Amore Mario, Scarlatti Fabiano, Quarta Antonio Lucio, Tagariello Pietro
Institute of Psychiatry, Department of Neurosciences, University of Parma, 43100 Parma, Italy.
Aging Clin Exp Res. 2009 Feb;21(1):1-8. doi: 10.1007/BF03324891.
This study provides a critical review of the literature on depressive symptoms of partial androgen deficiency (PADAM) and their treatment with Testosterone (T). PADAM in aging males is responsible for a variety of behavioral symptoms, such as weakness, decreased libido and erectile dysfunction, lower psychological vitality, depressive mood, anxiety, insomnia, difficulty in concentrating, and memory impairment. The psychological and behavioural aspects of PADAM may overlap with signs and symptoms of major depression. Evidence of the relationship between androgen deficiency and male depression comes from studies that have assessed depression in hypogonadal subjects, the association between low T level and male depressive illness, and the antidepressant action of androgen replacement. The etiology of depressive symptoms of PADAM is multifactorial, and results from the interaction of the biological and psychosocial changes that take place during the mid-life transition. Although data derived from androgen treatment trials and androgen replacement do not support T treatment or replacement as more efficacious than placebo for major depressive disorder (MDD), the clinical impression is that, in some sub-threshold depressive syndromes, T may lead to antidepressant benefits.
本研究对有关部分雄激素缺乏（PADAM）的抑郁症状及其睾酮（T）治疗的文献进行了批判性综述。老年男性的PADAM会导致多种行为症状，如虚弱、性欲减退和勃起功能障碍、心理活力降低、抑郁情绪、焦虑、失眠、注意力难以集中以及记忆障碍。PADAM的心理和行为方面可能与重度抑郁症的体征和症状重叠。雄激素缺乏与男性抑郁症之间关系的证据来自评估性腺功能减退受试者抑郁情况的研究、低T水平与男性抑郁疾病之间的关联以及雄激素替代的抗抑郁作用。PADAM抑郁症状的病因是多因素的，是中年过渡期间发生的生物和心理社会变化相互作用的结果。尽管来自雄激素治疗试验和雄激素替代的数据不支持T治疗或替代对重度抑郁症（MDD）比安慰剂更有效，但临床印象是，在一些亚阈值抑郁综合征中，T可能会带来抗抑郁益处。
