Sex steroids and the presence and course of a major depressive disorder

Wit, A.E. de (Anouk) (2015) Sex steroids and the presence and course of a major depressive disorder. thesis, Medicine.

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Abstract

Major depressive disorder (MDD) is a frequent and often recurrent disorder with substantial heterogeneity in terms of symptoms and pathophysiological mechanisms. Several treatments are available but unfortunately not effective in all patients. In order to develop new treatments, better understanding of the pathophysiology is essential. A consistent finding is the twice as high prevalence in women compared to men and the increase in morbidity in women during menopause. It has often been postulated that differences in sex steroid levels within and between the genders may attribute to this pattern. Therefore, we aim to investigate whether a) sex steroid levels in blood are associated with the presence of MDD and b) sex steroids levels are predictive of the course of MDD in both men and women. We included 1163 women (770 MDD and 393 controls) and 663 men (382 MDD and 252 controls) and have measured levels of sex hormone-binding globulin, dehydroepiandrosterone-(sulphate) and (free) testosterone in blood using radioimmunoassay. Baseline sex steroid levels were compared between a) controls and patients with MDD and b) between patients in remission and those with a chronic course after two years, using binary logistic regression. Time to remission was determined using cox regression. All analyses were adjusted for socio-demographic and clinical covariates. Lower total and free testosterone levels in men and lower SHBG levels in women were associated with the presence of MDD compared to controls (p=0.03, p=0.02 and p=0.03 respectively). However, after adjustment for covariates, none of the associations remained significant. None of the sex steroids predicted the two-year course or the time to remission. In summary, this study showed that sex steroids are not linked to MDD in all patients. Further research should focus on the identification of subgroups of MDD in which sex steroids may play a role.

Item Type:	Thesis (Thesis)
Supervisor name:	Faculty supervisor: and Schoevers, Prof. Dr. R.A. and Second supervisor: and Bosker, Dr. F.J. and Department: Psychiatry and UMCG
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:53
Last Modified:	25 Jun 2020 10:53
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1401

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