Early Puberty and Testosterone Associated With Depression in Girls

Teenage girl grief stricken on her first day of school.
Previous research indicated that estradiol and testosterone were linked to depression in adolescent girls, as opposed to testosterone alone.

Early puberty and testosterone are both associated with heightened levels of adolescent depression in girls, according to research published in the Journal of the American Academy of Child & Adolescent Psychiatry.

Researchers tested the relative contributions of pubertal timing, pubertal status, and sex hormones on escalations of female depression, using 8 waves of data from the prospective, representative Great Smoky Mountains Study. The data included 630 female participants aged 9 to 16 years, and determined depressive disorders through structured interviews. Participants rated their pubertal status using Tanner stage drawings, and sex steroids were assessed from dried blood spots.

The analysis revealed that the risk for depression during puberty was strongly associated with age as well as Tanner stage in univariate models. The effects of age and Tanner stage were diminished in terms of both statistical significance and effect size in adjusted models accounting for pubertal timing and sex steroids. The only significant predictors of change in depression status during puberty were early pubertal timing (odds ratio, 5.8; 95% CI, 1.9-17.9; P =.002 after age 12 years) and higher testosterone levels (odds ratio, 2.0; 95% CI 1.1-3.8; P =.03). This is different than previous findings based on earlier waves of the Great Smoky Mountain Study, in which estradiol and testosterone were linked to depression in adolescent girls. In addition, researchers had not previously considered the effects of the timing of puberty on depression.

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The researchers stated, “Our findings implicate multiple determinants with effects that are mediated through both social and biological pathways and may differ with different racial/ethnic groups,” and added that simplistic explanations of pubertal depression in girls are no longer valid.

According to the testosterone findings, the researchers suggested that additional attention be given to the central nervous system maturational processes, which influence depression susceptibility.

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Copeland WE, Worthman C, Shanahan L, Costello EJ, Angold A. Early pubertal timing and testosterone associated with higher levels of adolescent depression in girls [published online February 14, 2019]. J Am Acad Child Adolesc Psychiatry. doi:10.1016/j.jaac.2019.02.007

This article originally appeared on Psychiatry Advisor