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Dart DA, Bevan CL, Uysal-Onganer P, Jiang WG. Analysis of androgen receptor expression and activity in the mouse brain. Sci Rep 2024; 14:11115. [PMID: 38750183 PMCID: PMC11096401 DOI: 10.1038/s41598-024-61733-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 05/09/2024] [Indexed: 05/18/2024] Open
Abstract
Androgen deprivation therapy (ADT) is the core treatment for advanced prostate cancer (PCa), with a proven survival benefit. ADT lowers circulating testosterone levels throughout the body, but with it comes a variety of reported side effects including fatigue, muscle wastage, weight gain, hot flushes and importantly cognitive impairment, depression, and mood swings. Testosterone has a key role in brain masculinization, but its direct effects are relatively poorly understood, due both to the brain's extreme complexity and the fact that some of testosterone activities are driven via local conversion to oestrogen, especially during embryonic development. The exact roles, function, and location of the androgen receptor (AR) in the adult male brain are still being discovered, and therefore the cognitive side effects of ADT may be unrecognized or under-reported. The age of onset of several neurological diseases overlap with PCa, therefore, there is a need to separate ADT side effects from such co-morbidities. Here we analysed the activity and expression level of the AR in the adult mouse brain, using an ARE-Luc reporter mouse and immunohistochemical staining for AR in all the key brain regions via coronal slices. We further analysed our data by comparing to the Allen Mouse Brain Atlas. AR-driven luciferase activity and distinct nuclear staining for AR were seen in several key brain areas including the thalamus, hypothalamus, olfactory bulb, cerebral cortex, Purkinje cells of the cerebellum and the hindbrain. We describe and discuss the potential role of AR in these areas, to inform and enable extrapolation to potential side effects of ADT in humans.
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Affiliation(s)
- D Alwyn Dart
- UCL (University College London) Cancer Institute, University College London, Paul O'Gorman Building, 72 Huntley Street, London, WC1E 6DD, UK.
- Department of Surgery and Cancer, Imperial Centre for Translational and Experimental Medicine, Imperial College London, London, W12 0NN, UK.
- Cardiff China Medical Research Collaborative, School of Medicine, Cardiff University, Cardiff, CF14 4YS, UK.
| | - Charlotte L Bevan
- Department of Surgery and Cancer, Imperial Centre for Translational and Experimental Medicine, Imperial College London, London, W12 0NN, UK
| | - Pinar Uysal-Onganer
- Cancer Mechanisms and Biomarkers Research Group, School of Life Sciences, College of Liberal Arts and Sciences, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK
| | - Wen Guo Jiang
- Cardiff China Medical Research Collaborative, School of Medicine, Cardiff University, Cardiff, CF14 4YS, UK
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2
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Dyson T, Thomas SJ, Townsend ML, Finch A, South A, Barkus E, Walter E, Mendonca C, Grenyer BFS, Pickard JA. Salivary testosterone and cortisol levels in borderline personality disorder before and after a 12-week group dialectical behavior therapy intervention. Front Psychol 2023; 14:1195187. [PMID: 37529315 PMCID: PMC10389657 DOI: 10.3389/fpsyg.2023.1195187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/03/2023] [Indexed: 08/03/2023] Open
Abstract
Background Borderline Personality Disorder (BPD) is a chronic, debilitating, and difficult to treat condition. BPD has recently been linked to steroid hormone dysregulation and medical conditions characterized by disturbed androgen metabolism. This study aimed to investigate cortisol and testosterone levels in BPD, and changes in hormones following psychological treatment. Methods Participants with BPD (n = 33) completed a 12-week Dialectical Behavior Therapy group program. Pre and post salivary testosterone and cortisol were analyzed. Baseline hormones in the BPD group were compared to age-and-sex matched controls (n = 33). Non-parametric tests were utilized to investigate group differences, pre-post treatment hormone and symptom changes, and associations between symptoms and hormone levels. Results Participants with BPD had significantly higher testosterone levels than controls. Mean testosterone levels in females with BPD were double that of female controls. Testosterone and cortisol levels were related, and some BPD symptoms were associated with with hormone levels. BPD symptoms reduced significantly with treatment, however pre to post hormone levels did not change. Conclusions This study supports an association between BPD symptoms and neuroendocrine dysfunction at baseline, however we found no reduction in hormone dysfunction post treatment. Further research into relationships between stress signaling and neuroendocrine disturbances in BPD may inform aetiological and treatment models. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12618000477224. Registered on 3 April 2018.
