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Psychiatric characterization of children with genetic causes of hyperandrogenism

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Abstract
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.
Keywords
ATTENTION-DEFICIT/HYPERACTIVITY DISORDER, LUTEINIZING-HORMONE RECEPTOR, CORTICOTROPIN-RELEASING-FACTOR, CONGENITAL ADRENAL-HYPERPLASIA, MALE PRECOCIOUS PUBERTY, TOURETTES-SYNDROME, ANDROGENIC STEROIDS, CONDUCT DISORDER, SEX-DIFFERENCES, K-SADS

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Citation

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MLA
Müller, Sven et al. “Psychiatric Characterization of Children with Genetic Causes of Hyperandrogenism.” EUROPEAN JOURNAL OF ENDOCRINOLOGY 163.5 (2010): 801–810. Print.
APA
Müller, S., Ng, P., Sinaii, N., Leschek, E., Green-Golan, L., VanRyzin, C., Ernst, M., et al. (2010). Psychiatric characterization of children with genetic causes of hyperandrogenism. EUROPEAN JOURNAL OF ENDOCRINOLOGY, 163(5), 801–810.
Chicago author-date
Müller, Sven, Pamela Ng, Ninet Sinaii, Ellen Leschek, Liza Green-Golan, Carol VanRyzin, Monique Ernst, and Deborah Merke. 2010. “Psychiatric Characterization of Children with Genetic Causes of Hyperandrogenism.” European Journal of Endocrinology 163 (5): 801–810.
Chicago author-date (all authors)
Müller, Sven, Pamela Ng, Ninet Sinaii, Ellen Leschek, Liza Green-Golan, Carol VanRyzin, Monique Ernst, and Deborah Merke. 2010. “Psychiatric Characterization of Children with Genetic Causes of Hyperandrogenism.” European Journal of Endocrinology 163 (5): 801–810.
Vancouver
1.
Müller S, Ng P, Sinaii N, Leschek E, Green-Golan L, VanRyzin C, et al. Psychiatric characterization of children with genetic causes of hyperandrogenism. EUROPEAN JOURNAL OF ENDOCRINOLOGY. 2010;163(5):801–10.
IEEE
[1]
S. Müller et al., “Psychiatric characterization of children with genetic causes of hyperandrogenism,” EUROPEAN JOURNAL OF ENDOCRINOLOGY, vol. 163, no. 5, pp. 801–810, 2010.
@article{1929229,
  abstract     = {{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.}},
  author       = {{Müller, Sven and Ng, Pamela and Sinaii, Ninet and Leschek, Ellen and Green-Golan, Liza and VanRyzin, Carol and Ernst, Monique and Merke, Deborah}},
  issn         = {{0804-4643}},
  journal      = {{EUROPEAN JOURNAL OF ENDOCRINOLOGY}},
  keywords     = {{ATTENTION-DEFICIT/HYPERACTIVITY DISORDER,LUTEINIZING-HORMONE RECEPTOR,CORTICOTROPIN-RELEASING-FACTOR,CONGENITAL ADRENAL-HYPERPLASIA,MALE PRECOCIOUS PUBERTY,TOURETTES-SYNDROME,ANDROGENIC STEROIDS,CONDUCT DISORDER,SEX-DIFFERENCES,K-SADS}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{801--810}},
  title        = {{Psychiatric characterization of children with genetic causes of hyperandrogenism}},
  url          = {{http://dx.doi.org/10.1530/EJE-10-0693}},
  volume       = {{163}},
  year         = {{2010}},
}

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