Andreas Walther

University of Zurich | UZH · Psychologisches Institut

Pathophysiological landmarks of depressive disorders are chronic low-grade inflammation and elevated glucocorticoid output. Both can potentially interfere with cytoskeleton organization, cell membrane bending and cell function, suggesting altered cell morpho-rheological properties like cell deformability and other cell mechanical features in depres...

Background: Research suggests that male-specific psychotherapy approaches for major depressive disorder (MDD) that consider traditional masculinity ideologies (TMI) and their impact on men’s MDD may achieve improved treatment efficacy and reduced therapy dropout. However, to date, randomized controlled studies examining male-specific psychotherapy...

Background: The endocannabinoid system (ECS) is increasingly being recognized as key regulatory system coupled with the glucocorticoid system implicated in the pathophysiology of major depressive disorder (MDD). However, prior studies examining the ECS in MDD have been inconclusive, of small sample size or of cross-sectional nature limiting interpr...

Because artificial intelligence powered language models such as the GPT series have most certainly come to stay and will permanently change the way individuals all over the world access information and form opinions, there is a need to highlight potential risks for the understanding and perception of men and masculinities. It is important to unders...

Background: In western countries, men are increasingly using cosmetic surgery. However, despite this trend, there remains a dearth of information on the prevalence, acceptance, and motivations behind men's use of cosmetic surgery. Furthermore, the potential association between men's use of cosmetic surgery and in particular male-specific cosmetic s...

Because artificial intelligence powered language models such as the GPT series have most certainly come to stay and will permanently change the way individuals all over the world access information and form opinions, there is a need to highlight potential risks for the understanding and perception of men and masculinities. It is important to unders...

Public Significance Statement The disclosure of a major depression diagnosis to men has the potential to alleviate male-typical externalizing depression symptoms and reduce gender role conflict, which can improve mental health and may increase likelihood for men to be receptive to mental health care. The increasing evidence for traditional masculin...

Background: Men are up to four times more likely to die by suicide than women. At the same time, men are less likely to disclose suicidal ideation and transition more rapidly from ideation to attempt. Recently, socialized gender norms such as traditional masculinity ideologies (TMI) have been discussed as driving factor for men's increased risk for...

Background: Psychotherapists differ in treatment success depending on the patient's gender, suggesting men to be a challenging patient group for many psychotherapists. On the patient's side, traditional masculinity ideologies (TMI) have been linked to differing symptom presentation in depression, reduced psychotherapy use, poorer therapy engagement...

How can clinicians identify early male-identified patients who are at high risk for psychotherapy dropout? Because male-identified patients are already at higher risk of discontinuing psychotherapy early, but by no means all do so, it is important to identify person-specific factors that provide clinicians with information as to whether their male-...

Despite increasing rates for suicidal ideation in university students, male students remain reluctant in reporting such thoughts. It is thus paramount to establish more easily detectable risk factors for male students. The present study examines study dropout thoughts as potential low-treshold risk factor as well as gender-differences in establishe...

Despite increasing rates for suicidal ideation in university students, male students remain reluctant in reporting such thoughts. It is thus paramount to establish more easily detectable risk factors for male students. The present study examines study dropout thoughts as potential low-threshold risk factor as well as gender-differences in establish...

The Psychic Pain Scale (PPS) measures a form of mental pain involving overwhelming negative affect and loss of self-control. Understanding psychic pain among men is needed to advance efforts for preventing male suicide. The present study examined the factor structure and psychosocial correlates of the PPS among 621 online help-seeking men. Confirma...

The notions that manhood is hard to attain, easy to lose, and needs to be proven via public action constitute precarious manhood beliefs (PMB). PMB is a new concept and it remains unclear whether and how PMB relate to erectile dysfunction (ED) in cisgender men. The ability to achieve an erection remains considered as a cornerstone of masculinity an...

Background Treatment of major depressive disorder (MDD) in men is complicated by the endorsement of traditional masculinity ideologies (TMI) often leading to reluctance toward psychotherapy, therapy interfering processes, or premature termination. In addition, it has been shown that men with MDD have a significantly increased risk of being hypogona...

Zusammenfassung Eine erfolgreiche Therapie psychischer Störungen ist angesichts des häufig vorhandenen Leidensdrucks der Betroffenen sehr wichtig. Da anerkannte pharmazeutische und psychotherapeutische Ansätze leider nicht für alle Patient:innen zur erwünschten Besserung ihres Leidens führen, findet intensive Forschung zu ergänzenden oder alternati...

