%0 Journal Article
%T Normal Intelligence in Female and Male Patients with Congenital Adrenal Hyperplasia
%A Sheri A Berenbaum
%A Kristina Bryk
%A Stephen C Duck
%J International Journal of Pediatric Endocrinology
%D 2010
%I BioMed Central
%R 10.1155/2010/853103
%X Controversies about the nature and causes of psychological outcome in individuals with disorders of sex development (DSDs) have focused on gender identity, sexuality (especially related to surgery), and quality of life [1¨C3]. There has been less attention paid to intelligence, although there has been a concern that intellectual impairment might be associated with adjustment problems [4]. Most of the systematic evidence about outcome in DSDs comes from congenital adrenal hyperplasia (CAH), the most common DSD.Intelligence is composed of several key attributes, including abstract thinking, reasoning, problem-solving, and ability to adapt to the environment [5]. Intelligence measured by standard tests is important because it is associated with a variety of psychological, social, economic, and health outcomes [5]. A review of studies through 2000 indicated that overall intelligence of individuals with CAH is within the normal range, but might be lower in patients with salt-wasting (SW) than with simple-virilizing (SV) CAH [6]. One aspect of intelligence, spatial ability, has been found to be affected by CAH, but in different ways in the two sexes: compared to same-sex controls, females with CAH have higher spatial ability (probably as a result of prenatal androgen excess) and males have lower spatial ability (for unknown reasons) [6¨C8]. Data published since the review suggest that there is a more pronounced intellectual deficit in female patients with CAH than had been reported previously [4]. The deficit was proposed to be caused by the disease and its treatment (e.g., prenatal androgen excess, hyponatremia) and to lead to lowered quality of life, but the hypothesized causes and consequences of the deficit were not tested.The renewed concerns about intellectual deficits in CAH and associations with psychological adjustment [4] generate three key questions. First, what is the nature and extent of the deficit, and is it found in both sexes? Although most work focuses on
%U http://www.ijpeonline.com/content/2010/1/853103