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Hanneke J C M Wouters Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands
Department of Hematology, University of Groningen, University Medical Center Groningen, The Netherlands

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Bruce H R Wolffenbuttel Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands

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Anneke C Muller Kobold Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, The Netherlands

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Thera P Links Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands

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Gerwin Huls Department of Hematology, University of Groningen, University Medical Center Groningen, The Netherlands

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Melanie M van der Klauw Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands

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as depression and impaired mental well-being ( 3 ). Earlier, we demonstrated that HRQoL is impaired in women using levothyroxine compared with those not using levothyroxine ( 4 ). Several possible causes of reduced HRQoL in hypothyroidism have been

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Ulla Schmidt Endocrine Unit, Department of Medicine, Endocrine Unit, Faculty of Health Sciences, Department of Medicine O, Herlev University Hospital, Herlev Ringvej, DK-2730 Herlev, Denmark

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Birte Nygaard Endocrine Unit, Department of Medicine, Endocrine Unit, Faculty of Health Sciences, Department of Medicine O, Herlev University Hospital, Herlev Ringvej, DK-2730 Herlev, Denmark

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Ebbe Winther Jensen Endocrine Unit, Department of Medicine, Endocrine Unit, Faculty of Health Sciences, Department of Medicine O, Herlev University Hospital, Herlev Ringvej, DK-2730 Herlev, Denmark

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Jan Kvetny Endocrine Unit, Department of Medicine, Endocrine Unit, Faculty of Health Sciences, Department of Medicine O, Herlev University Hospital, Herlev Ringvej, DK-2730 Herlev, Denmark

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Anne Jarløv Endocrine Unit, Department of Medicine, Endocrine Unit, Faculty of Health Sciences, Department of Medicine O, Herlev University Hospital, Herlev Ringvej, DK-2730 Herlev, Denmark

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Jens Faber Endocrine Unit, Department of Medicine, Endocrine Unit, Faculty of Health Sciences, Department of Medicine O, Herlev University Hospital, Herlev Ringvej, DK-2730 Herlev, Denmark
Endocrine Unit, Department of Medicine, Endocrine Unit, Faculty of Health Sciences, Department of Medicine O, Herlev University Hospital, Herlev Ringvej, DK-2730 Herlev, Denmark

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monotherapy with respect to quality of life (QOL), depression and anxiety rating scales, and the patients' own preference. Our results indicate that peripheral extra-pituitary tissues can register the addition of T 3 to the substitution regimen. The European

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Pravik Solanki Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
Alfred Health, Melbourne, Victoria, Australia

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Beng Eu Prahran Market Clinic, Victoria, Australia
Department of General Practice, Melbourne Medical School, The University of Melbourne, Victoria, Australia

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Jeremy Smith Faculty of Science, University of Western Australia, Perth, Australia

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Carolyn Allan Hudson Institute of Medical Research, Melbourne, Victoria, Australia

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Kevin Lee Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia

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maintain serum testosterone in the physiological range. Table 1 Possible sequelae of AAS abuse ( 8 ). Physical Psychological Biochemical Acne Depression Reduced testosterone Alopecia Increased anxiety Increased

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S U Jayasinghe
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S J Torres
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C A Nowson
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A J Tilbrook Centre for Physical Activity and Nutrition Research, Livestock and Farming Systems, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Melbourne, Victoria 3125, Australia

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A I Turner
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Introduction The ability of stress to impair physiological processes such as growth, reproduction and immune competence and its association with diseases such as cardiovascular disease, type 2 diabetes and anxiety and depression are well known (1

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Hong Jiang Department of Neurosurgery, Rui-Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Department of Neurosurgery, Rui-Jin Lu-Wan Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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WenJie Yang Department of Radiology, Rui-Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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QingFang Sun Department of Neurosurgery, Rui-Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Department of Neurosurgery, Rui-Jin Lu-Wan Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Chang Liu The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
College of Information Technology and Engineering, Chengdu University, Chengdu, China
College of Computer Science, Sichuan Normal University, Chengdu, Sichuan, China

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LiuGuan Bian Department of Neurosurgery, Rui-Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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condition ( 9 ). In addition, although volumes of the left amygdala of active CS patients negatively correlated with depression scores, differences could only be found in right (but not left) amygdala volumes when compared with controls ( 10 ). Our total

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Sebastian Franik Department of Obstetrics and Gynaecology, Radboudumc, Nijmegen, The Netherlands

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Kathrin Fleischer Department of Obstetrics and Gynaecology, Radboudumc, Nijmegen, The Netherlands

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Barbara Kortmann Department of Pediatric Urology, Radboudumc, Nijmegen, The Netherlands

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Nike M Stikkelbroeck Department of Internal Medicine, Radboudumc, Nijmegen, The Netherlands

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Kathleen D’Hauwers Department of Urology, Radboudumc, Nijmegen, The Netherlands

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Claire Bouvattier Department of Pediatric Endocrinology, Bicêtre Hospital, Paris Sud University, France

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Jolanta Slowikowska-Hilczer Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Poland

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Solange Grunenwald Department of Endocrinology and Metabolic Disease, Centre Hospitalier Universitaire de Toulouse, France

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Tim van de Grift Departments of Plastic Surgery and Medical Psychology, Amsterdam UMC location VUmc, Amsterdam, The Netherlands

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Audrey Cartault Department of Pediatrics, Hospital Des Enfants, Toulouse, France

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Annette Richter-Unruh Kinderendokrinologie und Diabetologie, Universitätsklinikum Ruhr-Universität Bochum, Kinderklinik, Bochum, Germany