Many women and men experience intimate partner violence (IPV) during their lifetime. However, only relatively few people actually seek formal help after such an experience. The current study applied the mediated-moderation model of self-compassion and stigma that has previously been used to explain men's help-seeking behavior for depressive symptom...

Purpose of review Societal, cultural, and contextual norms about how men should be and behave (so called traditional masculinity ideologies; TMI) affect men’s presentation of depressive disorders, psychotherapy use, and treatment engagement. Only recently, however, male-tailored psychotherapy approaches for depressive disorders have been developed,...

Background Men are disproportionately often perpetrators of physical domestic violence (DV). Gender role constructs, such as traditional masculinity ideologies (TMI), are broadly accepted as an explanation for this effect. Emotional competence further constitutes an important role in TMI and the prevention of DV. However, the interactions between t...

The present study translated the 30-item Conformity to Masculine Norms Inventory (CMNI-30) from English to German. Indices for measurement invariance across gender and sexual orientation, test–retest reliabilities, and indicators of convergent (positive correlations with the Male Role Norms Inventory–Short Form and the Gender Role Conflict Scale–Sh...

Background: Increasing prevalence rates for suicidal ideation among university students call for better understanding of critical risk factors. Because of traditional masculinity ideologies (TMI; socially defined sets of standards and norms how men are expected to be or behave), men are less likely to report suicidal ideation but up to four times m...

Background: Treatment of major depressive disorder (MDD) in men is complicated by the endorsement of traditional masculinity ideologies (TMI) often leading to reluctance towards psychotherapy, therapy interfering processes, or premature termination. In addition, it has been shown that men with MDD have a significantly increased risk of being hypogo...

Societal, cultural, and contextual norms about how men should be and behave affect the presentation of depressive disorders as well as psychotherapy use. Only recently, however, male-tailored psychotherapy approaches for depressive disorders have been developed, which consider and aim to systematically soften dysfunctional masculinity norms. Althou...

The COVID-19 pandemic restrictions, uncertainties and management inconsistencies have been implicated in men’s rising distress levels, which in turn have somewhat normed the uptake of telemental healthcare services (i.e., phone and/or video-conference-based therapy). Given past evidence of poor engagement with telemental health among men, this mixe...

Background: Cell deformability of all major blood cell types is increased in depressive disorders (DD). Furthermore, impaired glucocorticoid secretion is causally related to DD. Nevertheless, there are no longitudinal studies examining changes in glucocorticoid output and depressive symptoms regarding cell deformability in DD. Aim: To investigate,...

The COVID-19 pandemic is causing extensive job loss leading to a loss of social status in many men. Endorsement of traditional masculinity ideology may render some men particularly sensitive to status loss and thereby to an increased risk for suicidality. In this anonymous online survey conducted in German-speaking European countries, 490 men compl...

Background: Men are disproportionately often perpetrators of physical domestic violence (DV). Gender role constructs, such as traditional masculinity ideologies (TMI), are broadly accepted as an explanation for this effect. Emotional competence further constitutes an important role in TMI and the prevention of DV. However, the interactions between...

The COVID-19 (SARS-CoV-2) pandemic has had a global impact on healthcare provision. Changes in prescribing of commonly used medications can be used as a marker for diagnoses of new patients as well as measuring service levels for patients in primary care [1]. The consequences of the COVID-19 pandemic in rela- tion to incident cases of depression an...

Background: The notion that manhood status is hard to earn, easy to lose and needs to be proven via public action is termed Precarious Manhood Beliefs (PMB). Since PMB is a new concept, it is entirely unclear whether and how PMB relate to erectile dysfunction (ED) in cisgender men. The ability to achieve an erection is often still considered a corn...

This paper presents defense-oriented psychoanalytic psychotherapy as a tailored treatment for boys through a neurophysiological hypothesis. Male central nervous system development is reviewed, with a focus on the development of the emotion regulation system. The organizational effects of pre- and post-natal androgens delay central nervous system de...

Stress-related exhaustion symptoms have a high prevalence which is only likely to increase further in the near future. Understanding the physiological underpinnings of exhaustion has important implications for accurate diagnosis and the development of effective prevention and intervention programs. Given its integrative role in stress-regulation, t...

Attachment anxiety and avoidance might explain gender differences in psychotherapy use, which is generally lower in men. In addition, university students are a particularly vulnerable group for mental health problems, and understanding psychotherapy use, especially among mentally distressed male students, is pivotal. A total of 4894 students comple...

Supplementary Material Content S-Table 1: Logistic Regression Models predicting current Psychotherapy Use - page 2 S-Table 2: Logistic Regression Models predicting Intention to Start Psychotherapy - page 3 S-Table 3: Gender Differences in Psychotherapy Use for Syndromic Subgroups - page 4 S-Figure 1: Odds Ratios for current Psychotherapy Use for...

