxine index (FT4I), T3 resin uptake (T3RU), and dehydroepiandrosterone sulfate (DHEA-S) in 79 patients suffering from MDD and 71 healthy controls. The existence of MDD was confirmed by a face-to-face structured clinical interview. We started the investigation by taking a blood sample from the study population. Then, hormone levels were measured by enzyme-linked immunosorbent assay. Significant differences were found between TSH, FT4I, DHEA-S, ACTH, testosterone, and cortisol/DHEA-S ratio in MDD patients compared to the healthy controls. We also demonstrated a correlation between MDD recurrence and FT4I index and TSH, respectively. Regarding some hormonal changes in patients with MDD, hormonal shifts should be considered in the treatment or management of MDD patients.
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Affiliation(s)
- Gholamreza Asadikaram
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.,Department of Biochemistry, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Ezetollah Khaleghi
- Department of Psychiatry, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Ahmadreza Sayadi
- Department of Psychiatry, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Shahnaz Foulady
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammadreza Seyed Ghasemi
- Department of Psychiatry, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Moslem Abolhassani
- Department of Biochemistry, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Behshid Garrusi
- Department of Psychiatry, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Hadi Nematollahi
- Department of Biochemistry, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran.,Student research committee, Kerman University of Medical Sciences, Kerman, Iran
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Asselmann E, Kische H, Haring R, Hertel J, Schmidt CO, Nauck M, Beesdo-Baum K, Grabe HJ, Pané-Farré CA. Prospective associations of androgens and sex hormone-binding globulin with 12-month, lifetime and incident anxiety and depressive disorders in men and women from the general population. J Affect Disord 2019; 245:905-911. [PMID: 30699875 DOI: 10.1016/j.jad.2018.11.052] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 10/05/2018] [Accepted: 11/03/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Findings on associations of androgens and sex hormone-binding globulin (SHBG) with anxiety and depressive disorders in the general population remain inconclusive. METHODS We used data of n = 993 men and n = 980 women from the Study of Health in Pomerania (SHIP, a prospective-longitudinal general population study from northeastern Germany). Immunoassay-measured serum concentrations of total testosterone, androstenedione and SHBG were assessed when participants were aged 20-80. 12-month, lifetime and incident DSM-IV anxiety and depressive disorders were assessed with the DIA-X/M-CIDI at 10-year follow-up, when participants were aged 29-89. Logistic regressions were adjusted for age, smoking, alcohol consumption, physical activity, waist circumference, hypertension and oral contraceptive use (women only) at baseline and follow-up interval. RESULTS In men and women, androgens and SHBG were not associated significantly with incident anxiety and depressive disorders. In men, higher total testosterone predicted any 12-month (OR = 1.46) and lifetime (OR = 1.34) anxiety disorder, lifetime social phobia (OR = 2.15), and 12-month (OR = 1.48) and lifetime (OR = 1.39) specific phobia, but neither 12-month nor lifetime depression. Moreover, androstenedione in men interacted with age in predicting lifetime anxiety disorders (OR = 0.98): Higher androstenedione more strongly predicted lifetime anxiety in younger vs. older men. These findings, however, did not survive correction for multiple testing. In women, androgens and SHBG were not associated significantly with 12-month and lifetime anxiety and depressive disorders. LIMITATIONS The follow-up period was relatively long and other factors might have affected the examined associations. CONCLUSIONS Higher serum total testosterone in men and androstenedione in younger men may relate to an increased risk of anxiety disorders.
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Affiliation(s)
- Eva Asselmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany; Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
| | - Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Robin Haring
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Johannes Hertel
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | | | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research, Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Hans-Jörgen Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Christiane A Pané-Farré
- Department of Physiological and Clinical Psychology, University of Greifswald, Greifswald, Germany
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Sher L, Flory J, Bierer L, Makotkine I, Yehuda R. Dehydroepiandrosterone and dehydroepiandrosterone sulfate levels in combat veterans with or without a history of suicide attempt. Acta Psychiatr Scand 2018; 138:55-61. [PMID: 29790155 DOI: 10.1111/acps.12897] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/16/2018] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The goal of this study was to determine whether combat veterans who have made a suicide attempt postdeployment can be distinguished from combat veterans who have never made a suicide attempt based on differences in psychological and biological variables. METHODS Demographic and clinical parameters of suicide attempters and non-attempters were assessed. Blood samples were assayed for dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS). RESULTS Suicide attempters had higher Scale for Suicidal Ideation and Montgomery-Åsberg Depression Rating Scale (MADRS)-suicidal thoughts item scores in comparison with non-attempters. There was a trend toward higher MADRS scores in the suicide attempter group compared with non-attempters. Suicide attempters had significantly lower levels of DHEA and DHEAS compared with non-attempters. Scale for Suicidal Ideation scores in all study participants combined negatively correlate with DHEA and DHEAS levels. DHEAS levels negatively correlate with Scale for Suicidal Ideation scores in suicide non-attempters but not in suicide attempters. DHEA/DHEAS ratios positively correlate with total adolescence aggression scores, total adulthood aggression scores, and total aggression scale scores in suicide attempters but not in suicide non-attempters. CONCLUSION There are psychobiological differences between combat veterans with or without a history of suicidal behaviour.
