Congenital Adrenal Hyperplasia, Polycystic Ovary Syndrome and criminal behavior: A Swedish population based study

Gotby, Agnes Ohlsson; Nordenström, Anna; Falhammar, Henrik; Nordenskjöld, Agneta; Hirschberg, Angelica Lindén; Frisén, Louise; Landén, Mikael; Lichtenstein, Paul

doi:10.1016/j.psychres.2015.07.008

Cited by 11 publications

(6 citation statements)

References 63 publications

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“…These may use information from screening programs, hospital morbidity data, or data from specific disease registries or clinic samples, providing there are patient identifiers (such as date of birth) that are common to all datasets. In countries that operate a newborn screening program for CAH or have a national disease register, data can be linked to morbidity and mortality datasets and analyzed progressively, providing information on a wide range of outcomes [7, 66-69]. These can also be combined with other data sources, such as stored pharmaceutical prescription data, which can act as proxies for underlying diagnoses or even act as indices of severity [45].…”

Section: Epidemiological Considerationsmentioning

confidence: 99%

Adrenal Crises in Children: Perspectives and Research Directions

et al. 2018

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Adrenal crises (AC) are life-threatening physiological disturbances that occur at a rate of 5–10/100 patient years in patients with adrenal insufficiency (AI). Despite their seriousness, there is a paucity of information on the epidemiology of AC events in the paediatric population specifically, as most investigations have focused on AI and ACs in adults. Improved surveillance of AC-related morbidity and mortality should improve the delineation of AC risk overall and among different subgroups of paediatric patients with AI. Valid incidence measures are essential for this purpose and also for the evaluation of interventions aimed at reducing adverse health outcomes from ACs. However, the absence of an agreed AC definition limits the potential benefit of research and surveillance in this area. While approaches to the treatment and prevention of ACs have much in common across the lifespan, there are important differences between children and adults with regards to the physiological, psychological, and social milieu in which these events occur. Education is considered to be an essential element of AC prevention but studies have shown that ACs occur even among well-educated patients, suggesting that new strategies may be needed. In this review, we examine the current knowledge regarding AC events in children with AI; assess the existing definitions of an AC and offer a new definition for use in research and the clinic; and suggest areas for further investigation that are aimed at reducing the incidence and health impact of ACs in the paediatric age group.

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Section: Epidemiological Considerationsmentioning

confidence: 99%

Adrenal Crises in Children: Perspectives and Research Directions

et al. 2018

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“…Psychological research on females with CAH has investigated the impact of androgens on gender typical play [ 38 ], sex-typed toy preference [ 39 , 40 ], gender identity [ 41 , 42 ], gendered occupational interest [ 43 – 45 ], sexual behavior [ 45 – 47 ], levels of aggression [ 48 ], and spatial abilities [ 49 ]. Females with classic 21OHD have also served as human models for the study of early androgen exposure effects on the developing brain [ 50 , 51 ]. While knowledge about females with CAH is important and needed, there is a definite lack of literature exploring the potential psychological consequences of CAH in males, probably explained by the assumption that males with CAH are exposed to normal prenatal androgen levels [ 52 ].…”

Section: Introductionmentioning

confidence: 99%

Psychological adjustment, quality of life, and self-perceptions of reproductive health in males with congenital adrenal hyperplasia: a systematic review

et al. 2018

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PurposeCongenital adrenal hyperplasia (CAH) has been shown to potentially affect psychological adjustment. However, most research has focused on females, and knowledge about psychological challenges in males remains sparse. The aim of this systematic review was therefore to assess these in males with CAH.MethodsWe systematically searched the OVID Medline, PsycINFO, CINAHL, and Web of Science databases, for articles published up to April 20, 2018, investigating psychological adjustment in males with CAH.ResultsEleven studies were included in the review. Three main health domains were identified: psychological and psychiatric health, quality of life (QoL), and self-perceptions of reproductive health. Some studies covered more than one health domain. Seven studies explored psychological adjustment and/or the presence of psychiatric symptoms or disorders. Results indicated that males with CAH had more problems related to internalizing behaviors (negative behaviors directed toward the self) and more negative emotionality compared to reference groups. Six studies examined QoL, five of them reporting reduced QoL compared to reference groups. Three studies explored the impact of fertility and sexual health issues on psychological health with varying results from impaired to normal sexual well-being.ConclusionsCAH seems to have an impact on males' psychological health. However, the number of identified studies was limited, included few participants, and revealed divergent findings, demonstrating the need for larger studies and highlighting a number of methodological challenges that should be addressed by future research.

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“…Testosterone concentrations have been reported to be associated with violence and criminal behavior ( 30 ). However, a national population-based study by our group did not find any association with CAH and conviction of any crime, violent crime, or sex crime ( 31 ). Interestingly, these convictions were increased in women with polycystic ovary syndrome (ie, a condition with increased concentrations of androgens postnatally) ( 31 ).…”

Section: Discussionmentioning

confidence: 58%

Increased Prevalence of Accidents and Injuries in Congenital Adrenal Hyperplasia: A Population-based Cohort Study

Falhammar,

Hirschberg,

Nordenskjöld

et al. 2023

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context It has been suggested that injuries and accidents are increased in females with congenital adrenal hyperplasia (CAH), but the prevalence is unclear. Objective To study the prevalence of injuries and accidents in females and males with CAH. Design, Setting, and Participants Patients with CAH (n = 714, all 21-hydroxylase deficiency) were compared with matched controls (n = 71,400). Data were derived by linking National Population-Based Registers. Main Outcome Measures Prevalence of injuries and accidents. Results Mean age was 29.8 ± 18.4 years. Injuries were more prevalent in patients with CAH than in controls (RR 1.34, 95%CI 1.24-1.44), and this was found in both sexes (females: 1.43, 1.29-1.58; males: 1.25, 1.12-1.38). In the classical phenotype, the prevalence of injuries was higher, especially in females but not in the non-classic phenotype. In the genotype groups, injuries were mainly increased in females. Head injuries were increased in all patients with CAH and in the different phenotypes and were mainly driven by females. More patients with CAH born before the introduction of neonatal screening had had an injury compared to controls (1.48, 1.35-1.62), this was seen in both sexes. In patients with CAH born after the introduction of screening, the prevalence of injuries was overall increased (1.20, 1.07-1.35), and in females with CAH but not in males. Accidents showed a similar pattern to injuries in all comparisons. Conclusions Patients with CAH had an increased prevalence of both injuries and accidents, especially in females and in those born before the neonatal screening program. Patients with NC phenotype were hardly affected.

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Congenital Adrenal Hyperplasia, Polycystic Ovary Syndrome and criminal behavior: A Swedish population based study

Cited by 11 publications

References 63 publications

Adrenal Crises in Children: Perspectives and Research Directions

Adrenal Crises in Children: Perspectives and Research Directions

Psychological adjustment, quality of life, and self-perceptions of reproductive health in males with congenital adrenal hyperplasia: a systematic review

Increased Prevalence of Accidents and Injuries in Congenital Adrenal Hyperplasia: A Population-based Cohort Study

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