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Affiliation(s)
- Tori Dyson
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Susan J. Thomas
- School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | | | - Adam Finch
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Alexandra South
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Emma Barkus
- Department of Psychology, Northumbria University, Newcastle upon Tyne, North East England, United Kingdom
| | - Emma Walter
- School of Psychology, Western Sydney University, Penrith, NSW, Australia
| | - Carley Mendonca
- School of Psychology, University of Technology Sydney, Sydney, NSW, Australia
| | - Brin F. S. Grenyer
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Judy A. Pickard
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
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3
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Current Trends and Challenges in Point-of-care Urinalysis of Biomarkers in Trace Amounts. Trends Analyt Chem 2022. [DOI: 10.1016/j.trac.2022.116786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Shivarov V, Shivarov H, Yordanov A. Seasonality of Suicides among Cancer Patients. BIOL RHYTHM RES 2022. [DOI: 10.1080/09291016.2022.2054124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Velizar Shivarov
- Department of Experimental Research, Medical University - Pleven, Pleven, Bulgaria
| | - Hristo Shivarov
- Department of Nephrology, Singing River Hospital, Pascagoula, Mississippi, USA
| | - Angel Yordanov
- Department of Experimental Research, Medical University - Pleven, Pleven, Bulgaria
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Esan O, Fela-Thomas A. The significance of sleep quality in euthymic bipolar patients from Nigeria. S Afr J Psychiatr 2022; 28:1739. [PMID: 35281965 PMCID: PMC8905369 DOI: 10.4102/sajpsychiatry.v28i0.1739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 09/15/2021] [Indexed: 11/23/2022] Open
Abstract
Background Bipolar disorder is highly under-researched in Africa. Existing studies show that racial/ethnic disparities exist for sleep quality. Poor sleep quality in bipolar disorder causes significant morbidity and mortality even during periods of euthymia. Aim This study aimed to assess sleep quality and its correlates amongst euthymic patients with bipolar I disorder from Nigeria. Setting The study was carried out in a teaching hospital, and state hospital, in Ibadan, Nigeria. Method This cross-sectional study was conducted amongst 76 euthymic bipolar patients aged between 18 and 60 years, meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic criteria for bipolar disorder. Euthymia was defined as having a score of ≤ 5 on the Young Mania Rating Scale and < 8 on the Hamilton Depression Rating Scale. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). Results A total of 37 (48.7%) participants had poor quality sleep. Sleep quality was associated with marital status (p = 0.013) and suicide plan (p = 0.047). Participants with good sleep quality had higher total sleep duration, lower time to fall asleep (sleep latency), better subjective quality of sleep, were less likely to use sleep medications and had less daytime dysfunction than participants with poor sleep quality. All p-values were < 0.05. Subjective quality of sleep, ongoing use of sleep medication, daytime dysfunction were independently associated with poor sleep quality. Conclusion Poor sleep quality frequently persists during euthymic periods in patients with bipolar disorder. The correlates identified can be targeted for intervention during treatment.