Heterosexual-identified men, as compared to non-heterosexual-identified men, are less likely to seek out psychotherapy when experiencing psychological distress. Stronger endorsement of traditional masculinity ideologies (TMI) has been reported to be associated with reduced psychotherapy use among men. However, the relationship between psychotherapy...

The COVID-19 pandemic has presented a suite of circumstances that will simultaneously affect mental health and mobilize coping strategies in response. Building on a lack of research specifically exploring men's mental health impacts during the COVID-19 pandemic, this study presents the results of a qualitative survey exploring men's self-reported a...

In the early days of the first global wave of the COVID-19 pandemic, the potential for a postviral syndrome to manifest following COVID-19 infection was first recognized. Here, we present an analysis of a case series of the first 20 patients' data collected in clinical practice to evaluate the potential of a possible alternative treatment for Long...

In the light of the COVID-19 pandemic and claims that traditional masculinity may put some men at increased risk for infection, research reporting men’s health behaviors is critically important. Traditional masculine norms such as self-reliance and toughness are associated with a lower likelihood to vaccinate or follow safety restrictions. Furtherm...

Men’s low job satisfaction has been shown to be associated with greater symptoms of psychological distress. Meaning in life may be an important factor in this relationship, but its role as a mediator has not been reported. The present study investigated meaning in life as a mediator in the relationship between job satisfaction and psychological dis...

Background: In the light of the COVID-19 pandemic and claims that traditional masculinity may put some men at increased risk for infection, research reporting men's health behaviors is critically important. Traditional masculine norms such as self-reliance and toughness are associated with a lower likelihood to vaccinate or follow safety restrictio...

Background: Heterosexual-identified men, as compared to non-heterosexual-identified men, are less likely to seek out psychotherapy when experiencing psychological distress. Stronger endorsement of traditional masculinity ideologies (TMI) has been reported to be associated with reduced psychotherapy use among men. However, the relationship between p...

Background: The endocannabinoid system (ECS) is increasingly being recognized as key regulatory system coupled with the glucocorticoid system implicated in the pathophysiology of stress-related mental disorders. However, prior studies examining the ECS in depression or burnout have been inconclusive, of small sample size or of cross-sectional natur...

Background: The COVID-19 pandemic is causing extensive job loss leading to a loss of social status in many men. Endorsement of traditional masculinity ideology may render some men particularly sensitive to status loss and thereby to an increased risk for suicidality. Methods: In this anonymous online survey conducted in German-speaking European cou...

Background: Attachment anxiety and avoidance have been insufficiently studied in relation to psychotherapy use. Attachment theory, specifically attachment anxiety and avoidance, might explain gender differences in psychotherapy use, which is generally lower in those identifying as male. In addition, university students are a particularly vulnerable...

Background. Pathophysiological landmarks of depressive disorders are chronic low-grade inflammation and elevated glucocorticoid output. Both can potentially interfere with cell membrane bending and cell function, suggesting altered cell morpho-rheological properties like cell deformability and other cell mechanical features in depressive disorders....

Aims In the early days of the first global wave of the COVID-19 pandemic, the potential for a post-viral syndrome to manifest following COVID-19 infection was highlighted. It was pointed out that an early intervention applying management techniques used in patients with CFS/ME appeared to help reduce the fatigue related symptoms of Long COVID. Here...

Men as compared to women are half as often affected by depressive and anxiety disorders and seek significantly less help for mental health issues than women. Adherence to traditional male role norms (AtTMRN) may hinder men from describing prototypical depression symptoms and from seeking psychotherapy. The current study compared whether the AtTMRN,...

While romantic infatuation and separation influence psychological and physiological functioning, the hypothalamic-pituitary-adrenal axis with its biomarkers cortisol, dehydroepiandrosterone (DHEA), and progesterone central for coping and distress has been scarcely researched in this context. In particular, endocrine hair analyses assumed to be more...

For poor sleep quality (SQ) as well as major depressive disorder (MDD) and burnout, a dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis has been identified. Although poor SQ is often reported as an early symptom of MDD or burnout, it is not clear whether HPA axis-related hormones can influence the association between SQ and MDD or burn...

Non-detectable (ND) and outlying concentration values (OV) are a common challenge of biomarker investigations. However, best practices on how to aptly deal with the affected cases are still missing. The high methodological heterogeneity in biomarker-oriented research, as for example, in the field of psychoneuroendocrinology, and the statistical bia...

