Psychiatric manifestations in young females with congenital adrenal hyperplasia in Taiwan.
BACKGROUND
Congenital adrenal hyperplasia (CAH) is a syndrome of prenatal and/or postnatal androgen excess secondary to genetic deficits in the cytochrome p450 enzymes of the cortisol synthesis pathway. Women with CAH may suffer from different degrees of androgenization. This study documented psychiatric manifestations in young women born with CAH in Taiwan.


METHODS
From July 1, 2005 to February 31, 2006 the psychiatric morbidity, gender identity and sex-typed behavior during childhood of 11 young women with CAH were assessed either using questionnaire-based semi-structured interviews or self-reported questionnaires.


RESULTS
Of the 11 young women (mean age 15.3 +/- 5.6 years), 3 (27.3%) had salt-wasting CAH and 8 (72.7%) had simple-virilizing CAH. Two patients without prior gender assignment (delayed diagnosis) were evaluated for primary amenorrhea 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 to have 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 evaluation and intervention for these patients is suggested.
Liang
Hsin-Yi
HY
Department of Child Psychiatry, Chang Gung Memorial Hospital, Taipei, Chang Gung University College of Medicine, Gueishan Township, Taoyuan, Taiwan, ROC.
Chang
Hsueh-Ling
HL
Chen
Ching-Yen
CY
Chang
Pei-Yeh
PY
Lo
Fu-Sung
FS
Lee
Li-Wei
LW
D000293:Adolescent; D000312:Adrenal Hyperplasia, Congenital / Q000150:complications*; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005783:Gender Identity; D006801:Humans; D001523:Mental Disorders / Q000209:etiology*; D009017:Morbidity; D012725:Sexual Behavior