Internal and External Behavior Outcomes in Children with Congenital Adrenal Hyperplasia: A Systematic Review

Abstract

Introduction: Congenital adrenal hyperplasia (CAH) is autosomal recessive disorders that disrupt adrenal steroidogenesis. Congenital adrenal hyperplasia (CAH) has been shown to potentially affect psychological adjustment. However, the behavior effect on glucocorticoid treatment in CAH patient remain unclear. The aim of this systematic review was to assess the internal and external behavior problems in CAH children due to glucocorticoid treatment. Methods: The systematic review was carried out using the PRISMA framework and the search strategy was based on the population, intervention, control, and outcome (PICO) model. The relevant article was search from Cochrane, Google Scholar, PubMed, Science Direct, Springer Link, Wiley Online Library Databases from February and March 2022. Results: Six studies were included in this review. The primary domain identified are internal and external behavior from the CBCL questionnaire. Three studies compared the external and internal behavior of CAH children with glucocorticoid treatment to healthy control, two studies post-natal, and one study during prenatal. Three other studies compared CAH with glucocorticoid treatment and the CAH control group. Conclusion: Children with CAH had better behavioral outcomes, especially in internal behavior in glucocorticoid-exposed children.