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Psychiatric Manifestations in Young Females with Congenital Adrenal Hyperplasia in Taiwan

Author(s): Hsin-Yi Liang | Hsueh-Ling Chang | Ching-Yen Chen | Pei-Yeh Chang | Fu-Sung Lo | Li-Wei Lee

Journal: Chang Gung Medical Journal
ISSN 2072-0939

Volume: 31;
Issue: 01;
Start page: 66;
Date: 2008;
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Keywords: congenital adrenal hyperplasia (CAH) | psychiatric comorbidity

Background: Congenital adrenal hyperplasia (CAH) is a syndrome of prenatal and/or postnatalandrogen excess secondary to genetic deficits in the cytochrome p450enzymes of the cortisol synthesis pathway. Women with CAH may sufferfrom different degrees of androgenization. This study documented psychiatricmanifestations in young women born with CAH in Taiwan.Methods: From July 1, 2005 to February 31, 2006 the psychiatric morbidity, genderidentity and sex-typed behavior during childhood of 11 young women withCAH were assessed either using questionnaire-based semi-structured interviewsor self-reported questionnaires.Results: Of the 11 young women (mean age 15.3 5.6 years), 3 (27.3%) had saltwastingCAH and 8 (72.7%) had simple-virilizing CAH. Two patients withoutprior gender assignment (delayed diagnosis) were evaluated for primaryamenorrhea at age 19 and 24 years, respectively. Four of the eleven participants(36.4%) had had an axis I psychiatric diagnosis within the past year.The subjects with more atypical sex-typed behavior in childhood tended tohave a higher risk of minor psychiatric illness (r = –0.706, p < 0.05).Conclusions: This study examined the impact of CAH on the patients’ psychological wellbeing.Psychiatric needs were found to be unmet. Earlier psychiatric evaluationand intervention for these patients is suggested.

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