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METHODS: The adults with body mass index (BMI) more than 27 kg/m2 were enrolled in the study. General personal information, physical condition, TCMBC, biochemical, and SNPs were collected for eligible subjects. The body constitution questionnaire (BCQ) was used to evaluate the relationships between TCMBC tendency, biochemical values, and obesity-related SNPs. RESULTS: Obesity patients tended to have a yin deficiency constitution (YinDC) (n = 33, 66.0%); however, TCMBC in combination is not uncommon (30 subjects with more than two TCMBC in combination). For biochemical profiles, leptin was higher among patients with yang deficiency constitution (YangDC) (YangDC versus non-YangDC: 29.7 ± 24.8 versus 15.9 ± 9.9, P=0.020) and YinDC (YinDC versus non-YinDC: 28.8 ± 23.5 versus 14.4 ± 9.6, P=0.020). The leptin level was highest among YangDC subjects. Higher leptin was found among subjects with three-combined TCMBC than balanced TCMBC subjects who were not inclined to any of three TCMBC. For obesity-related SNPs, the adrenergic receptor beta-3 (ADRB3) gene tended to be high expression among YangDC (YangDC versus non-YangDC: 89.7% versus 71.4%, P=0.091) and uncoupling protein 1 (UCP1) tended to be high expression among phlegm-stasis constitution (PSC) (PSC versus non-PSC: 37.9% versus 9.5%, P=0.052). CONCLUSIONS: The relationships between TCMBC, leptin, and SNPs present alternative viewpoints about TCMBC and could be used as a guide to treat obese patients.

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PURPOSE: The aging males' symptoms (AMS) scale is an instrument used to determine the health-related quality of life in adult and elderly men. The purpose of this study was to synthesize internal consistency (Cronbach's alpha) and test-retest reliability for the AMS scale and its three subscales. METHODS: Of the 123 studies reviewed, 12 provided alpha coefficients which were then used in the meta-analyses of internal consistency. Seven of the 12 included studies provided test-retest coefficients, and these were used in the meta-analyses of test-retest reliability. RESULTS: The AMS scale had excellent internal consistency [α = 0.89 (95% CI 0.88-0.90)]; the mean alpha estimates across the AMS subscales ranged from 0.79 to 0.82. The AMS scale also had good test-retest reliability [r = 0.85 (95% CI 0.82-0.88]; the test-retest reliability coefficients of the AMS subscales ranged from 0.76 to 0.83. There was significant heterogeneity among the included studies. CONCLUSIONS: The AMS scale and the three subscales had fairly good internal consistency and test-retest reliability. Future psychometric studies of the AMS scale should report important characteristics of the participants, details of item scores, and test-retest reliability.

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The aim of this study was to develop a psychometrically sound short version of the 17-item Aging Males' Symptoms (AMS) scale using Mokken scale analysis (MSA) and Rasch analysis. We recruited a convenient sample of 1787 men (age: mean (SD) = 43.8 (11.5) years) who visited a men's health polyclinic in Taiwan and completed the AMS scale. The scale was first assessed using MSA. The remaining items were assessed using Rasch analysis. We used a stepwise approach to remove items with χ(2) item statistics and mean square values while monitoring unidimensionality. The item reduction process resulted in a 6-item version of the AMS scale (AMS-6). The AMS-6 scale included a 5-item psychosomatic subscale (original items 1, 4, 5, 8, and 9) and a 1-item sexual subscale (original item 16). Analyses confirmed that the 5-item psychosomatic subscale was a Rasch scale. The AMS-6 correlated well with the AMS scales: the 5-item psychosomatic subscale correlated with the AMS scale (r between 0.50 and 0.92); the 1-item sexual subscale correlated with the sexual subscale of the AMS scale (r = 0.81). A 6-item short form of the AMS scale had satisfactory measurement properties. This version may be useful for estimating psychosomatic and sexual symptoms as well as health-related quality of life with a minimal burden on respondents.