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Nicole Reisch Department of Endocrinology, Medizinische Klinik and Poliklinik IV, University Hospital Munich, Munich, Germany

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Ute Thyen Klinik fur Kinder- und Jugendmedizin, Universitat zu Lubeck, Ratzeburger Allee, Lubeck, Germany

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Joanna IntHout Department for Health Evidence, Radboudumc, Nijmegen, The Netherlands

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Hedi L Claahsen-van der Grinten Department of Pediatric Endocrinology, Amalia Childrens Hospital, Radboudumc, Nijmegen, The Netherlands

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the dsd-LIFE group
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the dsd-LIFE group

a small cohort of 43 boys with KS reported also lower psychosocial health scores, including QOL, low self-esteem, a poor self-concept, and a risk for depression ( 7 ). Men with KS might have a higher risk of experiencing discrimination due to their

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N Bergmann Endocrine Unit, The National Research Centre for the Working Environment, Faculty of Health Sciences, Department of Medicine O, Herlev University Hospital, DK-2730 Herlev, Denmark

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F Gyntelberg Endocrine Unit, The National Research Centre for the Working Environment, Faculty of Health Sciences, Department of Medicine O, Herlev University Hospital, DK-2730 Herlev, Denmark

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J Faber Endocrine Unit, The National Research Centre for the Working Environment, Faculty of Health Sciences, Department of Medicine O, Herlev University Hospital, DK-2730 Herlev, Denmark
Endocrine Unit, The National Research Centre for the Working Environment, Faculty of Health Sciences, Department of Medicine O, Herlev University Hospital, DK-2730 Herlev, Denmark

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is a necessary defence mechanism in situations of acute stress. However, if stress persists a state designated allostatic-load or chronic stress is reached, which among other things results in distress, reduced quality of life, or depression (4

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Ann-Cathrin Koschker Division of Endocrinology and Diabetology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany

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Bodo Warrings Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany
Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital, University of Würzburg, Würzburg, Germany

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Caroline Morbach Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany
Division of Cardiology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany

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Florian Seyfried Department of General, Visceral, Transplant, Vascular, and Pediatric Surgery, University Hospital, University of Würzburg, Würzburg, Germany

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Nicole Rickert Department of Radiology, University Hospital, University of Würzburg, Würzburg, Germany

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Pius Jung Division of Pneumology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany

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Andreas Geier Division of Hepatology, Department of Internal Medicine II, University Hospital, University of Würzburg, Würzburg, Germany

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Ulrich Dischinger Division of Endocrinology and Diabetology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany

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Maike Krauthausen Department of General Practice, University Hospital, University of Würzburg, Würzburg, Germany

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Martin J Herrmann Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital, University of Würzburg, Würzburg, Germany

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Christine Stier Division of Endocrinology and Diabetology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
Department of General, Visceral, Transplant, Vascular, and Pediatric Surgery, University Hospital, University of Würzburg, Würzburg, Germany

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Stefan Frantz Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany
Division of Cardiology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany

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Uwe Malzahn Center for Clinical Trials, University Hospital, University of Würzburg, Würzburg, Germany

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Stefan Störk Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany
Division of Cardiology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany

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Martin Fassnacht Division of Endocrinology and Diabetology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany

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the WAS Study Group
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the WAS Study Group

and cardiac function. Furthermore, the effect of bariatric surgery on several other obesity-related diseases as non-alcoholic fatty liver disease (NAFLD) or psycho-emotional stressors as depression has not been investigated in randomized trials. We

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Gavin P Vinson School of Biological and Chemical Sciences, Queen Mary University of London, London E1 4NS, UK

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Caroline H Brennan School of Biological and Chemical Sciences, Queen Mary University of London, London E1 4NS, UK

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psychological and behavioural aspects of the actions of corticosteroids themselves. Almost as the corticosteroids were first characterized, their paradoxical capacity to generate both euphoria and depression in humans has been well known, although poorly

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Hamidreza Mani Diabetes Research Centre, Leicester Diabetes Centre, University of Leicester, Leicester General Hospital, Leicester, UK
Department of Diabetes and Endocrinology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK

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Yogini Chudasama Diabetes Research Centre, Leicester Diabetes Centre, University of Leicester, Leicester General Hospital, Leicester, UK

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Michelle Hadjiconstantinou Diabetes Research Centre, Leicester Diabetes Centre, University of Leicester, Leicester General Hospital, Leicester, UK

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Danielle H Bodicoat Diabetes Research Centre, Leicester Diabetes Centre, University of Leicester, Leicester General Hospital, Leicester, UK

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Charlotte Edwardson Diabetes Research Centre, Leicester Diabetes Centre, University of Leicester, Leicester General Hospital, Leicester, UK
The Leicester Biomedical Research Centre, Leicester and Loughborough, UK

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Miles J Levy Department of Diabetes and Endocrinology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK

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Laura J Gray Department of Health Sciences, University of Leicester, Leicester, UK

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Janette Barnett Department of Diabetes and Endocrinology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK

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Heather Daly Leicester Medical Group, Thurmaston Health Centre, Leicester, UK

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Trevor A Howlett Department of Diabetes and Endocrinology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK

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Kamlesh Khunti Diabetes Research Centre, Leicester Diabetes Centre, University of Leicester, Leicester General Hospital, Leicester, UK

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Melanie J Davies Diabetes Research Centre, Leicester Diabetes Centre, University of Leicester, Leicester General Hospital, Leicester, UK

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) and cardiovascular risk factors) and mental health issues (reduced QoL, depression and anxiety) ( 1 , 2 , 3 ). Women with PCOS have described their challenges in living with PCOS ( 4 ) and their dissatisfaction with lack of information around their

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