Psychological Outcome in Congenital Adrenal Hyperplasia

  • Sheri A. Berenbaum
Part of the Serono Symposia USA book series (SERONOSYMP)


Studies of psychological outcome in congenital adrenal hyperplasia due to 21-hydroxylase deficiency (CAH) are important for three reasons.* First, this information helps in the medical management of the patients, as well as in educating patients and their families about the likely course and consequences of the disease. This is a particular concern in CAH because changes in physical appearance and growth (including virilization in girls and short stature in both boys and girls) may affect psychological development. Second, CAH provides a unique opportunity to examine the effects of prenatal and neonatal hormones on the development of the brain and behavior because individuals with CAH are exposed to high levels of androgen beginning early in gestation and continuing throughout important periods for brain development. Thus, studies of CAH allow us to confirm studies in nonhuman mammalian species, which indicate that gonadal hormones play a major role in the development of sex differences in behavior and in the brain (1,2). Third, resolutions of controversies in the treatment of girls with CAH depend on adequate data. This includes the benefits versus the costs of prenatal treatment and the best age for surgical reconstruction of virilized genitalia. These issues have become increasingly important with the addition of CAH to many state and national newborn screening programs and the increased number of cases detected (3,4).


Gender Identity Congenital Adrenal Hyperplasia Psychological Outcome Androgen Effect Early Androgen 
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© Springer Science+Business Media New York 2000

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  • Sheri A. Berenbaum

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