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題名 | Psychiatric Manifestations in Young Females with Congenital Adrenal Hyperplasia in Taiwan=患有先天性腎上腺素增生之年輕女性患者之精神症狀表現 |
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作者 | 梁歆宜; 張學岺; 陳景彥; 張北葉; 羅福松; 李立維; Liang, Hsin-yi; Chang, Hsueh-ling; Chen, Ching-yen; Chang, Pei-yeh; Lo, Fu-sung; Lee, Li-wei; |
期刊 | 長庚醫學 |
出版日期 | 20080100、20080200 |
卷期 | 31:1 2008.01-02[民97.01-02] |
頁次 | 頁66-73 |
分類號 | 415.952 |
語文 | eng |
關鍵詞 | 先天性腎上腺素增生; 精神科共病症; Congenital adrenal hyperplasia; CAH; Psychiatric comorbidity; |
中文摘要 | 背景:患有先天性腎上腺素增生之患者,在胎兒時期暴露在過多的雄性激素,導致外生殖器、性徵、幼年時期行為,皆可能出現不同程度的雄性化表現。相關議題及病患心性適應等問題在國外已有不少的研究,但國內卻鮮少有此相關研究。因此,本實驗目的試圖探討臺灣地區患有先天性腎上腺素增生之年輕女性患者之精神症狀表現。 方法:研究對象為11名患有先天性腎上腺素增生之年輕女性患者。以半結構式之診斷性會談及自增問卷評估受試者之精神疾患共病症性別認同及幼兒時期性別類型行為。 結果:受試者平均年齡為15.3±5.6歲。36.4%之受試者患有精神科第一軸診斷。分別為輕鬱症、適應障礙、社交恐懼症,及未分類之性別認同障礙。受試者在幼年期出現較雄性化之表現傾向有較高之精神科輕型寂患之罹病率(r=-0.706, p=0.015)。 結論:本研究發現,臺灣地區患有先天性腎上腺素增生之患者,有較高的精神疾患共病症。建議精神科儘早診斷及介入,以協助病患適應。 |
英文摘要 | Background: Congenital adrenal hyperplasia (CAH) is a syndrome of prenatal and/or postnatal androgen excess secondary to genetic deficits in the cytochrome p450 enzymes of the cortisol synthesis pathway. Women with CAH may suffer from different degrees of androgenization. This study documented psychiatric manifestations in young women born with CAH in Taiwan. Methods: From July 1, 2005 to February 31, 2006 the psychiatric morbidity, gender identity and sex-typed behavior during childhood of 11 young women with CAH were assessed either using questionnaire-based semi-structured interviews or self-reported questionnaires. Results: Of the 11 young women (mean age 15.3 5.6 years), 3 (27.3%) had salt-wasting CAH and 8 (72.7%) had simple-virilizing CAH. Two patients without prior gender assignment (delayed diagnosis) were evaluated for primary amenorrhea at age 19 and 24 years, respectively. Four of the eleven participants (36.4%) had had an axis I psychiatric diagnosis within the past year. The subjects with more atypical sex-typed behavior in childhood tended to have a higher risk of minor psychiatric illness (r = V0.706, p < 0.05). Conclusions: This study examined the impact of CAH on the patient’s psychological wellbeing. Psychiatric needs were found to be unmet. Earlier psychiatric evaluation and intervention for these patients is suggested. |
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