Saliva testosterone and cortisol in male depressive syndrome, a community study. The Sudurnesjamenn Study

Abstract

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 significantly higher than evening values (236 vs. 145 pg/ml, P = 0.009). Evening testosterone was significantly 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 specificity 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 specificity for clinical diagnosis of depressive disorder.

• Community
• Cortisol
• Depression
• Males
• Testosterone

Acknowledgments

We thank the laboratory staff of the Department of Pharmacology and Toxicology, University of Iceland, and our research assistant Kristin Jonsdottir, as well as Sigurlaug Sigurdardottir, secretary, for their contribution in the study. We also thank Jan Walinder for advice and encouragement. This study was funded by the Landakot Medical Foundation, the Research Fund of the Icelandic College of Family Physicians and the Memorial Foundation of Helga Jonsdottir and Sigurlidi Kristjansson (Medical Division). The funding sources had no involvement in the study.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.