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Affiliation(s)
- L Sher
- James J. Peters Veterans' Administration Medical Center, Bronx, NY, USA.,Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J Flory
- James J. Peters Veterans' Administration Medical Center, Bronx, NY, USA.,Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - L Bierer
- James J. Peters Veterans' Administration Medical Center, Bronx, NY, USA.,Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - I Makotkine
- James J. Peters Veterans' Administration Medical Center, Bronx, NY, USA.,Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - R Yehuda
- James J. Peters Veterans' Administration Medical Center, Bronx, NY, USA.,Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Savic D, Knezevic G, Matic G, Damjanovic S. PTSD and depressive symptoms are linked to DHEAS via personality. Psychoneuroendocrinology 2018; 92:29-33. [PMID: 29621722 DOI: 10.1016/j.psyneuen.2018.03.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 03/19/2018] [Accepted: 03/25/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Research results on dehydroepiandrosterone sulfate ester (DHEAS) in post-traumatic stress disorder (PTSD) are inconsistent. We hypothesized that personality traits could be the confounders of DHEAS levels and disease symptoms, which could in part explain the discrepancy in findings. METHOD This study was a part of a broader project in which simultaneous psychological and biological investigations were carried out in hospital conditions. 380 male subjects were categorized in four groups: A) current PTSD (n = 132), B) lifetime PTSD (n = 66), C) trauma controls (n = 101), and D) healthy controls (n = 81), matched by age. RESULTS The level of DHEAS is significantly lower in the current PTSD group than in trauma controls. All groups significantly differ in personality traits Disintegration and Neuroticism (current PTSD group having the highest scores). DHEAS is related to both PTSD and depressive symptoms; however, Structural Equation Model (SEM) shows that the relations are indirect, realized via their confounder - personality trait Disintegration. CONCLUSIONS According to our project results, DHEAS is the second putative biomarker for trauma-related disorders that fails to fulfil this expectation. It appears to be more directly related to personality than to the disease symptoms (the first one being basal cortisol). Our data promote personality as a biologically based construct with seemingly important role in understanding the mental health status.
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Affiliation(s)
- Danka Savic
- University of Belgrade, Vinca Institute, Laboratory of Theoretical and Condensed Matter Physics 020/2, Mike Petrovica Alasa 12-14, 11001 Belgrade, Serbia.
| | - Goran Knezevic
- University of Belgrade, School of Psychology, Cika Ljubina 18-20, 11000 Belgrade, Serbia.
| | - Gordana Matic
- University of Belgrade, Institute for Biological Research "Sinisa Stankovic", Bulevar despota Stefana 142, 11060 Belgrade, Serbia
| | - Svetozar Damjanovic
- University of Belgrade, Clinic of Endocrinology, Diabetes and Metabolic Diseases, Doktora Subotica 13, 11000 Belgrade, Serbia.
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Naylor JC, Kilts JD, Strauss JL, Szabo ST, Dunn CE, Wagner HR, Hamer RM, Shampine LJ, Zanga JR, Marx CE. An exploratory pilot investigation of neurosteroids and self-reported pain in female Iraq/Afghanistan-era Veterans. ACTA ACUST UNITED AC 2018; 53:499-510. [PMID: 27533747 DOI: 10.1682/jrrd.2014.11.0294] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 10/21/2015] [Indexed: 11/05/2022]
Abstract
Female Veterans are the most rapidly growing segment of new users of the Veterans Health Administration (VHA), and a significant proportion of female Veterans receiving treatment from VHA primary care providers report persistent pain symptoms. Currently, available data characterizing the neurobiological underpinnings of pain disorders are limited. Preclinical data suggest that neurosteroids may be involved in the modulation of pain symptoms, potentially via actions at gamma-aminobutyric acid (GABA) and N-methyl-D-aspartate (NMDA) receptors. Dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) are neurosteroids that modulate inhibitory GABA receptors and excitatory NMDA receptors, producing complex neuronal effects. Emerging evidence from male Iraq/Afghanistan-era Veterans suggests that reductions in neurosteroid levels are associated with increased pain symptoms and that neurosteroids may be promising biomarker candidates. The current exploratory study thus examined associations between self-reported pain symptoms in 403 female Iraq/Afghanistan-era Veterans and serum DHEAS and DHEA levels. Serum DHEAS levels were inversely correlated with low back pain in female Veterans (Spearman r = -0.103; p = 0.04). Nonparametric analyses indicate that female Veterans reporting moderate/extreme low back pain demonstrated significantly lower DHEAS levels than those reporting no/little low back pain (|Z| = 2.60; p = 0.009). These preliminary findings support a role for DHEAS in pain physiology of low back pain and the rationale for neurosteroid therapeutics in pain analgesia.
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Kische H, Pieper L, Venz J, Klotsche J, März W, Koch-Gromus U, Pittrow D, Lehnert H, Silber S, Stalla GK, Zeiher AM, Wittchen HU, Haring R. Longitudinal change instead of baseline testosterone predicts depressive symptoms. Psychoneuroendocrinology 2018; 89:7-12. [PMID: 29306775 DOI: 10.1016/j.psyneuen.2017.12.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 12/16/2017] [Accepted: 12/20/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND The association between total testosterone (T) and depression mostly relies on single sex hormone assessment and remains inconclusive. Thus, we investigated the comparative predictive performance of baseline T and change in T with development of depressive symptoms and incident depressive episodes. METHODS We used data from 6493 primary care patients (2653 men and 3840 women) of the DETECT study (Diabetes Cardiovascular Risk-Evaluation: Targets and Essential Data for Commitment of Treatment), including four-year follow-up, repeated immunoassay-based measurement of serum T and depressive symptoms assessed by the Depression Screening Questionnaire (DSQ). Cross-sectional and longitudinal associations of baseline T and one-year change in T with prevalent and incident depression were investigated using age- and multivariable-adjusted regression models. RESULTS Baseline T showed no association with prevalent or incident depressive symptoms and episodes in both sexes. In men, a positive change in T (higher T at one-year follow-up compared to baseline) was associated with a lower burden of depressive symptoms (β-coefficient per unit change in T: -0.17; 95% CI: -0.31 to -0.04) and lower risk of incident depressive symptoms (odds ratio per unit change in T: 0.84; 95% CI: 0.72-0.98) at four-year follow-up. In women, the association of T change with incident depressive episodes was rendered non-significant after multivariable adjustment. DISCUSSION The present study observed a sex-specific inverse association of T change, but not baseline T, with increased depressive symptom burden in men. Future studies should assess longitudinal changes in sex hormone status as predictor of adverse health outcomes related to low T.
