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“Andropausal” Depression – biological fact or psychosocial possibility?

INTRODUCTION: In contrast to women, men do no experience a sudden cessation of gonadal function comparable to menopause. However, there is a progressive decline in hypothalamic-pituitary-gonadal function in aging men: testosterone level decline, and there is a loss of circadian rhythm of testosteron...

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Autores principales: Alexopoulos, C. G., Jovanovic Mirkovic, J. M., Jurinjak, Z. Z., Golubovic, G. Z.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10479326/
http://dx.doi.org/10.1192/j.eurpsy.2023.1753
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author Alexopoulos, C. G.
Jovanovic Mirkovic, J. M.
Jurinjak, Z. Z.
Golubovic, G. Z.
author_facet Alexopoulos, C. G.
Jovanovic Mirkovic, J. M.
Jurinjak, Z. Z.
Golubovic, G. Z.
author_sort Alexopoulos, C. G.
collection PubMed
description INTRODUCTION: In contrast to women, men do no experience a sudden cessation of gonadal function comparable to menopause. However, there is a progressive decline in hypothalamic-pituitary-gonadal function in aging men: testosterone level decline, and there is a loss of circadian rhythm of testosterone secretion. By age 75 years, mean plasma testosterone levels have decreased 35% compared with young adults, and more than 25% of men of this age are clinically hypogonadal. Age related hypogonadism, which has been termed»andropause«, is thought to be responsible for variety of symptoms experienced by elderly men, including reduced muscle and bone mass, sexual dysfunction, depression, fatigue and irritability. OBJECTIVES: However, it has been difficult to establish correlations between these symptoms and plasma testosterone levels. Clinical trials of testosterone replacement have documented some symptoms relief (improved muscle strength and bone mineral density), yet studies to date on the specific relation between depression and testosterone level have been methodologically flawed. METHODS: 1. population-based assessments of the relation between testosterone level, genetic factors and depression in elderly men, 2. placebo-controlled clinical trials of testosterone replacement in men with major depressive disorder. RESULTS: Results suggest that age-related hypothalamo-pituitary-gonadal hypofunction may have particular etiologic importance in late-onset male dysthimia. CONCLUSIONS: However, there is still the dilemma whether late-onset depression in older men is predominantly biological (in which testosterone decline certainly plays an important role), psychosocial, or stress-diathesis origin. DISCLOSURE OF INTEREST: None Declared
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spelling pubmed-104793262023-09-06 “Andropausal” Depression – biological fact or psychosocial possibility? Alexopoulos, C. G. Jovanovic Mirkovic, J. M. Jurinjak, Z. Z. Golubovic, G. Z. Eur Psychiatry Abstract INTRODUCTION: In contrast to women, men do no experience a sudden cessation of gonadal function comparable to menopause. However, there is a progressive decline in hypothalamic-pituitary-gonadal function in aging men: testosterone level decline, and there is a loss of circadian rhythm of testosterone secretion. By age 75 years, mean plasma testosterone levels have decreased 35% compared with young adults, and more than 25% of men of this age are clinically hypogonadal. Age related hypogonadism, which has been termed»andropause«, is thought to be responsible for variety of symptoms experienced by elderly men, including reduced muscle and bone mass, sexual dysfunction, depression, fatigue and irritability. OBJECTIVES: However, it has been difficult to establish correlations between these symptoms and plasma testosterone levels. Clinical trials of testosterone replacement have documented some symptoms relief (improved muscle strength and bone mineral density), yet studies to date on the specific relation between depression and testosterone level have been methodologically flawed. METHODS: 1. population-based assessments of the relation between testosterone level, genetic factors and depression in elderly men, 2. placebo-controlled clinical trials of testosterone replacement in men with major depressive disorder. RESULTS: Results suggest that age-related hypothalamo-pituitary-gonadal hypofunction may have particular etiologic importance in late-onset male dysthimia. CONCLUSIONS: However, there is still the dilemma whether late-onset depression in older men is predominantly biological (in which testosterone decline certainly plays an important role), psychosocial, or stress-diathesis origin. DISCLOSURE OF INTEREST: None Declared Cambridge University Press 2023-07-19 /pmc/articles/PMC10479326/ http://dx.doi.org/10.1192/j.eurpsy.2023.1753 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstract
Alexopoulos, C. G.
Jovanovic Mirkovic, J. M.
Jurinjak, Z. Z.
Golubovic, G. Z.
“Andropausal” Depression – biological fact or psychosocial possibility?
title “Andropausal” Depression – biological fact or psychosocial possibility?
title_full “Andropausal” Depression – biological fact or psychosocial possibility?
title_fullStr “Andropausal” Depression – biological fact or psychosocial possibility?
title_full_unstemmed “Andropausal” Depression – biological fact or psychosocial possibility?
title_short “Andropausal” Depression – biological fact or psychosocial possibility?
title_sort “andropausal” depression – biological fact or psychosocial possibility?
topic Abstract
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10479326/
http://dx.doi.org/10.1192/j.eurpsy.2023.1753
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