Depression in men with testosterone deficiency (Preliminary results of the study)

Introduction

Clinical practice in psychiatry is shifting toward personalized approach. In other words, clinicians aim to help patients based on their individual characteristics. It’s known that testosterone play a crucial role in the regulation of the emotions specially in men. The problems of hypogonadism and its possible role as an etiological factor in the development of depression in men are available in detail. But there is no solid date about the features of depression in men with testosteron defficency and theraputic approach including testosterone replacement therapy and antidepressants.

Objectives

Аssessment of efficiency of different pharmacological approaches in the treatment of depression in men with testosterone deficiency

Methods

The main group included 37 men with a depressive episode that arose against the background of a decrease in testosterone levels (≤12.1 nmol / L). A depressive episode was diagnosed based on the ICD-10 criteria for a depressive episode (F32). Patients were randomized into 3 treatment groups, depending on the received treatment: 1) sertraline; 2) testosterone gel; 3) sertraline + testosterone gel. The control group consisted of men (n = 40) aged 18 to 65 years, suffering from depression in accordance with the ICD-10 criteria with normal testosterone levels

Results

An insufficient effectiveness of antidepressant monotherapy in relation to sexual dysfunction was found in main group, while testosterone monotherapy did not give statistically significant improvements in depression indicators.

Conclusions

Combination therapy was most effective for the main symptoms and can be regarded as the most appropriate algorithm for the treatment of depression in men with low testosterone levels

Disclosure

No significant relationships.

Use of the Communication Checklist - Self Report (Cc-Sr) in Schizophrenia: Language Impairments Correlate with Poor Premorbid Social Adjustment

BACKGROUND

The present study reports preliminary results from the multicentre project on the approbation of the Russian language version of the "The Communication Checklist-Self Report" (RL-CC-SR) and its first use in schizophrenia (SZ), aiming to evaluate the contribution of language disturbances in the pathogenesis of this heterogeneous disorder.

SUBJECTS AND METHODS

The study evaluated patients' clinical state with the Diagnostic Interview for Psychoses (DIP), and assessed language and communication disturbances (LCD) with the RL-CC-SR in all participants (213 healthy controls (HC), 83 SZ patients, 31 SZ first-degree relatives). Data from the current sample of SZ (n=50), and HC (n=213) was analysed to calculate the relationships between LCD, social and clinical variables using descriptive statistics methods, T-test and Pearson's correlations (SPSS-26, 2019).

RESULTS

The quotient scores (<6) and raw scores on all three CC-SR subscales demonstrated prominent LCD in SZ: (i) language structure (LS) (SZ:11.92±8.01, HC:7.54±5.91; p<0.001), (ii) pragmatic skills (PS) (SZ:11.30±10.07, HC:8.71±7.39; p=0.040), (iii) social engagement (SE) (SZ:31.94±11.76, HC:19.42±10.35; p<0.001). In SZ, Pearson correlations of LS scores were significant for the DIP-items Odd Speech (p=0.033), and Social Engagement - Blunted Affect (p=0.042). PS was related to early disease onset (p=0.027), poor premorbid work adjustment (p=0.003), along with LS (p=0.005), and was also linked to poor premorbid social adjustment (p=0.005).

CONCLUSIONS

SZ patients are aware of their LCD at all levels of language structure, pragmatics, and nonverbal communication, but are unable to compensate. Disturbances of LS and PS in SZ patients relate to their poor social adjustment and functioning, and may prove to be associated with the primary negative symptoms domain of the disorder and its generally poor outcome.