Psychiatry Res. 2026 Oct 19. pii: S0165-1781(26)00599-8. [Epub ahead of print]367
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BACKGROUND: Sex hormones influence brain circuits that regulate mood, but previous studies in men have focused on few hormones and treated depression as a single condition. In a nationally representative sample of men, we systematically examine 12 serum sex hormones across the adult lifespan in relation to dimensional depressive symptoms.
METHODS: We analyzed cross-sectional data from the National Health and Nutrition Examination Survey (2017-2023). Serum sex hormones were measured, and depressive symptoms were assessed by PHQ-9, with a score ≥5 indicating mild or greater symptoms. Survey-weighted regression models examined associations between hormones and depressive symptoms, total scores, somatic/non-somatic subscales, and nine individual symptoms.
RESULTS: Among 5668 men (mean age 51.1 years), 1344 (23.7%) had depressive symptoms. Higher anti-Müllerian hormone (AMH, OR=0.86), dehydroepiandrosterone sulfate (DHEAS, OR=0.83), and estrone sulfate (ES1, OR=0.87) were associated with lower odds of depressive symptoms; higher luteinizing hormone (LH, OR=1.11) with increased odds. Age-stratified analyses showed ES1 was inversely associated with depressive symptoms in middle-aged and older men, DHEAS only in older men, and AMH in younger and middle-aged men. Dimensionally, ES1, AMH, and testosterone were associated with lower somatic symptom scores (β=-0.12, -0.16, and -0.17), while AMH was also associated with lower non-somatic scores (β=-0.23). AMH was inversely associated with concentration difficulties; FSH and LH with sleep disturbance.
CONCLUSIONS: Sex hormones show distinct, age and symptom-dimension-specific associations with male depression, challenging unitary diagnostic approaches. These findings support hormone-informed subtyping of male depression and suggest clinical assessment should consider both age and symptom presentation.
Keywords: Age-specific associations; Anti-Müllerian hormone; Estrone sulfate; Male depression; Symptom dimensions