Background: Screening for depressive disorders in men may be complicated by traditional male role norms. The Male Depression Risk Scale (MDRS) was developed to aid screening for depression in men adhering to traditional male role norms and to facilitate identification of depression in men in general and to promote treatment uptake. Aims: Validation...

Background: Relationship satisfaction has been identified as an important factor in terms of extradyadic sexual involvement. However, in men, fatherhood might be associated with infidelity by leading to changes in relationship satisfaction and the social life of parents. To date, no study has focused on the association of fatherhood and infidelity,...

This article develops theory on responsible leadership based on a model involving three leadership roles: an expert who displays organizational expertise, a facilitator who cares for and motivates employees and a citizen who considers the consequences of her or his decisions for society. It draws on previous responsible leadership research, stakeho...

Halb so hohe Prävalenzraten depressiver Störungen und dreifach erhöhte Suizidraten bei Männern weisen auf die Bedeutung von Geschlechterrollen für die Präsentation und den Verlauf depressiver Störungen hin. Konformität zu traditionellen Geschlechterrollen führt bei Männern zu atypischer Symptomatik und erschwert die Identifikation depressiver Störu...

The purpose of this study is to examine the relationship between contextual work-related factors in terms of job demands (workload—WL) and job resources (work flexibility—WF), work–life conflict (WLC) and the burnout dimension emotional exhaustion (EE) in a large population-based sample. Building on the job demands resources model (JDRM), we have d...

Objectives: The association between depressive symptomatology and endogenous testosterone levels is inconclusive. Large inter- and intra-individual testosterone differences suggest point measurements from saliva or serum to be inadequate to map basal testosterone concentrations highlighting the potential for long-term integrated testosterone levels...

Objectives: Although males and females gain comparable weight when prescribed second-generation antipsychotics (SGAs), males may be uniquely vulnerable to an array of endocrinological, inflammatory, and psychosocial adverse drug effects. Methods: This opinion piece reviews work in each of these three areas for consideration. Results: Androgens ma...

While life expectancy continues to increase, aging can bring several distinct endocrine and psychosocial changes. The study aimed to investigate the interplay between biopsychosocial factors of healthy aging in specifically healthy aging men. Ninety-seven healthy aging men were investigated at two time points spanning 4 years. Participants complete...

The endocannabinoid system has been implicated in the dynamic regulation of the stress response, fear memory formation, and inflammatory processes. Endocannabinoids (eCBs) and N-acylethanolamines (NAEs) are primarily quantified from serum or cerebrospinal fluid representing acute measures, while no validated method for the quantification of long-te...

Zusammenfassung Hintergrund: Frauen erkranken fast doppelt so häufig wie Männer an einer Major Depression. Eine Hyperaktivität der Hypothalamus-Hypophysen-Nebennierenrinden-Achse (HHNA) und eine chronisch niedrig-gradige Inflammation sind 2 der konsistentesten biologischen Befunde bei schweren Depressionen. Inwiefern diese Parameter für die Existen...

Hintergrund: Frauen erkranken fast doppelt so häufig wie Männer an einer Major Depression. Eine Hyperaktivität der Hypothalamus-Hypophysen-Nebennierenrinden-Achse (HHNA) und eine chronisch niedrig-gradige Inflammation sind 2 der konsistentesten biologischen Befunde bei schweren Depressionen. Inwiefern diese Parameter für die Existenz von Geschlecht...

It is debated as to whether major depressive disorder (MDD) and the burnout syndrome represent different aspects of the same syndrome or whether they reflect separate entities. A dysregulation of the hypothalamus-pituitary-adrenal-axis has been related to both conditions separately. Dissecting the pathophysiology of the conditions and describing di...

Sleep quality (SQ) is considered to be a critical variable in major depressive syndrome (MD) as well as in burnout syndrome (B). Thus far, no study examined the differential influence of these syndromes on SQ. MD and B have been assessed in 4,415 participants at baseline and in 1,396 participants at follow-up based on the Patient Health Questionnai...

Research is increasingly focusing on promoting healthy aging and the related extension of the health span by targeting crucial biological processes responsible for age-related conditions. While age-related gradual changes in steroid hormones such as testosterone, estradiol, or cortisol are well described in men, their interactions among each other...

Major depressive disorder (MDD) and its treatment are challenges for global health. Optogenetics and chemogenetics are driving MDD research forward by unveiling causal relations between cell­type specific control of neurons and depressive‐like behaviour in rodents. Using a systematic search process, in this review, a set of 43 original studies appl...

Background: Although chronic fatigue syndrome (CFS) sometimes referred to as myalgic encephalomyelitis (ME) is a very challenging condition to treat, there is evidence that individual cognitive behavioral therapy (ICBT) can be effective for treatment and management of its symptoms. Furthermore, group cognitive behavioral therapy (GCBT) is emerging...

