title: Psychiatric approaches for disorders of sex development: experience of a multidisciplinary team.
abstract: OBJECTIVE
  Disorders of sex development (DSD) are a group of congenital medical conditions that affect life as a whole. In this study, we aimed to reflect the experience of a multidisciplinary team in the clinical/psychiatric follow-up of a group of children and adolescents with DSD.
  
  
  METHODS
  The study group consisted of 51 patients diagnosed with DSD. The Kiddie-Schedule for Affective Disorders and Schizophrenia, Wechsler Intelligence Scale for Children-Revised, Draw a Person Test and Children's Apperception Test, and the Clinical Global Impression Scale (CGIS) were used for psychiatric evaluations.
  
  
  RESULTS
  The mean age of the patients was 7.8 years (median: 7.8; min: 1.0; max: 18.0). Genetic evaluation showed 46,XX configuration in 15 patients (29.4%) and 46,XY in 35 (68.6%). One patient (2.0%) was diagnosed to have a sex chromosome disorder. Forty patients (78.4%) had no problems with their given gender identity and gender role. Thirty-four (66.7%) patients had normal intellectual capacity. Twenty-eight (54.9%) patients did not have any psychiatric problem. Depression, anxiety disorders, attention deficit/hyperactivity disorder, and adjustment disorders were the common diagnoses. The mean score of symptom severity on CGIS-severity-baseline was 6.15±0.68 and after one year, it was 1.46±0.51 (Z=-3.236 p=0.001). The mean score of CGI-Improvement was 1.23±0.44.
  
  
  CONCLUSIONS
  It is important to identify and treat the psychiatric disorders encountered in patients with DSD. A psychiatrist needs to be included in the professional team following these patients. Examination and observation results need to be shared by holding periodic team meetings to establish a wholesome point of view for every unique child.
authors.affiliation: Ege University Faculty of Medicine, Child and Adolescent Psychiatry, İzmir, Turkey. E-mail: drbbeker@yahoo.com.
authors.forename: Burcu
authors.initials: B
authors.lastname: Özbaran
authors.forename: Samim
authors.initials: S
authors.lastname: Özen
authors.forename: Damla
authors.initials: D
authors.lastname: Gökşen
authors.forename: Özlem
authors.initials: Ö
authors.lastname: Korkmaz
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Onay
authors.forename: Ferda
authors.initials: F
authors.lastname: Özkınay
authors.forename: Özgür
authors.initials: Ö
authors.lastname: Çoğulu
authors.forename: Serpil
authors.initials: S
authors.lastname: Erermiş
authors.forename: Sezen
authors.initials: S
authors.lastname: Köse
authors.forename: Ali
authors.initials: A
authors.lastname: Avanoğlu
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Ulman
authors.forename: Şükran
authors.initials: Ş
authors.lastname: Darcan
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D039721:Diagnostic and Statistical Manual of Mental Disorders; D012734:Disorders of Sex Development / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007621:Karyotyping; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D010348:Patient Care Team; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D014888:Wechsler Scales