Testosterone, estradiol, DHEA and cortisol in relation to anxiety and depression scores in adolescents

•In 2016, we examined 545 boys and girls (ages 11–17y) in rural Ecuador.•Elevated testosterone, cortisol and estradiol were associated with altered mood.•Estradiol had the strongest associations with depression and anxiety scores.•Cortisol and Testosterone were effect modifiers to hormone-mood associations.•There was effect modification between and within the HPA and HPG with mood. Background Adrenal and sex hormone dysregulation have been independently associated with increased depression and anxiety. Cortisol can modify production of sex hormones and hormone-mood associations. This study evaluated associations and interplay of sex and adrenal hormones with depression and anxiety. Methods We assessed 545 Ecuadorian adolescents (11–17y, 50.4% female, ESPINA) for depression and anxiety symptoms using standardized scales. Testosterone, cortisol, dehydroepiandrosterone (DHEA), and estradiol (boys only) were measured in saliva. We performed logistic regression modeling to calculate odds ratios (OR) of elevated depression or anxiety (scores ≥60) comparing participants with low (