Amanatkar Hamid R, Chibnall John T, Seo Byung-Woun, Manepalli Jothika N, Grossberg George T
Department of Neurology and Psychiatry, Saint Louis University, St. Louis, MO, USA. E-mail:
Ann Clin Psychiatry. 2014 Feb;26(1):19-32.
In the last decade, there has been a surge of new clinical trials studying the impact of exogenous testosterone on mood. The results of these studies have been inconsistent.
Meta-analysis of controlled clinical trials using common depression rating scales was performed.
Sixteen trials with a total of 944 subjects met selection criteria. Meta-analysis of data showed a significant positive impact of testosterone on mood (z=4.592; P<.0001). Subgroup analysis showed a significant effect size of 5.279 (P<.0001) in the trials with a mean age of <60 years. However, the effect size was not statistically significant in those trials with a mean age of >60 years. The effect size in hypogonadal men was 4.192 (P<.0001), whereas the result was not statistically significant in eugonadal men. In addition, the effect size was larger in subthreshold depression compared with major depression. Oral testosterone compared with oral dehydroepiandrosterone, testosterone gel, and intramuscular testosterone did not show a significant result. Larger
Testosterone may be used as a monotherapy in dysthymia and minor depression or as an augmentation therapy in major depression in middle-aged hypogonadal men.
在过去十年中，涌现出大量研究外源性睾酮对情绪影响的新临床试验。这些研究结果并不一致。
采用常用抑郁评定量表对对照临床试验进行荟萃分析。
16项试验共944名受试者符合入选标准。数据荟萃分析显示睾酮对情绪有显著的积极影响（z = 4.592；P <.0001）。亚组分析显示，在平均年龄<60岁的试验中，效应量显著为5.279（P <.0001）。然而，在平均年龄>60岁的试验中，效应量无统计学意义。性腺功能减退男性的效应量为4.192（P <.0001），而性腺功能正常男性的结果无统计学意义。此外，与重度抑郁症相比，亚阈值抑郁症的效应量更大。口服睾酮与口服脱氢表雄酮、睾酮凝胶和肌内注射睾酮相比，未显示出显著结果。更大
睾酮可作为中年性腺功能减退男性心境恶劣障碍和轻度抑郁症的单一疗法，或作为重度抑郁症的增效疗法。