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Affiliation(s)
- Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Germany.
| | - Lars Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Germany
| | - John Venz
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Germany
| | | | - Winfried März
- Medical Clinic V, Medical Faculty Mannheim of Heidelberg University, Germany
| | - Uwe Koch-Gromus
- Department of Medical Psychology, University Medical Center Eppendorf, Hamburg, Germany
| | - David Pittrow
- Institute of Clinical Pharmacology, Medical Faculty, Technical University Carl Gustav Carus, Dresden, Germany
| | - Hendrik Lehnert
- Department of Medicine I, University of Schleswig-Holstein, Lübeck, Germany
| | | | - G K Stalla
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Andreas M Zeiher
- Department of Medicine III Cardiology, Goethe-University Frankfurt, Germany
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Germany
| | - Robin Haring
- European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Giltay EJ, van der Mast RC, Lauwen E, Heijboer AC, de Waal MWM, Comijs HC. Plasma Testosterone and the Course of Major Depressive Disorder in Older Men and Women. Am J Geriatr Psychiatry 2017; 25:425-437. [PMID: 28132748 DOI: 10.1016/j.jagp.2016.12.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 12/21/2016] [Accepted: 12/21/2016] [Indexed: 12/14/2022]
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). CONCLUSION 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.
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Affiliation(s)
- Erik J Giltay
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.
| | - Roos C van der Mast
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands; Department of Psychiatry, CAPRI-University of Antwerp, Antwerp, Belgium
| | - Esther Lauwen
- Department of Psychiatry, Haga Ziekenhuis, The Hague, The Netherlands
| | - Annemieke C Heijboer
- Department of Clinical Chemistry, Endocrine Laboratory, VU University Medical Center, Amsterdam, The Netherlands
| | - Margot W M de Waal
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Hannie C Comijs
- GGZ InGeest, Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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Neonatal blockade of GABA‐A receptors alters behavioral and physiological phenotypes in adult mice. Int J Dev Neurosci 2017; 57:62-71. [DOI: 10.1016/j.ijdevneu.2017.01.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 12/11/2016] [Accepted: 01/16/2017] [Indexed: 11/21/2022] Open
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Kulej-Lyko K, Majda J, von Haehling S, Doehner W, Lopuszanska M, Szklarska A, Banasiak W, Anker SD, Ponikowski P, Jankowska EA. Could gonadal and adrenal androgen deficiencies contribute to the depressive symptoms in men with systolic heart failure? Aging Male 2016; 19:221-230. [PMID: 27650467 DOI: 10.1080/13685538.2016.1208166] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Testosterone (TT) and dehydroepiandrosterone sulphate (DHEAS) are neurosteroids and their deficiencies constitute the hormone risk factors promoting the development of depression in elderly otherwise healthy men. We investigated the link between hypogonadism and depression in accordance with age and concomitant diseases in men with systolic HF using the novel scale previously dedicated for elderly population. METHODS We analysed the prevalence of depression and severity of depressive symptoms in population of 226 men with systolic HF (40-80 years) compared to 379 healthy peers. The severity of depression was assessed using the Polish long version of Geriatric Depression Scale (GDS). RESULTS In men aged 40-59 years the severity of depressive symptoms was greater in NYHA classes III-IV compared to NYHA classes I-II and reference group. In men aged 60-80 years depressive symptoms were more severe in NYHA class III-IV compared to controls (all p ≤ 0.001). In multivariate logistic regression model in men aged 40-59 years advanced NYHA class was associated with higher prevalence of mild depression (OR = 2.14, 95%CI: 1.07-4.29) and chronic obstructive pulmonary disease (COPD) with higher prevalence of severe depression (OR = 69.1, 95%CI: 2.11-2264.3). In men aged 60-80 years advanced NYHA class and TT deficiency were related to higher prevalence of mild depression (respectively: OR = 2.9, 95%CI: 1.3-6.4; OR = 3.6, 95%CI: 1.2-10.63). CONCLUSION TT deficiency, COPD and advanced NYHA class were associated with higher prevalence of depression in men with systolic HF.
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Affiliation(s)
| | - Jacek Majda
- b Laboratory Department , Military Hospital , Wroclaw , Poland
| | - Stephan von Haehling
- c Applied Cachexia Research, Department of Cardiology, Charité Medical School , Berlin , Germany
| | - Wolfram Doehner
- c Applied Cachexia Research, Department of Cardiology, Charité Medical School , Berlin , Germany
- d Center for Stroke Research Berlin, Charité Medical School , Berlin , Germany
| | - Monika Lopuszanska
- e Polish Academy of Sciences, Institute of Anthropology , Wroclaw , Poland
| | - Alicja Szklarska
- e Polish Academy of Sciences, Institute of Anthropology , Wroclaw , Poland
| | | | - Stefan D Anker
- c Applied Cachexia Research, Department of Cardiology, Charité Medical School , Berlin , Germany
- f Centre for Clinical and Basic Research, IRCCS San Raffaele , Rome , Italy , and
| | - Piotr Ponikowski
- a Centre for Heart Diseases, Military Hospital , Wroclaw , Poland
- g Laboratory for Applied Research on Cardiovascular System , Department of Heart Diseases, Wroclaw Medical University , Wroclaw , Poland
| | - Ewa A Jankowska
- a Centre for Heart Diseases, Military Hospital , Wroclaw , Poland
- e Polish Academy of Sciences, Institute of Anthropology , Wroclaw , Poland
- g Laboratory for Applied Research on Cardiovascular System , Department of Heart Diseases, Wroclaw Medical University , Wroclaw , Poland
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Ge F, Pietromonaco PR, DeBuse CJ, Powers SI, Granger DA. Concurrent and prospective associations between HPA axis activity and depression symptoms in newlywed women. Psychoneuroendocrinology 2016; 73:125-132. [PMID: 27494071 PMCID: PMC5048568 DOI: 10.1016/j.psyneuen.2016.07.217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 07/21/2016] [Accepted: 07/21/2016] [Indexed: 11/17/2022]
Abstract
We investigated the extent to which individual differences in activity of the hypothalamic pituitary adrenal axis (HPA) are associated with depressive symptoms among newlywed couples. Participants were 218 couples (M age 28.4 years; 94% White) who provided 5 saliva samples (later assayed for cortisol and DHEA-S) before and after participation in a discussion of a major area of disagreement in their relationship. Depressive symptoms were assessed initially, and approximately 19- and 37-months later. Results revealed an interactive effect suggesting that concordant levels of cortisol and DHEA-S (either both high or both low) were concurrently and prospectively associated with higher depression scores. Interestingly, this interactive effect was observed for wives only - not for husbands. These observations underscore contemporary theoretical assumptions that the expression of the association between HPA activity and depression is dependent on factors related to the interaction between characteristics of the person and features of the social environment, and moderated by co-occurring variation in endocrine milieu.