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Affiliation(s)
- Oluyomi Esan
- Department of Psychiatry, Faculty of Clinical Sciences, University of Ibadan, Ibadan, Nigeria
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6
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Ma J, Zhao M, Niu G, Wang Z, Jiang S, Liu Z. Relationship between thyroid hormone and sex hormone levels and non-suicidal self-injury in male adolescents with depression. Front Psychiatry 2022; 13:1071563. [PMID: 36620661 PMCID: PMC9810634 DOI: 10.3389/fpsyt.2022.1071563] [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: 10/16/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Non-suicidal self-injury (NSSI) is the intentional and repeated direct injury to one's bodily tissues or organs without the intent to die, which is not socially sanctioned and does not result in death. This study will be the first to explore the relationship between NSSI behavior and thyroid hormone and sex hormone levels in male adolescents with depression. METHODS Among the inpatients in the children's ward of Shandong Mental Health Center, eighty male patients with first-episode depressive disorder were randomly selected. Forty male adolescent depressed patients with NSSI behaviors were set as the NSSI group, and forty male adolescent depressed patients without NSSI behaviors were set as the No-NSSI group. Their thyroid hormones (free triiodothyronine, free thyroxine, and thyroid stimulating hormone) and sex hormones (estradiol, progesterone, and testosterone) were measured, and the severity of self-injury in the NSSI group was assessed using the Adolescent Self-Injury Questionnaire. The NSSI group was tested again after 6 weeks of sertraline treatment for biological indicators and assessed by the Self-Injury Questionnaire to compare the hormonal differences between the NSSI group and the No-NSSI group and compare the differences of each index before and after treatment in the NSSI group. RESULTS T3/T4 (p = 0.001) and FT3 (p = 0.023), TSH levels (p < 0.001) were lower in the NSSI group than in the No-NSSI group before treatment, and FT4 (p = 0.036) and T (p < 0.001) levels were higher than in the No-NSSI group. T3/T4 levels were higher in the NSSI group after treatment (p < 0.001). FT4 (p < 0.001) and T (p = 0.001) levels and self-injury questionnaire scores (p < 0.001) decreased after treatment in the NSSI group. In the NSSI group at baseline, FT4 levels were negatively correlated with self-injury questionnaire scores (r = -0.459, p = 0.003) and testosterone levels were positively correlated with self-injury questionnaire scores (r = 0.383, p = 0.015), and in the NSSI group after treatment, FT4 difference was negatively correlated with self-injury questionnaire score reduction rate (r = -0.037, p = 0.019), and testosterone difference was positively correlated with self-injury questionnaire score reduction rate (r = 0.424, p = 0.006). Logistic regression analysis showed that low TSH and high testosterone levels were independent risk factors for the development of non-suicidal self-harming behaviors in male adolescent depressed patients. CONCLUSION Changes in thyroid hormone and sex hormone levels may be associated with non-suicidal self-injurious behavior in male adolescent depressed patients.
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Affiliation(s)
- Jiahui Ma
- Department of Psychiatry, Jining Medical University, Jining, China
| | - Mingming Zhao
- Department of Psychiatry, Jining Medical University, Jining, China
| | - Gengyun Niu
- Department of Psychiatry, Shandong Mental Health Center, Jinan, China
| | - Zhifei Wang
- Department of Psychiatry, Jining Medical University, Jining, China
| | - Shan Jiang
- Department of Psychiatry, Jining Medical University, Jining, China
| | - Zengxun Liu
- Department of Psychiatry, Shandong Mental Health Center, Jinan, China
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Charkhgard N, Razaghi E. Opiates Possibly Boosted Human Civilization. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2021; 15. [DOI: 10.5812/ijpbs.114491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 07/24/2021] [Accepted: 08/17/2021] [Indexed: 09/01/2023]
Abstract
: Testosterone is a fundamental biological drive for human survival. Evidence documents an association between the evolutionary suppression of testosterone and the civilization processes, especially their socialization and family colonization abilities, among early humans. Interestingly, opiates suppress testosterone as a side effect. However, in clinical practice, clients undergoing opioid substitution therapy have subnormal, normal, or even above-normal testosterone. This paper discusses a possibility indicating that opiates promoted civilization processes among early humans. We further suggest that modern humans might have inherited the positive impact of opiates on early humans as a biological propensity for using opioids. Some users may use opioids for self-medication to decrease their extraordinarily high testosterone levels.
