Relationship between symptoms of androgen deficiency and psychological factors and quality of life among Chinese men

Androgen deficiency in the ageing male (ADAM) was proposed to characterize a symptom cluster of decrease in sexual function and strength, dysphoria and osteopenia in ageing men with decreased levels of androgens. Unlike menopause, literature on the topic is scarce and focuses mainly on the physiological aspects of the problem. However, men with ADAM also face a milieu of psychosocial stressors which may adversely affect their mental health. It is pertinent to examine ADAM within a psychological context. This study aims to determine the prevalence of symptoms of ADAM among Chinese men, and to examine their relationship with psychological distress and quality of life. A cross-sectional design was employed with standardized questionnaires to assess symptoms of ADAM and related psychological factors. The ADAM questionnaire, Hospital Anxiety and Depression Scale, Perceived Stress Scale, General Health Questionnaire and Short Form Health Survey-12 were administered to a community sample of 311 Chinese men (aged 40-80) attending a family medicine clinic in Hong Kong. Demographic information was also collected. A total of 87.8% of the sample was screened ADAM positive using the ADAM questionnaire. Age, duration of marriage, occupation, household income and physical health were found to be significantly associated with ADAM status. ADAM positive individuals were found to have higher anxiety and depression scores, higher stress level, higher psychiatric morbidity and poorer physical and mental quality of life compared with their ADAM negative counterparts. Symptoms of ADAM are prevalent among the Chinese. ADAM positivity as measured by the ADAM questionnaire is associated with poorer psychological well-being and quality of life in the ageing population. Further research and clinical attention to the psychological needs of this population is warranted.