Testosterone, estradiol, DHEA and cortisol in relation to anxiety and depression scores in adolescents

Briana NC Chronister, Eduardo Gonzalez, Dolores Lopez-Paredes, Jose Suarez-Torres, Sheila Gahagan, Danilo Martinez, Janeth Barros, David R. Jacobs, Harvey Checkoway, Jose R. Suarez-Lopez

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background Adrenal and sex hormone dysregulation have been independently associated with increased depression and anxiety. Cortisol can modify production of sex hormones and hormone-mood associations. This study evaluated associations and interplay of sex and adrenal hormones with depression and anxiety. Methods We assessed 545 Ecuadorian adolescents (11–17y, 50.4% female, ESPINA) for depression and anxiety symptoms using standardized scales. Testosterone, cortisol, dehydroepiandrosterone (DHEA), and estradiol (boys only) were measured in saliva. We performed logistic regression modeling to calculate odds ratios (OR) of elevated depression or anxiety (scores ≥60) comparing participants with low (<10th percentile) and elevated hormones (≥90th percentile) to normal concentrations (10th–90th percentile). Effect modification by cortisol and testosterone was assessed. Models adjusted for demographic, anthropometric, and circadian measures. Results In all participants, elevated testosterone (OR [95%CI:]=1.78 [0.98, 3.23]) and cortisol (OR=1.69 [0.95, 2.99]) were marginally associated with elevated anxiety scores. In boys, elevated estradiol was associated with elevated depression (OR=4.75 [1.95, 11.56]) and anxiety scores (OR=2.43 [1.01, 5.84]). In linear regression, estradiol was positively associated with depression (difference/10% hormone increase (β=0.45 [0.15, 0.75]) and anxiety scores (β=0.42 [0.13, 0.72]). Higher cortisol levels strengthened the depression association with estradiol in boys (β=0.54 [0.12, 0.96]), and with testosterone (β= -0.19 [-0.35, -0.03]) and DHEA (β= -0.12 [-0.22, -0.02]) in girls. Testosterone also modified associations. Limitations This was a cross-sectional analysis. Discussion Elevated testosterone, cortisol, and estradiol (≥90th percentile) were associated with altered mood. Cortisol and testosterone were considerable effect modifiers to the associations of most hormones with depression and anxiety.

Original languageEnglish (US)
Pages (from-to)838-846
Number of pages9
JournalJournal of Affective Disorders
StatePublished - Nov 1 2021

Bibliographical note

Funding Information:
The ESPINA study received funding from the National Institute of Occupational Safety and Health ( 1R36OH009402 ) and the National Institute of Environmental Health Sciences ( R01ES025792 , R21ES026084, R01ES030378 ). Briana Chronister was funded by the National Institute of Mental Health (5T32MH122376).

Publisher Copyright:
© 2021


  • Adolescents
  • Adrenal hormones
  • Anxiety
  • Depression
  • Ecuador
  • Gonadal hormones


Dive into the research topics of 'Testosterone, estradiol, DHEA and cortisol in relation to anxiety and depression scores in adolescents'. Together they form a unique fingerprint.

Cite this