Psychological Medicine

Pubertal changes in hormone levels and depression in girls

A. ANGOLD a1c1, E. J. COSTELLO a1, A. ERKANLI a1 and C. M. WORTHMAN a1
a1 Department of Psychiatry and Behavioral Sciences, Duke University Medical Center; and Department of Anthropology, Emory University, NC, USA


Background. Throughout their reproductive years, women suffer from a higher prevalence of depression than men. Before puberty, however, this is not the case. In an earlier study, we found that reaching Tanner Stage III of puberty was associated with increased levels of depression in girls. This paper examines whether the morphological changes associated with puberty (as measured by Tanner stage) or the hormonal changes underlying them are more strongly associated with increased rates of depression in adolescent girls.

Methods. Data from three annual waves of interviews with 9 to 15-year-olds from the Great Smoky Mountains study were analysed.

Results. Models including the effects of testosterone and oestradiol eliminated the apparent effect of Tanner stage. The effect of testosterone was non-linear. FSH and LH had no effects on the probability of being depressed.

Conclusions. These findings argue against theories that explain the emergence of the female excess of depression in adulthood in terms of changes in body morphology and their resultant psychosocial effects on social interactions and self-perception. They suggest that causal explanations of the increase in depression in females need to focus on factors associated with changes in androgen and oestrogen levels rather than the morphological changes of puberty.

c1 Address for correspondence: Dr Adrian Angold, Developmental Epidemiology Program, DUMC Box 3454, Durham, NC 27710, USA.