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Yıl:2014; Cilt: 7; Sayı: 3>> Özet
Türkiye Klinikleri Psikiyatri Özel Dergisi; 2014;7(3):14-22
Erkek Ruh Sağlığı ve Hormonlar
PÇ Aydın, N Aydın
 Bakırköy Prof.Dr. Mazhar Osman Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul
Androjenlerin içinde en potent olan ve vücutta en yüksek düzeyde bulunan testosterondur. Ayrıca bu hormonun davranış ve duygudurum üzerine etkilerinin olduğu da bilinmektedir. Testosteronun agresif davranışın düzenlenmesinden sorumlu olduğu düşünülmekte ve bu işlevi serotonin ve kortizolle etkileşerek yerine getirdiği kabul edilmektedir. Klinik olarak hipogonadal ya da yaşlı erkeklerde testosteron eksikliğinin yorgunluk, libidoda azalma, irritabilite, uykusuzluk, depresyon gibi nöropsikiyatrik problemlere yol açabildiği görülebilmekte ve Testosteron Yerine Koyma Tedavisi ile bu belirtiler düzelebilmektedir. Depresyon ile testosteron arasındaki ilişki, Hipotalamo-Pituiter-Adrenal ve Hipotalamo-Pituiter-Gonadal eksenler arasındaki etkileşimle açıklanmaya çalışılmaktadır. Erkeklerde şizofreninin daha erken yaşta başlaması ve şizofreni insidansının da daha yüksek olması testosteronla ilişkiyi akla getirmektedir. Erkek şizofreni hastalarında negatif belirti şiddeti ile testosteron düzeyleri arasında negatif bir ilişki gözlenmekle beraber testosteron düzeyi düşüklüğünün hastalığın etyolojisine katkıda bulunup bulunmadığı ya da hipogonadizmin hastalık sürecinin bir sonucu olup olmadığı soruları henüz yanıtlanmamıştır. Alzheimer Hastalığı görülme riski ile testosteron düzeyleri arasında negatif bir ilişki olduğu da bildirilmiştir. Tüm bu veriler; erkeklerde androjenler içinde özellikle testosteronun agresyonun düzenlenmesi yanısıra şizofreni, depresyon ve Alzheimer Hastalığı belirtilerinin oluşumunda rolü olduğunu düşündürmektedir.
Male Mental Health and Hormones
Testosterone is the most potent among the androgens and is found within the body at the highest level. Moreover it is known that this hormone has effects on behaviors and mood. It is thought that testosterone is responsible from regulation of the aggressive behavior and accepted that this function is performed by interaction of serotonin and cortisol. Clinically it is observed that hypogonadal or the testosterone deficiency at elderly men leads to fatigue, decrease of libido, irritability, insomnia, depression and similar neuropsychiatric issues. However such symptoms may be improved by means of Testosterone Replacement Therapy. The relation between depression and testosterone is tried to be explained by means of interaction between the Hypothalamic-Pituitary-Adrenal and the Hypothalamic-Pituitary-Gonadal axes. Early occurrence of the schizophrenia at the men and higher incidences of schizophrenia as well, is the reminder of relation with testosterone. Beside the observation of a negative relation between the severity of negative symptoms and levels of testosterone at male patients with schizophrenia it has not been answered yet whether the low levels of testosterone contribute to the etiology of the disease or hypogonadism is a result of disease process. A negative relation was reported too, between the risk of Alzheimer Disease occurrence and levels of testosterone. All of this data makes think that among the androgens especially the testosterone plays a role in the occurrence of schizophrenia, depression and Alzheimer Disease symptoms as well as regulation of the aggression.

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