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Delgado PF, Maya-Rosero E, Franco M, Montoya-Oviedo N, Guatibonza R, Mockus I. Testosterona y homicidio: aspectos neuroendocrinos de la agresión. REVISTA DE LA FACULTAD DE MEDICINA 2020. [DOI: 10.15446/revfacmed.v68n2.73237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. Las tasas de homicidio, suicidio y agresión son mayores en el sexo masculino; la testosterona podría desempeñar un papel importante en el desarrollo de estos comportamientos. Objetivo. Realizar una revisión de los aspectos endocrinos y neurobiológicos de la testosterona y su relación con comportamientos agresivos, homicidas y suicidas.Materiales y métodos. Se realizó una revisión narrativa con diferentes estrategias de búsqueda en PubMed, SpringerLink, ScienceDirect y SciELO. Se incluyeron artículos de investigación, revisiones y reportes de caso publicados en español y en inglés entre 2002 y 2018.Resultados. De los 66 estudios incluidos en la revisión, más del 50% asociaron el comportamiento agresivo u homicida con niveles elevados de testosterona, hormona que podría modular la actividad de las vías cerebrales serotoninérgicas y dopaminérgicas involucradas en el comportamiento agresivo por medio de receptores androgénicos y estrogénicos. Se encontraron relaciones entre uso de esteroides anabólicos y homicidio, y entre testosterona circulante en mujeres y rasgos de personalidad antisocial. Asimismo, se observaron cambios de concentraciones séricas de testosterona en sujetos con tendencias suicidas.
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Zinchuk MS, Avedisova AS, Zhabin MO, Guekht AB. [Suicidality in the elderly: socio-cultural and clinical risk factors]. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:104-111. [PMID: 30132468 DOI: 10.17116/jnevro201811871104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Advanced age is a significant risk factor for a completed suicide. The review considers the patterns of suicidal behavior of older adults in the context of their gender, ethnicity as well as social and cultural factors. In terms of pro- and antisuicidal variables, special emphasis is made on the role of somatic and psychic disorders. The article looks at the features of committing a suicide peculiar to the older people and debates some specific issues of self-inflicted death by elderly people. The obtained data indicate the involvement of multilevel factors (biological, clinical, cultural, micro- and microsocial) in suicidal behavior in later life.
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Affiliation(s)
- M S Zinchuk
- Solov'ev Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | - A S Avedisova
- Serbsky Federal Medical Research Center of Psychiatry and Narcology, Moscow, Russia
| | - M O Zhabin
- Solov'ev Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | - A B Guekht
- Solov'ev Research and Clinical Center for Neuropsychiatry, Moscow, Russia
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10
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Lenz B, Röther M, Bouna-Pyrrou P, Mühle C, Tektas OY, Kornhuber J. The androgen model of suicide completion. Prog Neurobiol 2018; 172:84-103. [PMID: 29886148 DOI: 10.1016/j.pneurobio.2018.06.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 09/02/2017] [Accepted: 06/05/2018] [Indexed: 10/14/2022]
Abstract
Suicide is a devastating public health issue that imposes severe psychological, social, and economic burdens not only for the individuals but also for their relatives, friends, clinicians, and the general public. Among the different suicidal behaviors, suicide completion is the worst and the most relevant outcome. The knowledge of biological etiopathological mechanisms involved in suicide completion is limited. Hitherto, no objective markers, either alone or in combination, can reliably predict who will complete a suicide. However, such parameters are strongly needed to establish and optimize prediction and prevention. We introduce here a novel ideation-to-completion framework in suicide research and discuss the problems of studies aiming at identifying and validating clinically useful markers. The male gender is a specific risk factor for suicide, which suggests that androgen effects are implicated in the transition from suicidal ideation to suicide completion. We present multiple lines of direct and indirect evidence showing that both an increased prenatal androgen load (with subsequent permanent neuroadaptations) and increased adult androgen activity are involved in suicide completion. We also review data arguing that modifiable maternal behavioral traits during pregnancy contribute to the offspring's prenatal androgen load and increase the risk for suicide completion later in life. We conclude that in utero androgen exposure and adult androgen levels facilitate suicide completion in an synergistic manner. The androgen model of suicide completion provides the basis for the development of novel predictive and preventive strategies in the future.
