Psychiatric characterization of children with genetic causes of hyperandrogenism
Open accessAbstract
Objective: Very little is known about the mental health status in children with genetic causes of hyperandrogenism. This study sought to characterize psychiatric morbidity in this group. Design/methods: Children (8–18 years) with the diagnosis of classic congenital adrenal hyperplasia (CAH) or familial male precocious puberty (FMPP) underwent a semi-structured psychiatric interview, the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. According to sex and the literature, incidence of identified psychopathology was compared between the two endocrinological groups. We evaluated 72 patients: 54 CAH (21 females) and 18 FMPP. Results: Twenty-four (44.4%) CAH patients and 10 (55.6%) FMPP patients met the criteria for at least one lifetime psychiatric diagnosis. Attention-deficit hyperactivity disorder (ADHD) was present in 18.2% of CAH males, 44.4% of FMPP males, and one case (4.8%) in CAH females. A high rate of anxiety disorders was also found in all the three groups (17–21%). Relative to females with CAH, the FMPP patients exhibited higher rates of ADHD. Age at diagnosis and the treatment modalities were not associated with psychopathology. Rates of psychiatric disorder, specifically ADHD and anxiety disorders, were higher than in the general population. Conclusion: Although anxiety disorders may occur at an increased rate in children with chronic illness, androgens may contribute to higher risk for psychopathology in pediatric patients with genetic cause of excess androgen. Early diagnosis and treatment of childhood hyperandrogenism is essential for optimal development. The results suggest that assessment for psychiatric disorders should be part of the routine evaluation of these patients.
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The low interest in motherhood in women with SW CAH may be caused by effects of prenatal androgen exposure on gender role behavior, including reduced interest in infants, lack of a partner, dissatisfaction with genital appearance, decreased sexual satisfaction, and urogenital and sexual dysfunction as a result of corrective surgery.
“This may be caused by the effects of prenatal androgen exposure on gender role behavior, including reduced interest in infants (592,660), the lack of a partner, dissatisfaction with genital appearance, decreased sexual satisfaction, and urogenital and sexual dysfunction as a result of corrective surgery (365).”
From Congenital Adrenal Hyperplasia—Current Insights in Pathophysiology, Diagnostics, and Management (2022) · cites this paper as [592]
The Introduction reports more male-typical traits and behaviors in girls with CAH and discusses early androgen exposure as a possible influence on behavior. It does not address reduced interest in infants or link that interest to low interest in motherhood. The later claims about partners, genital appearance, sexual satisfaction, and surgery are attached to a different citation. (LLM, conf=0.78)
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Congenital Adrenal Hyperplasia—Current Insights in Pathophysiology, Diagnostics, and Management
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- Authors
- Mueller, S. C., Ng, P., Sinaii, N., Leschek, E. W., Green-Golan, L., VanRyzin, C., Ernst, M., & Merke, D. P.
- Affiliations
- National Institutes of Health (US)
- Venue
- European Journal of Endocrinology
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-11
- Volume
- 163
- Issue
- 5
- Pages
- 801-810
- ISSN
- 0804-4643 (ISSN-L)
- 1479-683X
- PMC
- PMC5576023
- OpenAlex
- W2157865750
- Cited by
- 88
- References
- 60
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 5 · 2023: 6 · 2022: 4 · 2021: 8 · 2020: 9 · 2019: 5 · 2018: 7 · 2017: 1 · 2016: 4 · 2015: 6 · 2014: 3 · 2013: 7 · 2012: 3
- FWCI
- 2.22
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- European Journal of Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion, other-oa)
- Funders
- CARES Foundation
- National Institutes of Health (Z99CL999999)
- National Institute of Mental Health
- National Institute of Child Health and Human Development
- NIH Clinical Center
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- hyperandrogenism, congenital adrenal hyperplasia, psychiatric morbidity, attention deficit hyperactivity disorder, anxiety disorders, children, androgens, psychopathology
- MeSH terms
- Adolescent, Adrenal Hyperplasia, Congenital, Anxiety, Attention Deficit Disorder with Hyperactivity, Mental Disorders, Child, Female, Humans, Male, Puberty, Precocious, Hyperandrogenism
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