Psychiatric Approaches for Disorders of Sex Development: Experience of a Multidisciplinary Team
Makaleler > Tam Makale · 2013
Yazarlar: Nazlı Burcu ÖZBARAN, Samim ÖZEN, Ruhsar Damla GÖKŞEN, Ozlem KORKMAZ, HÜSEYİN ONAY, Feriştah Ferda ÖZKINAY, Muhsin Özgür ÇOĞULU, Serpil ERERMIS, Sezen KÖSE, ALİ AVANOĞLU, İbrahim ULMAN, Şükran DARCAN
Journal of Clinical Research in Pediatric Endocrinology, SCI Expanded İndekslerine Giren Dergi, Uluslararası, Scopus, 2013, cilt 5, ss 229-235
DOI: 10.4274/jcrpe.1044
Özet
OBJECTIVE: Disorders of sex development (DSD) are a group of congenital medical conditions that affect life as a whole. In this study, we aimed to reflect the experience of a multidisciplinary team in the clinical/psychiatric follow-up of a group of children and adolescents with DSD. METHODS: The study group consisted of 51 patients diagnosed with DSD. The Kiddie-Schedule for Affective Disorders and Schizophrenia, Wechsler Intelligence Scale for Children-Revised, Draw a Person Test and Children's Apperception Test, and the Clinical Global Impression Scale (CGIS) were used for psychiatric evaluations. RESULTS: The mean age of the patients was 7.8 years (median: 7.8; min: 1.0; max: 18.0). Genetic evaluation showed 46,XX configuration in 15 patients (29.4%) and 46,XY in 35 (68.6%). One patient (2.0%) was diagnosed to have a sex chromosome disorder. Forty patients (78.4%) had no problems with their given gender identity and gender role. Thirty-four (66.7%) patients had normal intellectual capacity. Twenty-eight (54.9%) patients did not have any psychiatric problem. Depression, anxiety disorders, attention deficit/hyperactivity disorder, and adjustment disorders were the common diagnoses. The mean score of symptom severity on CGIS-severity-baseline was 6.15±0.68 and after one year, it was 1.46±0.51 (Z=-3.236 p=0.001). The mean score of CGI-Improvement was 1.23±0.44. CONCLUSION: It is important to identify and treat the psychiatric disorders encountered in patients with DSD. A psychiatrist needs to be included in the professional team following these patients. Examination and observation results need to be shared by holding periodic team meetings to establish a wholesome point of view for every unique child.