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Affiliation(s)
- Fiona Ge
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, 01003, USA
| | - Paula R Pietromonaco
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, 01003, USA.
| | - Casey J DeBuse
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, 01003, USA
| | - Sally I Powers
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, 01003, USA
| | - Douglas A Granger
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, 01003, USA
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Kim C, Barrett-Connor E, Aroda VR, Mather KJ, Christophi CA, Horton ES, Pi-Sunyer X, Bray GA, Labrie F, Golden SH. Testosterone and depressive symptoms among men in the Diabetes Prevention Program. Psychoneuroendocrinology 2016; 72:63-71. [PMID: 27371769 PMCID: PMC5070975 DOI: 10.1016/j.psyneuen.2016.06.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/12/2016] [Accepted: 06/13/2016] [Indexed: 01/09/2023]
Abstract
OBJECTIVE We examined associations between intensive lifestyle intervention (ILS) and changes in testosterone and associations with mood among middle-aged men. DESIGN Secondary analysis of men (n=886) participating in the Diabetes Prevention Program which randomized glucose-intolerant, overweight men to ILS, metformin, or placebo between 1996 and 1999. MAIN OUTCOME MEASURES Changes in testosterone between baseline and 1-year follow-up asnd associations of these changes with mood measures (Beck Depression Inventory [BDI-II], Beck Anxiety Inventory [BAI]). RESULTS Median baseline testosterone was 10.98nmol/l and 44% (n=385) had testosterone<10.41nmol/l or 300ng/dl. Testosterone increases were greater among men randomized to ILS vs. metformin vs. placebo (1.15nmol/l vs. -0.12nmol/l vs. -0.27nmol/l, p<0.001). The association between changes in testosterone and mood differed by study arm (p<0.001 for interaction); there were no significant associations between changes in testosterone and mood changes among men in the ILS or placebo arms. Among men in the metformin arm, increases in testosterone were significantly associated with decreases in BDI-II (improved depressive symptoms) (β-coefficient -0.2336, p=0.0002) indicating a 0.23 decrease in BDI-II for every 1nmol/l increase in testosterone and decreases in BAI (improved anxiety symptoms) (β-coefficient -0.2147, p=0.0014). Similar patterns were observed for bioavailable testosterone. CONCLUSIONS Among overweight middle-aged men with glucose-intolerance, ILS increased endogenous testosterone slightly but without significant improvements in mood. Metformin did not increase testosterone, but among metformin users, testosterone increases were associated with improvements in mood. Thus, interventions that increase endogenous testosterone may not also improve mood.
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Affiliation(s)
- Catherine Kim
- University of Michigan, Ann Arbor, MI, United States.
| | | | - Vanita R Aroda
- MedStar Health Research Institute, Hyattsville, MD, United States
| | | | | | | | | | - George A Bray
- Louisiana State University, Baton Rouge, LA, United States
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Buckwalter JG, Castellani B, McEwen B, Karlamangla AS, Rizzo AA, John B, O'Donnell K, Seeman T. Allostatic Load as a Complex Clinical Construct: A Case-Based Computational Modeling Approach. COMPLEXITY 2016; 21:291-306. [PMID: 28190951 PMCID: PMC5300684 DOI: 10.1002/cplx.21743] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Allostatic load (AL) is a complex clinical construct, providing a unique window into the cumulative impact of stress. However, due to its inherent complexity, AL presents two major measurement challenges to conventional statistical modeling (the field's dominant methodology): it is comprised of a complex causal network of bioallostatic systems, represented by an even larger set of dynamic biomarkers; and, it is situated within a web of antecedent socioecological systems, linking AL to differences in health outcomes and disparities. To address these challenges, we employed case-based computational modeling (CBM), which allowed us to make four advances: (1) we developed a multisystem, 7-factor (20 biomarker) model of AL's network of allostatic systems; (2) used it to create a catalog of nine different clinical AL profiles (causal pathways); (3) linked each clinical profile to a typology of 23 health outcomes; and (4) explored our results (post hoc) as a function of gender, a key socioecological factor. In terms of highlights, (a) the Healthy clinical profile had few health risks; (b) the pro-inflammatory profile linked to high blood pressure and diabetes; (c) Low Stress Hormones linked to heart disease, TIA/Stroke, diabetes, and circulation problems; and (d) high stress hormones linked to heart disease and high blood pressure. Post hoc analyses also found that males were overrepresented on the High Blood Pressure (61.2%), Metabolic Syndrome (63.2%), High Stress Hormones (66.4%), and High Blood Sugar (57.1%); while females were overrepresented on the Healthy (81.9%), Low Stress Hormones (66.3%), and Low Stress Antagonists (stress buffers) (95.4%) profiles.
