Psychological impact of congenital adrenal hyperplasia on adolescent and young girls in Saudi Arabia

Abstract

Background: Congenital adrenal hyperplasia (CAH) consists of a family of defects in the synthesis of steroid hormone in the adrenal cortex which results in high androgen levels. The androgen excess is present from early embryogenesis and results in varying degrees of virilization of the external genitalia. It can lead to major medical and psycho-social consequences. Design and setting: Eight Saudi adolescent and young women whose age ranged between 15 to 25 y with variable severity of CAH were studied to determine the psychosocial impact at the endocrine service, King Khalid University Hospital (KKUH) Riyadh, Saudi Arabia in the period July 2017 to June 2018. Objective: The aim of this study was to determine the psychological impact of CAH on adolescent and young women who were diagnosis and appropriately reared in the early life. Methods: Eight Saudi adolescent and young women with similar clinical characteristics where chosen from a cohort of sixty four patients with CAH. Psychosocial information were gathering during a clinic visits from both participant and parents. Participants were interviewed by the primary treating endocrinologist (principal author NJ) to facilitate trust and confidence, utilizing the child behaviour checklist (CBCL) questioner. Results: There were significant differences between females with CAH diagnosed early in life and reared as females with higher incidence of anxiety, depression (25%), withdrawn/depressed behaviour (25%) and somatic complaints (75%), which depend on the variation of the severity. Conclusion: Psychological adjustment is variable in females with CAH who were diagnosed and properly reared in early life. Adjustment depends on the severity of the disease. Future multicentre studies involving CAH patients in Saudi Arabia are needed to ensure large sample size. In addition, further researchers should concentrate on various aspects of psychosocial issues of CAH.

Experience with Congenital Adrenal Hyperplasia in Tripoli Children's Hospital, Libya

“…5 Also, the patients in Asian countries where parental consanguinity with CAH ranged from 52.3 to 82%. 16 18 19 20 CAH is the most common adrenal disorder in childhood and was documented to be the most common cause of ambiguous genitalia in newborns. 21 This was also reflected in the present study in which half of the children presented with genital ambiguity.…”