TY - JOUR
AU - B. S. Khorashad
AU - O. Kaabi
AU - M. D. Gardner
AU - D. Getahun
AU - M. Goodman
AU - T. L. Lash
AU - P. A. Lee
AU - J. May
AU - C. McCracken
AU - M. Muzik
AU - S. Vupputuri
AU - R. Yacoub
AU - D. E. Sandberg
A1 - 
AB - CONTEXT: Although the increased burden of mental health problems among patients with classic 46,XX congenital adrenal hyperplasia (CAH) is well-documented, it remains unclear if this comorbidity is attributable to the burden of living with a chronic medical condition or the potential psychosocial/sexual consequences of being born with a difference of sex development (DSD) and its associated clinical management. OBJECTIVE: To compare the prevalence of psychiatric diagnoses among patients with CAH and 3 reference groups: matched males and females from the general population, and females with type 1 diabetes mellitus (T1DM). METHODS: This was a retrospective cross-sectional study using 3 large integrated health systems. Participants included patients with CAH (n = 115), general population male and female referents (n = 1150 per group), and 66 002 female T1DM referents. RESULTS: The prevalence of depression, anxiety, personality disorders, and suicidal ideation was higher among CAH participants than in males and females from the general population, but similar to or lower than in T1DM referents. Patients with CAH were more likely to be diagnosed with neurodevelopmental disorders than both female reference groups, whereas the prevalence of elimination disorders (predominantly enuresis) and gender dysphoria was higher in the CAH cohort than in all reference groups. CONCLUSION: Females with classic CAH experience a higher burden of psychiatric illness, including anxiety and depression, than demographically similar men and women in the general population. The similar psychiatric burden between females with CAH and T1DM suggests that morbidity may be influenced by the challenges associated with managing a chronic condition. Investigating long-term mental health trajectories in this population will require longitudinal studies.
AD - Susan B. Meister Child Health and Evaluation Research Center, University of Michigan Medical School, Ann Arbor, MI 48109, USA.; Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA.; Huntsman Mental Health Institute, University of Utah, Salt Lake City, UT 84108, USA.; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.; Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA 91101, USA.; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA 91101, USA.; Division of Endocrinology, Department of Pediatrics, Penn State College of Medicine, Hershey, PA 17033, USA.; Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta, GA 30305, USA.; Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI 48109, USA.; Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, MD 20002, USA.
AN - 39656806
BT - J Clin Endocrinol Metab
C5 - Healthcare Disparities
CP - 8
DA - Jul 15
DO - 10.1210/clinem/dgae831
DP - NLM
IS - 8
JF - J Clin Endocrinol Metab
LA - eng
N2 - CONTEXT: Although the increased burden of mental health problems among patients with classic 46,XX congenital adrenal hyperplasia (CAH) is well-documented, it remains unclear if this comorbidity is attributable to the burden of living with a chronic medical condition or the potential psychosocial/sexual consequences of being born with a difference of sex development (DSD) and its associated clinical management. OBJECTIVE: To compare the prevalence of psychiatric diagnoses among patients with CAH and 3 reference groups: matched males and females from the general population, and females with type 1 diabetes mellitus (T1DM). METHODS: This was a retrospective cross-sectional study using 3 large integrated health systems. Participants included patients with CAH (n = 115), general population male and female referents (n = 1150 per group), and 66 002 female T1DM referents. RESULTS: The prevalence of depression, anxiety, personality disorders, and suicidal ideation was higher among CAH participants than in males and females from the general population, but similar to or lower than in T1DM referents. Patients with CAH were more likely to be diagnosed with neurodevelopmental disorders than both female reference groups, whereas the prevalence of elimination disorders (predominantly enuresis) and gender dysphoria was higher in the CAH cohort than in all reference groups. CONCLUSION: Females with classic CAH experience a higher burden of psychiatric illness, including anxiety and depression, than demographically similar men and women in the general population. The similar psychiatric burden between females with CAH and T1DM suggests that morbidity may be influenced by the challenges associated with managing a chronic condition. Investigating long-term mental health trajectories in this population will require longitudinal studies.
PY - 2025
SN - 0021-972X (Print); 0021-972x
SP - e2562
EP - e2569+
ST - Prevalence of Psychiatric Comorbidities in Females With Classic Congenital Adrenal Hyperplasia
T1 - Prevalence of Psychiatric Comorbidities in Females With Classic Congenital Adrenal Hyperplasia
T2 - J Clin Endocrinol Metab
TI - Prevalence of Psychiatric Comorbidities in Females With Classic Congenital Adrenal Hyperplasia
U1 - Healthcare Disparities
U3 - 10.1210/clinem/dgae831
VL - 110
VO - 0021-972X (Print); 0021-972x
Y1 - 2025
ER -