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OBJECTIVE: Invariant item ordering (IIO) is defined as the extent to which items have the same order for each respondent who completes a scale. IIO is crucial for establishing a scale hierarchy that is replicable across samples; however, no research has demonstrated IIO in the Gotland Male Depression Scale (GMDS). The aim of this study was to determine if an IIO hierarchy of depressive symptoms existed in a clinical sample of men who completed the GMDS. METHODS: A convenience sample of 231 men (age: mean (SD) = 46.1 (11.0) yrs) who visited a men's health polyclinic in Taiwan and completed the GMDS. Mokken scale analysis was conducted to evaluate the psychometric properties of the GMDS. RESULTS: All items on the GMDS formed a strong uni-dimensional scale (H=0.592). Except for item #9 (alcohol/drug abuse, or hyperactivity), IIO was found for the remaining 12 items (H(T)=0.366). These symptoms reflected the following hierarchy: positive family history (#13), complaining (#12), anxiety (#8), loss of vitality (#10), depressed mood (#11), indecisiveness (#6), aggression (#2), irritability (#5), stress (#1), burn-out (#3), fatigue (#4), and sleep problems (#7). CONCLUSION: The GMDS is a psychometrically sound measure of depressive symptoms in Taiwanese male outpatients. The GMDS has both cumulative and hierarchical properties.

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INTRODUCTION: The Androgen Deficiency in the Aging Male (ADAM) questionnaire is widely used to screen for late-onset hypogonadism. The positive response to the ADAM questionnaire (positive ADAM) has been associated with depression and poorer quality of life in a number of studies. It is unclear whether there is any value of the ADAM questionnaire in psychiatric populations. In this study, we aimed to determine the utility of the ADAM questionnaire in a convenient sample of male psychiatric outpatients. METHODS: One hundred and seventy-six men (mean age: 54.3 years; standard deviation: 10.7 years; range: 40-80 years) completed the ADAM questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the Aging Males' Symptoms (AMS) scale. Anxiety was defined as a HADS anxiety subscore ≥8; depression as a HADS depression subscore ≥8; and moderate/severe impairment of health-related quality of life (HQoL) as AMS ≥37. ADAM, anxiety, and depression was used to model the moderate/severe impairment of HQoL. RESULTS: One hundred and sixty-four (93%) men had positive ADAM. Positive ADAM was associated with a lower body mass index (P<0.05) and moderate/severe impairment of HQoL (P<0.001), but was not associated with anxiety or depression (P>0.05). Positive ADAM was associated with five symptoms of the AMS scale: "decline of one's feeling of general well-being", "depressive mood", and three sexual symptoms. In regression analysis, positive ADAM was associated with increased risk of moderate/severe impairment of HQoL (unadjusted odds ratio 20.1, 95% confidence interval 3.77-372, P<0.01), which remained significant with covariates of anxiety and depression (adjusted odds ratio 15.6, 95% confidence interval 2.52-309, P<0.05). CONCLUSION: The ADAM questionnaire can be used to screen the sexual symptoms but not depression/anxiety in male psychiatric outpatients. Positive ADAM may indicate moderate/severe impairment of HQoL.

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INTRODUCTION: Symptoms of depression in males, such as aggression and irritability, are different from those in females. However, there are no adequate scales for detecting possible diagnoses in the Chinese population. The aim of this study was to assess whether the Chinese version of the Gotland Male Depression Scale (CV-GMDS) could identify male depression as effectively as the English version. MATERIALS AND METHODS: A total of 231 male outpatients were sampled from a men's health polyclinic. We used questionnaires to evaluate the characteristics and mood status of participants, including the CV-GMDS, the Chinese version of the Beck Depressive Inventory II (CV-BDI-II), and the Chinese version of the Aging Males' Symptoms (CV-AMS) scale. Cronbach's α-coefficient and Levene's test were used to investigate internal consistency and homogeneity, respectively. External validity was evaluated using Spearman's correlation coefficient. A factor analysis was conducted to evaluate the conceptual structure of the CV-GMDS, and a regression analysis was used to determine the relationship of the CV-AMS scale with the CV-GMDS and CV-BDI-II. RESULTS: The mean age of the 231 participants was 46.1 years (standard deviation 11.0). Of the participants, 36.8% (n=85) were found to have depression according to the CV-GMDS and 34.6% (n=80) according to the CV-BDI-II. The internal consistency of the CV-GMDS was demonstrated by a Cronbach's α of 0.933, and the test of homogeneity revealed a P-value of 0.762. The external validity for the CV-GDMS and CV-BDI-II was demonstrated by an intercorrelation of 0.835. The third and fourth items of the GMDS differed from the others, and the CV-GMDS showed a better relationship (R (2)=0.616) with the CV-AMS scale than the CV-BDI-II did. CONCLUSION: The CV-GMDS is a satisfactory and suitable psychometric questionnaire for detecting depression among a Chinese-speaking middle-aged or older male population. The results of this study could be used as a basis for investigating specific male depression and aging symptoms.