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Affiliation(s)
- Bernd Lenz
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany.
| | - Mareike Röther
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Polyxeni Bouna-Pyrrou
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Christiane Mühle
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Ozan Y Tektas
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
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11
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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
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12
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Walther A, Penz M, Ijacic D, Rice TR. Bipolar Spectrum Disorders in Male Youth: The Interplay between Symptom Severity, Inflammation, Steroid Secretion, and Body Composition. Front Psychiatry 2017; 8:207. [PMID: 29093685 PMCID: PMC5651281 DOI: 10.3389/fpsyt.2017.00207] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 10/03/2017] [Indexed: 12/27/2022] Open
Abstract
The morbidity and societal burden of youth bipolar spectrum disorders (BSD) are high. These disorders are multisystemic in that adult populations there are clear interactions with inflammatory processes and steroidal physiological systems. There are much less data concerning these areas of study in youth populations with BSD. This is surprising given the association of youth-onset BSD with puberty and its associated physiological changes. In this mini-review, we overview the theoretical role of inflammatory processes and steroidal physiological systems in youth BSD, describe the greater literature in adult populations, detail the literature in youth populations when available, and overview current proposed molecular mechanistic pathways and interaction effects based on the available data. We also attend to the interplay of this complex system with body composition and weight gain, an especially important consideration in relation to the role of second generation antipsychotics as the first line treatment for youth with BSD in major clinical guidelines. A developmental model of early onset BSD for boys is hypothesized with pubertal hormonal changes increasing risk for first (hypo-)manic/depressive episode. The dramatic androgen rise during puberty might be relevant for first onset of BSD in boys. A shift from general hypercortisolism driven by glucocorticoid resistance to hypocortisolism with further disease progression is assumed, while increased levels of inflammation are functionally associated with endocrine dysregulation. The interacting role of overweight body habitus and obesity in youth with BSD further indicates leptin resistance to be a central moderator of the dynamic neurobiology of BSD in youth. The intent of this mini-review is to advance our knowledge of youth BSD as multisystemic disorders with important contributions from endocrinology and immunology based on a developmental perspective. This knowledge can influence current clinical care and more importantly inform future research.
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Affiliation(s)
- Andreas Walther
- Department of Biological Psychology, Technische Universität Dresden, Dresden, Germany.,Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Marlene Penz
- Department of Biological Psychology, Technische Universität Dresden, Dresden, Germany
| | - Daniela Ijacic
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich, Zurich, Switzerland
| | - Timothy R Rice
- Department of Psychiatry - Child and Adolescent Inpatient Service, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Ringqvist T, Ambrus L, Träskman-Bendz L, Giwercman A, Giwercman YL, Westrin Å. Mendelian randomization in relation to androgens and suicidal behavior in males. Psychiatry Res 2016; 245:414-415. [PMID: 27611071 DOI: 10.1016/j.psychres.2016.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 06/08/2016] [Accepted: 06/19/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Torsten Ringqvist
- Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Psychiatry, Sweden
| | - Livia Ambrus
- Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Psychiatry, Sweden; Psychiatric Clinic, Lund, Division of Psychiatry, Region Skane, Sweden
| | - Lil Träskman-Bendz
- Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Psychiatry, Sweden
| | - Aleksander Giwercman
- Skåne University Hospital, Reproductive Medicine Center, Malmö, Sweden; Lund University, Department of Translational Medicine, Malmö, Sweden
| | | | - Åsa Westrin
- Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Psychiatry, Sweden; Psychiatric Clinic, Lund, Division of Psychiatry, Region Skane, Sweden.
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Sher L. Both high and low testosterone levels may play a role in suicidal behavior in adolescent, young, middle-age, and older men: a hypothesis. Int J Adolesc Med Health 2016; 30:/j/ijamh.ahead-of-print/ijamh-2016-0032/ijamh-2016-0032.xml. [PMID: 27269890 DOI: 10.1515/ijamh-2016-0032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 04/30/2016] [Indexed: 06/06/2023]
Abstract
Many studies suggest that testosterone plays a role in the regulation of mood and behavior. Most but not all investigations of the relationship between testosterone and suicidality found relations between testosterone and suicidal behavior. The balance of evidence is in favor of the view that testosterone is involved in the pathophysiology of suicidality. The author has previously proposed that suicidal behavior in adolescents and young adults is associated with high testosterone levels, whereas suicidality in older men is associated with decreased testosterone levels. However, both high and low testosterone levels can be observed in adolescent, young, middle-aged and older men. In this article, the author proposes that both high and low testosterone levels may play a role in suicidal behavior in men of any age.
