Psychiatric morbidity risk higher in men with congenital adrenal hyperplasia
Men with congenital adrenal hyperplasia appear to have an increased rate of psychiatric disorders and alcohol misuse vs. controls, according to data published in the Journal of Clinical Endocrinology and Metabolism.
“This is the first study investigating psychiatric morbidity in [congenital adrenal hyperplasia] males. We identified a 50% increased risk for any psychiatric disorder, specifically suicidality and alcohol misuse,” Henrik Falhammar, MD, PhD, of the department of endocrinology, metabolism and diabetes at Karolinska University Hospital in Stockholm, and colleagues wrote.
The first psychiatric diagnosis was established before age 18 years in 36% (13 of 36) of patients with congenital adrenal hyperplasia (CAH); 43% (1,067 of 2,486) controls, according to researchers.
The increased rate of psychiatric morbidity, including alcohol abuse (OR=1.9; 95% CI, 1-3.5) and suicidality (OR=2.3; 95% CI, 1.1-5), was found among 253 men with CAH and known CYP21A2 mutations (n=185), as compared with age-matched controls (n=25,300).
Mutation groups included null (n=41), I2splice (n=55), I172N (n=58), P30L (n=12), V281L (n=17), and P453S (n=1), according to data.
Data indicate that psychiatric disorders, personality disorders and alcohol misuse were increased in the I2splice group; suicide attempts and drug misuse was increased in the I172N group. Psychotic disorders were increased in the P30L and nonclassic group, researchers added.
“The psychiatric morbidities were not elevated in the most severely affected CAH group (the null genotype). Late diagnosis of CAH may explain some of the findings. Patients born before the introduction of neonatal screening seemed more affected, but this may be explained by the higher age in that cohort,” researchers wrote.
The association between increased psychiatric morbidity in men with CAH due to 21-hydroxylase deficiencies should be studied further, they added.
Disclosure: The researchers report no relevant financial disclosures.