Evaluation of aggression level in adolescent girls with classical congenital adrenal hyperplasia

• Published in: Clinical endocrinology (Oxford) Vol. 99; no. 2; pp. 135 - 141
• Main Authors: Isik, Recep Oğuzhan, Kizilcan Cetin, Sirmen, Cetinkaya, Semra, Berberoglu, Merih, Siklar, Zeynep, Özsu, Elif, Aycan, Zehra
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-08-2023
• Subjects: Adolescent; Adolescents; Adrenal Hyperplasia, Congenital - diagnosis; Aggression; Androgens; Buss‐Perry Aggression Scale; Children & youth; congenital adrenal hyperplasia; Female; Girls; Humans; Hydroxylase; Hyperplasia; Male; Pregnancy; Steroid 21-Hydroxylase; Teenagers; Virilism; Buss-Perry Aggression Scale; adolescent; aggression; congenital adrenal hyperplasia
• ISSN: 0300-0664; 1365-2265
• DOI: 10.1111/cen.14928

Objective
In patients with classical congenital adrenal hyperplasia (CAH), virilization affects the brain and external genitalia due to antenatal androgen exposure. There are few studies on how the effects of androgens on brain virilization are reflected in behavior. However, there is no study focused on the adolescence period. The aim of this study was to evaluate the level of aggression in adolescent girls with classical CAH (due to 21 hydroxylase and 11β hydroxylase deficiency) and to investigate the disease‐related factors that may affect aggression.
Design
Twenty female and 20 male patients aged 13–20 years, diagnosed with classical CAH, with 21 hydroxylase deficiency and 11β hydroxylase deficiency, and 20 healthy girls and 20 boys from the same age group were included. The Buss‐Perry Aggression Scale (BPAS), which consists of four subgroups measuring physical aggression, verbal aggression, hostility, and angry behaviors, was used.
Results
The ages of the male and female patients with CAH were 16.30 ± 2.65 and 16.60 ± 2.41 years, respectively. Total aggression scale scores were 73.3 ± 14.6 in adolescent girls with CAH, 74.1 ± 11.2 in healthy girls, 71.5 ± 14.8 in boys with CAH, and 75.3 ± 14.5 in healthy boys (p > .05). There was no difference between the subscale scores of patients and healthy adolescents. Aggression scores in adolescents with CAH increased significantly with age.
Conclusions
In this study, we found no difference between the aggression scores of adolescents with classical CAH compared to their healthy peers. The total aggression score and subscale were similar in unaffected female adolescents.