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Affiliation(s)
- J Galen Buckwalter
- Institute for Creative Technologies, University of Southern California, Los Angeles, California 90094
| | | | - Bruce McEwen
- Laboratory of Neuroendocrinology, Rockefeller University, New York, New York 10065
| | - Arun S Karlamangla
- Division of Geriatrics, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
| | - Albert A Rizzo
- Institute for Creative Technologies, University of Southern California, Los Angeles, California 90094
| | - Bruce John
- Institute for Creative Technologies, University of Southern California, Los Angeles, California 90094
| | - Kyle O'Donnell
- Institute for Creative Technologies, University of Southern California, Los Angeles, California 90094
| | - Teresa Seeman
- Division of Geriatrics, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
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Souza-Teodoro LH, de Oliveira C, Walters K, Carvalho LA. Higher serum dehydroepiandrosterone sulfate protects against the onset of depression in the elderly: Findings from the English Longitudinal Study of Aging (ELSA). Psychoneuroendocrinology 2016; 64:40-6. [PMID: 26600009 PMCID: PMC4712651 DOI: 10.1016/j.psyneuen.2015.11.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 11/05/2015] [Accepted: 11/07/2015] [Indexed: 01/23/2023]
Abstract
Depression is one of the major causes of disability worldwide, but the complete etiology of depression is not fully understood. Dehydroepiandrosterone (DHEA) and its sulphated form DHEA(S) have been associated with mood and healthy aging. Associations with mental illness over the middle to late years of life have not yet been extensively investigated in large, western community-dwelling samples. The aim of this study was to investigate whether low DHEA(S) levels are associated with the development of depressive symptoms in a large longitudinal cohort study of older men and women. We assessed data from English Longitudinal Study of Aging (ELSA) to evaluate the association of DHEA(S) levels and depressive symptoms measured by Center for Epidemiologic Studies Scale (CES-D) at baseline (n=3083) and at 4-year follow-up (n=3009). At baseline, there was an inverse association between DHEA(S) and depressive symptoms (B=-0.252, p=0.014). Adjustments for physical illnesses, impairments in cognitive function and health behaviors abolished this association (p=0.109) at baseline. Decreased DHEA(S) levels at baseline also predicted incident depression at 4-year follow-up (B=-0.332, p<0.001). In conclusion, higher DHEA(S) levels were associated with reduced risk of developing depressive symptoms in both men and women.
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Affiliation(s)
- Luis H Souza-Teodoro
- Department of Epidemiology and Public Health, University College London, London, UK,Chronopharmacology Laboratory, Institute of Biosciences, University of São Paulo, São Paulo, Brazil
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Kate Walters
- Research Department of Primary Care and Population Health, UCL and Medical Research Council General Practice Research Framework, London, UK
| | - Livia A Carvalho
- Department of Epidemiology and Public Health, University College London, London, UK.
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Ciocca G, Limoncin E, Carosa E, Di Sante S, Gravina GL, Mollaioli D, Gianfrilli D, Lenzi A, Jannini EA. Is Testosterone a Food for the Brain? Sex Med Rev 2016; 4:15-25. [PMID: 27872000 DOI: 10.1016/j.sxmr.2015.10.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 09/02/2015] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Testosterone is fundamental for psychological, sexological, cognitive, and reproductive aspects, and its lack or reduction largely impacts the quality of life in males and females. AIM Therefore, the aim of this review is to describe the role of testosterone in the neurophysiology of the brain and related aspects regarding the quality of general and sexual life. METHODS We listed and discussed the principal studies on the role of testosterone in the brain regarding sexual health, psychopathological conditions, and the elderly. The search strategies were composed by the insertion of specific terms in PubMed regarding the main studies from January 2000 to June 2015. MAIN OUTCOME MEASURES Using a psychoneuroendocrinologic perspective, we considered 4 main sections: brain and testosterone, sexuality and testosterone, psychopathology and testosterone, and cognitive impairment and testosterone. RESULTS Much evidence on the neuroendocrinology of testosterone regarding brain activity, sexual function, psychological health, and senescence was found. In any case, it is known that testosterone deficiency negatively impacts quality of life, first, but not exclusively, through a central effect. Moreover, testosterone and androgen receptors are differently expressed according to age and gender. This aspect contributes to gender differences and to the dimorphic physiological role of this hormone. CONCLUSION A universal role for testosterone can be recognized: low levels of testosterone are associated with mental disorders, sexual dysfunction, and cognitive impairment in both sexes. Hence, physicians should carefully assess testosterone levels, not only in the management of sexual dysfunctions but also when seeking to help patients with severe mental or organic diseases.
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Affiliation(s)
- Giacomo Ciocca
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Erika Limoncin
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Eleonora Carosa
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Stefania Di Sante
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Giovanni L Gravina
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Daniele Mollaioli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Daniele Gianfrilli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Emmanuele A Jannini
- Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy.
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Milman LW, Sammel MD, Barnhart KT, Freeman EW, Dokras A. Higher serum total testosterone levels correlate with increased risk of depressive symptoms in Caucasian women through the entire menopausal transition. Psychoneuroendocrinology 2015; 62:107-13. [PMID: 26280374 DOI: 10.1016/j.psyneuen.2015.07.612] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 07/10/2015] [Accepted: 07/28/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND Despite the high prevalence of depressive symptoms in women, the precise role of sex hormones in mood changes during the menopausal transition is unclear. Previous studies have been inconsistent with regard to identifying the association of androgens, namely total testosterone, with depressive symptoms. OBJECTIVE The objectives of this study were to evaluate changes in serum total testosterone levels and depressive symptoms during the entire menopausal transition, and examine the impact of covariates on the association between concurrent serum total testosterone levels and depressive symptoms during this time period. METHODS A longitudinal cohort study (428 women at baseline with 3634 repeated measures) using data from the Penn Ovarian Aging Study, a population-based cohort of late reproductive-aged women, followed through the menopausal transition. Serum hormone parameters and depression scores using the Center for Epidemiological Studies of Depression scale (CES-D) were measured at each annual visit over a 14-year period. General linear (for testosterone) and a generalized negative-binomial model (for depressive symptoms) for repeated measures were used for analysis. RESULTS Serum total testosterone levels increased progressively over the study period and were significantly associated with older age and with current smoking (p<0.001, respectively). In the post menopause total testosterone levels were significantly higher in African Americans compared to Caucasians (p=0.012). The proportion of women with CES-D ≥16 significantly decreased with increasing age and in the post-menopausal period, and were higher in women with a history of depression and hot flashes (p<0.001). The association between concurrent testosterone levels and high depressive symptoms (CES-D ≥16) differed by race (p=0.008). In Caucasians, but not African Americans, higher serum testosterone levels were associated with increased depressive symptoms after controlling for several variables including age, obesity status, hot flashes and menopausal status (RR 1.09, 95% CI 1.00-1.17, p=0.042). CONCLUSION In our cohort, testosterone levels were low but progressively increased from premenopause through post menopause. In addition to age and history of depression, we identified race to have a significant interaction between the association of testosterone levels and depressive symptoms. This study further supports the associations between sex hormones and increased risk of having depressive symptoms, although the precise underlying mechanisms for this association remain unclear.
