Saliva testosterone and cortisol in male depressive syndrome, a community study. The Sudurnesjamenn Study
Sammanfattning
Introduction: The association between testosterone levels and depression is unclear. The
relationship has been described as complex, i.e. more U (J)-shaped than linear in some previous
studies. Aim: The primary aim of this study was to examine the relationship between saliva
testosterone level variations and different levels of male depressive symptoms in a community
sample. The secondary aim was to investigate whether simultaneous testing of evening cortisol
and testosterone improved the detection of depression. Methods: In a community study, 534
males were screened, using the Beck Depression Inventory (BDI), the Gotland Male Depression
Scale (GMDS) and the Montgomery - Åsberg Depression Rating Scale (MADRS). Those with
signs of depression ( n 65) and randomly selected controls ( n 69) had psychiatric evaluation
for depressive disorder. In a sub-sample ( n 51) saliva testosterone was measured twice on a
single day. Results: Testosterone morning values were signifi cantly higher than evening values
(236 vs. 145 pg/ml, P 0.009). Evening testosterone was signifi cantly higher in depressive
males, according to both MADRS ( P 0.028) and BDI ( P 0.036). Having depression
increased the likelihood of being in the highest third of testosterone levels (BDI P 0.021;
MADRS P 0.018). Positive correlation was between total BDI score and elevated evening
testosterone with and without psychotropics ( P 0.017; P 0.002). Correlation was between
elevated evening cortisol and evening testosterone levels ( P 0.021) though simultaneous
testing did not increase specifi city of detecting depression. Conclusion: Evening saliva
testosterone measurements seem the most informative, as they correlate with male depressive
syndrome. Simultaneous testing for evening cortisol and evening testosterone levels did not
increase specifi city for clinical diagnosis of depressive disorder.