title: An Unusual Case: The Comorbidity of Mood Disorder and 17-α-Hydroxylase Deficiency.
abstract: 17-α-hydroxylase enzyme has a crucial role in the steroid biosynthesis and, deficiency of this enzyme is an autosomal recessive monogenic disorder which is one of the two hypertensive form of congenital adrenal hyperplasia. It is characterized with the deficiency in glucocorticoid, adrenal androgen, and sex steroid synthesis with concomitant mineralocorticoid excess due to genetic defect in steroid biosynthesis. The relationship of hormone system physiology with psychiatric signs and syndromes are complex. Any problem in the hypothalamo-pituitary axis may cause psychiatric syndromes. On the other hand, many psychiatric disorders, such as mood-anxiety symptoms, depression, mania, psychosis, and delirium can be seen secondary to the treatment of hormone deficiency. We present the case of a male patient with pseudohermaphroditism who has been followed and treated in Raşit Tahsin Mood Clinic with the diagnosis of mood disorder not otherwise specified and was diagnosed with 46, XY karyotype and 17-α-hydroxylase deficiency after referring to a hospital with delayed puberty. Considering the medical literature, 17-α-hydroxylase deficiency has been evaluated from the aspects of gender-related behavioral disorders, psychological developmental and anxiety disorders. To the best of our knowledge, in the medical literature, this is the first case of 17-α-hydroxylase deficiency associated with mood disorder. Here, the relationship between mood disorders and hypothalamo-pituitary axis is discussed in the light of the literature.
authors.affiliation: Kars Public Hospital, Kars, Turkey.
authors.forename: Serhat
authors.initials: S
authors.lastname: Tunç
authors.affiliation: Bakırköy Mental Health Hospital, AMATEM, İstanbul, Turkey.
authors.forename: Sera
authors.initials: S
authors.lastname: Yiğiter
authors.affiliation: Çanakkale Onsekiz Mart University Medical Faculty, Department of Psychiatry, Çanakkale, Turkey.
authors.forename: Kürşat
authors.initials: K
authors.lastname: Altinbaş
authors.affiliation: Çanakkale Onsekiz Mart University Medical Faculty, Department of Psychiatry, Çanakkale, Turkey.
authors.forename: Erhan
authors.initials: E
authors.lastname: Kurt
authors.affiliation: İstanbul Ticaret University, Department of Psychology, İstanbul, Turkey.
authors.forename: Timuçin
authors.initials: T
authors.lastname: Oral
keywords: 17-α-hydroxylase deficiency; congenital adrenal hyperplasia; mood disorder; pseudohermaphroditism