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Affiliation(s)
- Lauren W Milman
- Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Mary D Sammel
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Kurt T Barnhart
- Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Ellen W Freeman
- Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Anuja Dokras
- Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States.
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The Effects of Gender Differences in Patients with Depression on Their Emotional Working Memory and Emotional Experience. Behav Neurol 2015; 2015:807343. [PMID: 26578820 PMCID: PMC4633552 DOI: 10.1155/2015/807343] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 09/27/2015] [Accepted: 10/04/2015] [Indexed: 11/17/2022] Open
Abstract
A large amount of research has been conducted on the effects of sex hormones on gender differences in patients with depression, yet research on cognitive differences between male and female patients with depression is insufficient. This study uses emotion pictures to investigate the differences of the emotional working memory ability and emotional experience in male and female patients with depression. Despite identifying that the working memory of patients with depression is impaired, our study found no significant gender differences in emotional working memory. Moreover, the research results revealed that memory effects of mood congruence are produced in both men and women, which may explain why the depression state can be maintained. Furthermore, female patients have more emotional experiences than male patients, which is particularly significant in terms of negative emotional experiences. This result provides cognitive evidence to explain why women suffer from longer terms of depression, are more susceptible to relapse, and can more easily suffer from major depressive disorder in the future.
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Donovan KA, Walker LM, Wassersug RJ, Thompson LMA, Robinson JW. Psychological effects of androgen-deprivation therapy on men with prostate cancer and their partners. Cancer 2015; 121:4286-99. [PMID: 26372364 DOI: 10.1002/cncr.29672] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 07/24/2015] [Accepted: 07/29/2015] [Indexed: 01/07/2023]
Abstract
The clinical benefits of androgen-deprivation therapy (ADT) for men with prostate cancer (PC) have been well documented and include living free from the symptoms of metastases for longer periods and improved quality of life. However, ADT comes with a host of its own serious side effects. There is considerable evidence of the adverse cardiovascular, metabolic, and musculoskeletal effects of ADT. Far less has been written about the psychological effects of ADT. This review highlights several adverse psychological effects of ADT. The authors provide evidence for the effect of ADT on men's sexual function, their partner, and their sexual relationship. Evidence of increased emotional lability and depressed mood in men who receive ADT is also presented, and the risk of depression in the patient's partner is discussed. The evidence for adverse cognitive effects with ADT is still emerging but suggests that ADT is associated with impairment in multiple cognitive domains. Finally, the available literature is reviewed on interventions to mitigate the psychological effects of ADT. Across the array of adverse effects, physical exercise appears to have the greatest potential to address the psychological effects of ADT both in men who are receiving ADT and in their partners.
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Affiliation(s)
- Kristine A Donovan
- Supportive Care Medicine Department, Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Lauren M Walker
- Department of Psychosocial Resources and Rehabilitation Oncology, Tom Baker Cancer Center, Calgary, Alberta, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Richard J Wassersug
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada.,Australian Research Center in Sex, Health, and Society, La Trobe University, Melbourne, Victoria, Australia
| | - Lora M A Thompson
- Supportive Care Medicine Department, Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - John W Robinson
- Department of Psychosocial Resources and Rehabilitation Oncology, Tom Baker Cancer Center, Calgary, Alberta, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Psychology, University of Calgary, Calgary, Alberta, Canada
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Freeman EW. Depression in the menopause transition: risks in the changing hormone milieu as observed in the general population. Womens Midlife Health 2015; 1:2. [PMID: 30766689 PMCID: PMC6214217 DOI: 10.1186/s40695-015-0002-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 06/18/2015] [Indexed: 01/05/2023] Open
Abstract
There is accumulating evidence but no definitive answers about the incidence of depressed mood in the menopause transition and its association with the changing hormonal milieu. While a changing hormonal milieu is the natural condition for all women, only a minority of mid-life women experience debilitating depressive symptoms or clinical depression. This review focuses on associations between depressed mood and the menopause transition, primarily as identified in longitudinal, population-based studies in the past decade. Further aims were to present reported associations between depressed mood and reproductive hormones in the menopause transition as evaluated in the general population and associations of depressive symptoms or clinical depression with menopausal hot flashes or poor sleep in perimenopausal women. There is evidence to support the role of the changing endocrine milieu in the development of depressed mood in the menopause transition, but the contribution of hormones as measured is small. Disentangling the numerous factors that are associated with depression in midlife women is a major challenge for research and for clinical care, where treatments are needed to improve the most distressing menopausal symptoms.
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Affiliation(s)
- Ellen W. Freeman
- Department of Obstetrics/Gynecology and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3701 Market Street, Suite 820 (Mudd Suite), Philadelphia, PA 19104 USA
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Serum dehydroepiandrosterone sulfate and incident depression in the elderly: the Pro.V.A. study. Am J Geriatr Psychiatry 2015; 23:863-71. [PMID: 25537161 DOI: 10.1016/j.jagp.2014.10.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 10/14/2014] [Accepted: 10/30/2014] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Dehydroepiandrosterone sulfate (DHEAS) appears to have a protective effect against depression, but contrasting findings are available. Therefore, we investigated whether high serum DHEAS levels were associated with any protective effect on incident depression and incident severe depression in a representative group of elderly men and women. METHODS In a population-based cohort longitudinal study in the general community, 789 older participants without depression and cognitive impairment at the baseline were included, among 3,099 screened subjects. Serum DHEAS levels were determined based on blood samples; incident depression and severe depression were diagnosed by means of the Geriatric Depression Scale (GDS) and confirmed by geriatricians skilled in psychogeriatric medicine. RESULTS No baseline differences were found in GDS across age- and gender-specific tertiles of serum DHEAS. Over 4.4 years of follow-up, 137 new cases of depression were recorded. Of them, 35 among men and 64 in women were cases of incident severe depression. Cox's regression analysis, adjusted for potential confounders, revealed that higher DHEAS levels were associated with reduced risk of incident depression irrespective of gender (HR: 0.30; 95% CI: 0.09-0.96; Wald χ(2) = 4.09; df = 1; p = 0.04; women: HR: 0.31; 95% CI: 0.14-0.69; Wald χ(2) = 8.37; df = 1; p = 0.004) and of severe incident depression only in men (HR: 0.25; 95% CI: 0.06-0.99; Wald χ(2) = 4.05; df = 1; p = 0.04). CONCLUSION Higher serum DHEAS levels were found to be significantly protective for the onset of depression irrespective of gender, whereas only in men was this association found also for incident severe depression.
