title: Long-term effects of oxandrolone treatment in childhood on neurocognition, quality of life and social-emotional functioning in young adults with Turner syndrome.
abstract: Turner syndrome (TS) is the result of (partial) absence of one X-chromosome. Besides short stature, gonadal dysgenesis and other physical aspects, TS women have typical psychological features. Since psychological effects of androgen exposure in childhood probably are long-lasting, we explored long-term psychological functioning after oxandrolone (Ox) therapy during childhood in adults with TS in terms of neurocognition, quality of life and social-emotional functioning. During the initial study, girls were treated with growth hormone (GH) combined with placebo (Pl), Ox 0.03 mg/kg/day, or Ox 0.06 mg/kg/day from the age of eight, and estrogen from the age of twelve. Sixty-eight women participated in the current double-blinded follow-up study (mean age 24.0 years, mean time since stopping GH/Ox 8.7 years). We found no effects on neurocognition. Concerning quality of life women treated with Ox had higher anxiety levels (STAI 37.4 ± 8.4 vs 31.8 ± 5.0, p=0.002) and higher scores on the depression subscale of the SCL-90-R (25.7 ± 10.7 vs 20.5 ± 4.7, p=0.01). Regarding social-emotional functioning, emotion perception for fearful faces was lower in the Ox-treated patients, without effect on interpersonal behavior. Our exploratory study is the first to suggest that androgen treatment in adolescence possibly has long-term effects on adult quality of life and social-emotional functioning. However, differences are small and clinical implications of our results seem limited. Therefore we would not recommend against the use of Ox in light of psychological consequences.
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Center, 471, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Electronic address: Kim.Freriks@radboudumc.nl.
authors.forename: K
authors.initials: K
authors.lastname: Freriks
authors.affiliation: Department of Medical Psychology, Radboud University Medical Center, 118/925, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
authors.forename: C M
authors.initials: CM
authors.lastname: Verhaak
authors.affiliation: Department of Pediatrics, Erasmus Medical Centre/Sophia Children's Hospital, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands; Department of Pediatrics, Albert Schweitzer Hospital, P.O. Box 444, 3300 AK Dordrecht, The Netherlands.
authors.forename: T C J
authors.initials: TC
authors.lastname: Sas
authors.affiliation: Department of Pediatrics, Leiden University Medical Center, J6S, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
authors.forename: L A
authors.initials: LA
authors.lastname: Menke
authors.affiliation: Department of Pediatrics, Leiden University Medical Center, J6S, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: Wit
authors.affiliation: Department of Pediatrics, Radboud University Medical Center, 804, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
authors.forename: B J
authors.initials: BJ
authors.lastname: Otten
authors.affiliation: Department of Pediatrics, Erasmus Medical Centre/Sophia Children's Hospital, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands.
authors.forename: S M P F
authors.initials: SM
authors.lastname: de Muinck Keizer-Schrama
authors.affiliation: Department of Human Genetics, Radboud University Medical Center, 848, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
authors.forename: D F C M
authors.initials: DF
authors.lastname: Smeets
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Center, 471, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
authors.forename: R T
authors.initials: RT
authors.lastname: Netea-Maier
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Center, 471, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
authors.forename: A R M M
authors.initials: AR
authors.lastname: Hermus
authors.affiliation: Department of Medical Psychology, Radboud University Medical Center, 118/925, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands; Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, The Netherlands.
authors.forename: R P C
authors.initials: RP
authors.lastname: Kessels
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Center, 471, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
authors.forename: H J L M
authors.initials: HJ
authors.lastname: Timmers
mesh_terms: D000293:Adolescent; D000328:Adult; D000728:Androgens / Q000008:administration & dosage; D003071:Cognition / Q000187:drug effects*; D003863:Depression / Q000188:drug therapy / Q000523:psychology; D056348:Emotional Intelligence / Q000187:drug effects*; D004644:Emotions / Q000187:drug effects*; D004967:Estrogens / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D013006:Growth Hormone / Q000627:therapeutic use; D019382:Human Growth Hormone / Q000008:administration & dosage; D006801:Humans; D010074:Oxandrolone / Q000008:administration & dosage / Q000494:pharmacology*; D011788:Quality of Life / Q000523:psychology; D013997:Time Factors; D014424:Turner Syndrome / Q000188:drug therapy* / Q000523:psychology; D055815:Young Adult
chemical_list: D000728:Androgens; D004967:Estrogens; D019382:Human Growth Hormone; D010074:Oxandrolone; D013006:Growth Hormone
keywords: Androgen; Intelligence; Neurocognition; Psychosexual wellbeing; Quality of life; Social–emotional functioning; Turner syndrome