Psychological vulnerability to stress in carriers of congenital adrenal hyperplasia due to 21-hydroxylase deficiency
| Autor: | Evangelia Charmandari, Georgia Koltsida, George P. Chrousos, Emilia Mantzou, Eleni Magdalini Kyritsi, Emmanouil Zoumakis, Ioanna Farakla, Elena Critselis, Gerasimos Kolaitis, Aikaterini Papanikolaou |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Paranoid Disorders medicine.medical_specialty Hydrocortisone Psychometrics Endocrinology Diabetes and Metabolism Stimulation Anxiety Excretion 03 medical and health sciences 0302 clinical medicine Congenital adrenal hyperplasia due to 21-hydroxylase deficiency Adrenocorticotropic Hormone Internal medicine Psychoticism Medicine Humans Congenital adrenal hyperplasia Androstenedione Adrenal Hyperplasia Congenital business.industry 17-alpha-Hydroxyprogesterone General Medicine Middle Aged medicine.disease 030227 psychiatry Endocrinology Psychotic Disorders Case-Control Studies Temperament and Character Inventory Female medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Hormones (Athens, Greece). 16(1) |
| ISSN: | 2520-8721 |
| Popis: | Objective: Carriers of congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21-OHD) demonstrate increased secretion of cortisol precursors following ACTH stimulation, suggestive of impaired cortisol production and compensatory increases in hypothalamic corticotropin-releasing hormone (CRH) secretion. Both cortisol and CRH have behavioural effects, and hypothalamic CRH hypersecretion has been associated with chronic states of anxiety and depression. We performed endocrinologic and psychological evaluation in carriers of 21-OHD and matched control subjects. Design: We recruited twenty-nine parents of children with classic CAH (14 males, 15 females; age (mean ± SD ): 41. 8 ± 5.7 yr), and hence 21-OHD carriers , and 13 normal subjects (5 males, 8 females; age: 43. 8 ± 6.1 yr). All subjects underwent a formal ovine (o) CRH stimulation test with measurement of ACTH, cortisol, 17-hydroxyprogesterone (17-OHP), and androstenedione concentrations, which was preceded by determination of 24-hour urinary free cortisol (UFC) excretion. Psychometric assessment was performed by administering the State-Anxiety (STAI1) and Trait-Anxiety (STAI2) Inventory, Beck Depression Inventory, Symptom Checklist-90R, and Temperament and Character Inventory. Results: Carriers of 21-OHD had significantly higher 17-OHP concentrations following oCRH stimulation and higher STAI1 (47.6 ± 5.6 vs. 43.3 ± 5.4 , P=0.023 ) scores than control subjects. Mean 24-hour UFC concentrations were positively correlated with paranoid ideation (r=0.435; P=0.023 ) and psychoticism (r=0.454; P=0.017 ). Stepwise multiple linear regression analysis revealed that the single independent predictor of STAI1 was peak stimulated 17-OHP concentrations (β: 0.055, SE: 0.023, R 2 : 0.290, P=0.031 ). Conclusions: Carriers of 21-OHD may be predisposed to the development of anxiety disorders. |
| Databáze: | OpenAIRE |
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