Dioniz Vysocki1, Lukas Pilipavičius2
1Vilnius University, Faculty of Medicine, Vilnius, Lithuania
2Karoliniškės polyclinic, Vilnius, Lithuania
Abstract
Background. Affective disorders (mood disorders), together with anxiety disorders, are the most common psychiatric disorders in the world, affecting women almost twice as more as men. Testosterone is thought to be a factor in this difference in vulnerability and resilience to stress. Testosterone replacement therapies for depressed or anxious men are gaining popularity with positive results, but deterioration in the rates of affective and anxiety disorders in anabolic steroid users has also been described.
Aim. Conduct a literature review on affective disorders, find and present existing associations with testosterone in male patients.
Methods: A literature review was conducted on the PubMed database, using the keywords: „affective disorders“, „mood disorders“, „anxiety disorders“, „testosterone“, „testosterone replacement therapy“, „anabolic steroids“. Articles published in the last 10 years in English were selected for the analysis.
Results. Serum testosterone levels are found to be reduced in both depressed and bipolar male patients. Anxiety disorders are also more prevalent in hypogonadal patients compared to the healthy male population. Prescribed testosterone replacement therapy has a positive clinical effect in mild to moderate depression and is increasingly prescribed. Synthetic testosterone, used as an anabolic steroid, is associated with a mood destabilising effect, with hypomania and major depression in short and long term use, respectively.
Conclusions. Low serum testosterone levels are associated with affective and anxiety disorders in male patients. Testosterone replacement therapy has a positive effect on mild to moderate disorders, but high doses of synthetic testosterone are associated with mood destabilising effects.
Keywords: affective disorders, anxiety disorders, testosterone, replacement therapy, anabolic steroids.