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Affiliation(s)
- Leo Sher
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
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15
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Walther A, Rice T, Kufert Y, Ehlert U. Neuroendocrinology of a Male-Specific Pattern for Depression Linked to Alcohol Use Disorder and Suicidal Behavior. Front Psychiatry 2016; 7:206. [PMID: 28096796 PMCID: PMC5206577 DOI: 10.3389/fpsyt.2016.00206] [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: 10/12/2016] [Accepted: 12/15/2016] [Indexed: 12/30/2022] Open
Abstract
Epidemiological studies show low rates of diagnosed depression in men compared to women. At the same time, high rates of alcohol use disorders (AUDs) and completed suicide are found among men. These data suggest that a male-specific pattern for depression may exist that is linked to AUDs and suicidal behavior. To date, no underlying neuroendocrine model for this specific pattern of male depression has been suggested. In this paper, we integrate findings related to this specific pattern of depression with underlying steroid secretion patterns, polymorphisms, and methylation profiles of key genes in order to detail an original neuroendocrine model of male-specific depression. Low circulating levels of sex steroids seem to increase the vulnerability for male depression, while concomitant high levels of glucocorticoids further intensify this vulnerability. Interactions of hypothalamus-pituitary-gonadal (HPG) and hypothalamus-pituitary-adrenocortical (HPA) axis-related hormones seem to be highly relevant for a male-specific pattern of depression linked to AUDs and suicidal behavior. Moreover, genetic variants and the epigenetic profiles of the androgen receptor gene, well-known depression related genes, and HPA axis-related genes were shown to further interact with men's steroid secretion and thus may further contribute to the proposed male-specific pattern for depression. This mini-review points out the multilevel interactions between the HPG and HPA axis for a male-specific pattern of depression linked to AUDs and suicidal behavior. An integration of multilevel interactions within the three-hit concept of vulnerability and resilience concludes the review.
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Affiliation(s)
- Andreas Walther
- Clinical Psychology and Psychotherapy, University of Zurich , Zurich , Switzerland
| | - Timothy Rice
- Department of Psychiatry - Child and Adolescent Inpatient Service, Icahn School of Medicine at Mount Sinai , New York, NY , USA
| | - Yael Kufert
- Department of Psychiatry - Child and Adolescent Inpatient Service, Icahn School of Medicine at Mount Sinai , New York, NY , USA
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich , Zurich , Switzerland
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Abstract
OBJECTIVES Homicide is overwhelmingly committed by men compared to women. Conservative estimates suggest that more than a third of these individuals have a treatable psychiatric disorder. These data present an opportunity to mental health clinicians to assist in the prevention of homicide by improving men's mental health. METHODS We review the current literature on men's mental health with a focus on assessing and reducing homicide risk in men with psychiatric conditions. RESULTS Bipolar disorder and schizophrenia appear to share a neural endophenotype that is a risk factor for homicide. Dual disorders, or the presence of a substance use disorder with other major mental illness, are a major risk factor for homicide in males. Dual diagnosis disorders, personality disorders and pathological traits and male depression share emotion dysregulation, irritability, and reactive aggression. Promoting physician education, addressing firearm safety, reducing the reluctance of men relative to women to engage in help-seeking behaviour, and using targeted risk interviews which integrate these data are all currently recommended. CONCLUSIONS The main focus in prevention of homicidal behaviour in males with psychiatric disorders should be to identify high risk groups, to provide adequate treatment, and to facilitate compliance with long-term treatment while considering male specific problems and needs.
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Affiliation(s)
- Leo Sher
- Icahn School of Medicine at Mount Sinai , New York , USA
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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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Sher L. Alcohol, testosterone and suicide. Aust N Z J Psychiatry 2014; 48:688-9. [PMID: 24567539 DOI: 10.1177/0004867414525845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Leo Sher
- Icahn School of Medicine at Mount Sinai and James J Peters Veterans' Administration Medical Center, New York, USA
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