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Hui LY, Wang YW, Zhou FL, Ma XC, Yan RZ, Zhang L, Wang QL, Yu X. Association Between MKP-1, BDNF, and Gonadal Hormones with Depression on Perimenopausal Women. J Womens Health (Larchmt) 2015; 25:71-7. [PMID: 26176177 PMCID: PMC4741204 DOI: 10.1089/jwh.2015.5214] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Studies suggest that brain-derived neurotrophic factor (BDNF) exerts effects on the neuronal function of hippocampal neurons and increases hippocampal mitogen-activated protein kinase phosphatase-1 (MKP-1) expression, which causes depressive behaviors in rat or mouse. Here we focus on the change of serum MKP-1, BDNF, testosterone (T), and estradiol (E2) levels, in order to test the hypothesis that dysregulation of MKP-1, BDNF, T, and E2 are associated with depression in perimenopausal women. METHODS Women with depression, after meeting criteria in the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, for mental and behaviural disorders and the 17-item Hamilton Depression Rating Scale (HDRS), were included in the study. Psychosocial data and blood samples were obtained from the subjects in the study, including 38 perimenopausal and 32 young women with depression, 26 healthy control perimenopausal women, and 34 young women. RESULTS Serum MKP-1 levels were higher and T was lower in the women with depression compared to controls (p<0.05), and depressed perimenopausal women exhibited the highest serum MKP-1 levels and lowest T levels. Logistic regression analyses showed that MKP-1 levels were positively correlated with HDRS scores in the women, and T levels were inversely correlated with HDRS scores in the perimenopausal women (p<0.05). CONCLUSIONS This study suggests that high serum MKP-1 levels are associated with depression in women, and this association did not appear to be confounded by age. Further, the results provide evidence of association between depressive symptom severity and increasing serum MKP-1 levels in women, and decreasing T levels in perimenopausal women.
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Affiliation(s)
- Ling-yun Hui
- 1 First Affiliated Hospital, Xi'an Jiaotong University , Xi'an, Shaanxi, China
| | - Ya-wen Wang
- 1 First Affiliated Hospital, Xi'an Jiaotong University , Xi'an, Shaanxi, China
| | - Fu-ling Zhou
- 2 Second Affiliated Hospital, Xi'an Jiaotong University , Xi'an, Shaanxi, China
| | - Xian-cang Ma
- 1 First Affiliated Hospital, Xi'an Jiaotong University , Xi'an, Shaanxi, China
| | - Run-zhi Yan
- 1 First Affiliated Hospital, Xi'an Jiaotong University , Xi'an, Shaanxi, China
| | - Lin Zhang
- 1 First Affiliated Hospital, Xi'an Jiaotong University , Xi'an, Shaanxi, China
| | - Quan-li Wang
- 3 Medical College of Xi'an Jiaotong University , Xi'an, Shaanxi, China
| | - Xuewen Yu
- 1 First Affiliated Hospital, Xi'an Jiaotong University , Xi'an, Shaanxi, China
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Rodgers S, grosse Holtforth M, Hengartner MP, Müller M, Aleksandrowicz AA, Rössler W, Ajdacic-Gross V. Serum testosterone levels and symptom-based depression subtypes in men. Front Psychiatry 2015; 6:61. [PMID: 25999864 PMCID: PMC4418274 DOI: 10.3389/fpsyt.2015.00061] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 04/09/2015] [Indexed: 11/18/2022] Open
Abstract
The main objective of this preliminary study was to further clarify the association between testosterone (T) levels and depression by investigating symptom-based depression subtypes in a sample of 64 men. The data were taken from the ZInEP epidemiology survey. Gonadal hormones of a melancholic (n = 25) and an atypical (n = 14) depression subtype, derived from latent class analysis, were compared with those of healthy controls (n = 18). Serum T was assayed using an enzyme-linked immunosorbent assay procedure. Analysis of variance, analysis of covariance, non-parametrical tests, and generalized linear regression models were performed to examine group differences. The atypical depressive subtype showed significantly lower T levels compared with the melancholic depressives. While accumulative evidence indicates that, beyond psychosocial characteristics, the melancholic and atypical depressive subtypes are also distinguishable by biological correlates, the current study expanded this knowledge to include gonadal hormones. Further longitudinal research is warranted to disclose causality by linking the multiple processes in pathogenesis of depression.
