In a longitudinal clinical psychoendocrine study, serum testosterone levels (ng/dl) were measured at 2-week intervals during the course of hospitalization in 34 male psychiatric inpatients in four diagnostic groups, including post-traumatic stress disorder (PTSD), major depressive disorder (endogenous type) (MDD-E), paranoid schizophrenia (PS), and bipolar I disorder- manic (BP), as well as in a group of normal male control subjects (CONT). A one-way analysis of variance revealed that the mean (± SE) testosterone levels were significantly higher (p<0.0002) in the PTSD (578±59), PS (571±49), and CONT (494±24) groups than in the MDD-E (331±47) and BP (351±31) groups. The same group differences were significant in the first sample (p<0.02), while in the last sample the values were significantly higher (p<0.0004) in the PTSD (623±66) and PS (566±72) groups than in the CONT (482±26), BP (353±61), and MDD-E (291±52) groups. These preliminary findings, then, indicate that in spite of considerable depressive symptomatology, PTSD patients do not show the relatively low testosterone levels seen in major depressive disorder patients, but instead align more closely with the schizophrenic patients with regard to the pituitary-gonadal system. There is also an indication that chronic basal testosterone levels in PTSD patients may be elevated in comparison with normal subjects. The possible link suggested by the psychoendocrine literature between testosterone levels and trait factors, particularly paranoid style, in these patient groups is considered, as is the potential application of these findings for multidimensional approaches to the development of improved biologic criteria for psychiatric
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