Chronic stress experienced at work is considered a major health challenge for modern societies. In fact there is ample evidence that deleterious work environments, based on high efforts in relation to few rewards, substantially augment the risk for a number of highly prevalent diseases (e.g. ischemic heart disease, stroke). One potential pathway me...

Thyroid hormones (THs) play a key role within the endocrine system. Incorporated biomarkers in hair can reflect endogenous excretion patterns over several months. We present an online solid phase extraction-liquid chromatography-mass spectrometry (online SPE-LC-MS/MS) method for quantification of THs in human hair and test it in the volunteers suff...

Depressive and anxiety disorders substantially contribute to the global burden of disease, particularly in poor countries. Higher prevalence rates for both disorders among women indicate sex hormones may be integrated in the pathophysiology of these disorders. The Kshetriya Gramin Financial Services study surveyed a random sample of 4160 households...

Background: Infidelity in romantic relationships is a common, but severe issue often causing breakup and severe psychological impairment. Higher levels of testosterone are related to mating-behavior, sexual desire, and infidelity in men with sexual dysfunctions. Previous studies, have insufficiently addressed the potential role of testosterone in...

Although demographic statistics show that populations around the world are rapidly ageing, this rising life expectancy is accompanied by an increase in the number of people living with age-related chronic conditions, such as frailty, cognitive decline, depression, or sexual dysfunction. In men, a progressive decline in androgens occurs with increas...

Background: Rodent and human studies indicate that testosterone has an antidepressant effect. The mechanisms via which testosterone exerts its antidepressant effect, however, remain to be elucidated. Some studies assume downstream effects of testosterone on sexual function and vitality followed by improvement of mood. Emerging evidence suggests tha...

The ratio between the length of the second (index) and the fourth (ring) finger (2D4D) is a putative biomarker of prenatal testosterone (T) exposure, with higher exposure leading to a smaller ratio. 2D4D has further been linked to mental and somatic disorders. Healthy male Swiss recruits (N = 245; Mage = 20.30 years) underwent a psychosocial stress...

Importance Countering depressive disorders is a public health priority. Currently, antidepressants are the first-line treatment, although they show modest effects. In men, testosterone treatment is a controversial alternative or adjunct treatment option. Objectives To examine the association of testosterone treatment with alleviation of depressive...

Importance: Countering depressive disorders is a public health priority. Currently, antidepressants are the first-line treatment, although they show modest effects. In men, testosterone treatment is a controversial alternative or adjunct treatment option. Objectives: To examine the association of testosterone treatment with alleviation of depressi...

Omic sciences coupled with novel computational approaches such as machine intelligence offer completely new approaches to major depressive disorder (MDD) research. The complexity of MDD's pathophysiology is being integrated into studies examining MDD's biology within the omic fields. Lipidomics, as a late-comer among other omic fields, is increasin...

Nowadays, people spend a considerable amount of their lives as older adults, but this longer lifespan is often accompanied by an increase in chronic conditions and disease, resulting in reduced quality of life and unprecedented societal and economic burden. Healthy aging is therefore increasingly recognized as a healthcare priority. Physical and me...

In males, age‐related decline in free testosterone (T) and dehydroepiandrosterone (DHEA) by 2–3% per year has been reported. Estradiol (E2) and progesterone (P) seem to decrease as well, but to a lesser extent. Lower sex steroid levels in men have been related to physical and mental symptoms. Low birthweight and left‐/mixed‐handedness (L/MH) are in...

Background: Male adolescents and young men benefit when their mental health care is specialized to match their unique gendered and developmental needs. Sensitivity to the social circumstances of this population is important; additionally, the emerging ability to tailor care through knowledge gleaned from the intersection of psychiatry, neurology,...

Background: Higher age is associated to a variety of physical and mental disorders. Age-related changes in steroid secretion have been suggested to be an underlying mechanism leading to frailty, depression, and sexual dysfunction. However, Tai chi qigong and similar forms of exercise have been shown to improve a great variety of health-related par...

The morbidity and societal burden of youth bipolar spectrum disorders (BSD) are high. These disorders are multisystemic in that adult populations there are clear interactions with inflammatory processes and steroidal physiological systems. There are much less data concerning these areas of study in youth populations with BSD. This is surprising giv...

Although aging increases the risk of cognitive and socioemotional deterioration, it has also been shown to be accompanied by an increase in experienced positive emotions and a decrease in negative emotions. Steroid hormones and age-related alterations in secretion patterns have been suggested to play a crucial role in these age-related changes in e...