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Affiliation(s)
- Stephanie Rodgers
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland
| | - Martin grosse Holtforth
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychology, University of Bern, Bern, Switzerland
| | - Michael P. Hengartner
- Department of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
| | - Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland
| | - Aleksandra A. Aleksandrowicz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland
- Collegium Helveticum, Swiss Federal Institute of Technology, University of Zurich, Zurich, Switzerland
- Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland
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van der Westhuizen D, Solms M. Social dominance and the Affective Neuroscience Personality Scales. Conscious Cogn 2015; 33:90-111. [DOI: 10.1016/j.concog.2014.12.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 11/04/2014] [Accepted: 12/07/2014] [Indexed: 11/17/2022]
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Krzascik P, Zajda ME, Majewska MD. The neurosteroid dehydroepiandrosterone sulfate, but not androsterone, enhances the antidepressant effect of cocaine examined in the forced swim test--Possible role of serotonergic neurotransmission. Horm Behav 2015; 70:64-72. [PMID: 25747464 DOI: 10.1016/j.yhbeh.2014.12.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Revised: 12/19/2014] [Accepted: 12/23/2014] [Indexed: 11/24/2022]
Abstract
One of the mechanisms of cocaine's actions in the central nervous system is its antidepressant action. This effect might be responsible for increased usage of the drug by individuals with mood disorders. Higher endogenous levels of the excitatory neurosteroid dehydroepiandrosterone sulfate (DHEAS) were reported to correlate with successful abstinence from cocaine use in addicts, but a clinical trial showed that supplementation with a high dose of DHEA increased cocaine usage instead. Such ambiguous effects of DHEA(S) could potentially be linked to its influence on the antidepressant effect of cocaine. In this study we tested DHEAS and its metabolite, androsterone, for interactions with cocaine in animal model of depression (forced swim test) and examined the effects of both steroids and cocaine on serotoninergic neurotransmission. All substances were also tested for influence on locomotor activity. A cocaine dose of 5mg/kg, which had no significant effect on locomotor activity, was chosen for the forced swim test. Neither DHEAS nor androsterone showed any antidepressant action in this test, while cocaine manifested a clear antidepressant effect. Androsterone slightly reduced the antidepressant influence of cocaine while DHEAS markedly, dose-dependently enhanced it. Such an effect might be caused by the influence of DHEAS on serotonin neurotransmission, as this steroid decreased serotonin concentration and turnover in the striatum. When DHEAS and cocaine were administered together, the levels of serotonin in the striatum and hippocampus remained unchanged. This phenomenon may explain the additive antidepressant action of DHEAS and cocaine and why co-administration of DHEAS and cocaine increases drug use.
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Affiliation(s)
- Pawel Krzascik
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 1b Banacha Street, 02-097 Warsaw, Poland
| | - Malgorzata Elzbieta Zajda
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 1b Banacha Street, 02-097 Warsaw, Poland; Marie Curie Program (EC), Department of Pharmacology and Physiology of the Nervous System, Institute of Psychiatry and Neurology, Sobieskiego 9, 02-957 Warsaw, Poland.
| | - Maria Dorota Majewska
- Marie Curie Program (EC), Department of Pharmacology and Physiology of the Nervous System, Institute of Psychiatry and Neurology, Sobieskiego 9, 02-957 Warsaw, Poland
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Abstract
Postmenopausal hyperandrogenism is a state of relative or absolute androgen excess originating from either the adrenals and/or the ovaries, clinically manifested as the appearance and/or increase in terminal hair growth or the development of symptoms/signs of virilization. In either settings, physicians need to evaluate such patients and exclude the presence of the relatively rare but potentially life-threatening underlying tumorous causes, particularly adrenal androgen-secreting tumors. It has been suggested that the rapidity of onset along with severity of symptom and the degree of androgen excess followed by relevant imaging studies may suffice to identify the source of excessive androgen secretion. However, up to date, there is no consensus regarding specific clinical and hormonal indices and/or imaging modalities required for diagnostic certainty. This is particularly relevant as the aging population is increasing and more cases of postmenopausal women with clinical/biochemical evidence of hyperandrogenism may become apparent. Furthermore, the long-term sequels of nontumorous hyperandrogenism in postmenopausal women in respect to cardiovascular morbidity and mortality still remain unsettled. This review delineates the etiology and pathophysiology of relative and absolute androgen excess in postmenopausal women. Also, it attempts to unravel distinctive clinical features along with specific hormonal cut-off levels and/or appropriate imaging modalities for the facilitation of the differential diagnosis and the identification of potential long-term sequels.
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Affiliation(s)
- Marios C Markopoulos
- Endocrinology and Metabolism UnitAretaieion University Hospital, Vasilisis Sofias 76, 11528 Athens, GreeceDepartment of BiochemistryDepartment of PathophysiologyLaikon Hospital, National University of Athens, Mikras Asias 75, 11527 Athens, Greece
| | - Evanthia Kassi
- Endocrinology and Metabolism UnitAretaieion University Hospital, Vasilisis Sofias 76, 11528 Athens, GreeceDepartment of BiochemistryDepartment of PathophysiologyLaikon Hospital, National University of Athens, Mikras Asias 75, 11527 Athens, Greece
| | - Krystallenia I Alexandraki
- Endocrinology and Metabolism UnitAretaieion University Hospital, Vasilisis Sofias 76, 11528 Athens, GreeceDepartment of BiochemistryDepartment of PathophysiologyLaikon Hospital, National University of Athens, Mikras Asias 75, 11527 Athens, Greece
| | - George Mastorakos
- Endocrinology and Metabolism UnitAretaieion University Hospital, Vasilisis Sofias 76, 11528 Athens, GreeceDepartment of BiochemistryDepartment of PathophysiologyLaikon Hospital, National University of Athens, Mikras Asias 75, 11527 Athens, Greece
| | - Gregory Kaltsas
- Endocrinology and Metabolism UnitAretaieion University Hospital, Vasilisis Sofias 76, 11528 Athens, GreeceDepartment of BiochemistryDepartment of PathophysiologyLaikon Hospital, National University of Athens, Mikras Asias 75, 11527 Athens, Greece
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Lambrinoudaki I, Bouziou G, Armeni E, Spyropoulou A, Koundi K, Rizos D, Augoulea A, Alexandrou A, Creatsa M, Panoulis C, Dendrinos S, Leonadrou AA, Zervas IM. Circulating androgens are associated with mood disturbances in young postmenopausal women. Climacteric 2015; 18:205-13. [DOI: 10.3109/13697137.2014.984674] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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The role of sex and sex-related hormones in cognition, mood and well-being in older men and women. Biol Psychol 2014; 103:158-66. [DOI: 10.1016/j.biopsycho.2014.08.015] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 08/26/2014] [Accepted: 08/27/2014] [Indexed: 11/24/2022]
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