Yıl: 2020 Cilt: 21 Sayı: 4 Sayfa Aralığı: 435 - 442 Metin Dili: İngilizce DOI: 10.5455/apd.72180 İndeks Tarihi: 08-11-2020

Prenatal androgens and autistic, attention deficit hyperactivity disorder, and disruptive behavior disorders traits

Öz:
Objective:Androgen exposure is hypothesized to play a role in the development of autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and disruptive behavior disorders/DBDs (oppositional defiant disorder/ODD and conduct disorder/CD). Theaim of this cross-sectional study was to investigate ASD, ADHD, and DBD (ODD and CD) traits in children and adolescents with congenital adrenal hyperplasia (CAH), a natural cause of prenatal androgen excess in females. Methods:Forty-five children and adolescents (27 girls, mean age 11.1±3; 18 boys, mean age 10.8±3.6)with CAH and their unaffected siblings (16 girls, mean age 11.4±3.9; 14 boys, mean age 12.6±4.2) were included in the study. Parents completed the Social Communication Questionnaire, to measure ASD symptoms; and the Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale to assess ADHD and DBD traits. Results: In this study, boys but not girls with CAH showed higher autistic traits. There was no significant difference between either girls or boys with CAH and their unaffected counterparts with respect to inattention or hyperactivity symptoms. Boys with CAH showed more ODD symptoms than the unaffected boys. There was a trend for boys to have more CD symptoms compared to unaffected boys. Conclusions:Our study does not support the hypothesis that prenatal androgen exposure is associated with ASD, ADHD or DBDs. Postnatal/circulating androgen levels, higher testosterone/cortisol ratio, lower basal cortisolor dysregulation in HPA axis might be related to higher autistic traits or increased DBDs symptoms found in boys with CAH. Further investigations with larger groups are needed to clarify these associations.
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  • 1.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Fifth Ed. Arlington: American Psychiatric Associ-ation, 2013.
  • 2.Rommelse N, Buitelaar JK, Hartman CA. Struc-tural brain imaging correlates of ASD and ADHD across the lifespan: a hypothesis-generating re-view on developmental ASD-ADHD subtypes. J Neural Transm 2017; 124 (2):259-271.
  • 3. Rosen TE, Mazefsky CA, Vasa RA, Lerner MD. Co-occurring psychiatric conditions in autism spectrum disorder. Int Rev Psychiatry 2018; 30(1):40-61.
  • 4. Baron-Cohen S, Lombardo MV, Auyeung B, Ashwin E, Chakrabarti B, Knickmeyer R. Why are autism spectrum conditions more prevalent in males? PLoS Biol 2011; 9(6):e1001081.
  • 5. Rucklidge JJ. Gender differences in attention-deficit/hyperactivity disorder. Psychiatr Clin North Am 2010; 33(2):357-373.
  • 6. Pliszka SR. Patterns of psychiatric comorbidity with attention-deficit/hyperactivity disorder. Child Adolesc Psychiatr Clin N Am 2000; 9(3):525-540.
  • 7. Demmer DH, Hooley M, Sheen J, McGillivray JA, Lum JAG. Sex differences in the prevalence of oppositional defiant disorder during middle child-hood: a meta-analysis. J Abnorm Child Psychol 2017; 45(2):313-325.
  • 8.Erskine HE, Ferrari AJ, Nelson P, Polanczyk G V., Flaxman AD, Vos T, et al. Epidemiological model-ling of attention-deficit/ hyperactivity disorder and conduct disorder for the Global Burden of Disease Study 2010. J Child Psychol Psychiatry 2013; 54(12):1263-1274.
  • 9. Wittchen HU, Jacobi F, Rehm J, Gustavsson A, Svensson M, Jönsson B, et al. The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsycho-pharmacol 2011; 21(9):655-679.
  • 10. Auyeung B, Lombardo MV, Baron-Cohen S. Pre-natal and postnatal hormone effects on the human brain and cognition. Pflügers Arch -Eur J Physiol 2013; 465(5):557-571.
  • 11. Auyeung B, Taylor K, Hackett G, Baron-cohen S. Foetal testosterone and autistic traits in 18 to 24-month-old children. Mol Autism 2010; 1(1):11.
  • 12. Auyeung B, Baron-Cohen S, Ashwin E, Knick-meyer R, Taylor K, Hackett G. Fetal testosterone and autistic traits. Br J Psychol 2009; 100(Pt1):1-22.
  • 13. Baron-Cohen S, Auyeung B, Nørgaard-Pedersen B, Hougaard DM, Abdallah MW, Melgaard L, et al. Elevated fetal steroidogenic activity in autism. Mol Psychiatry 2015; 20(3):369-376.
  • 14. Kung KTF, Spencer D, Pasterski V, Neufeld S, Glover V, Connor TGO, et al. No relationship be-tween prenatal androgen exposure and autistic traits: convergent evidence from studies of chil-dren with congenital adrenal hyperplasia and of amniotic testosterone concentrations in typically developing children.J Child Psychol Psychiatry 2016; 57(12):1455-1462.
  • 15. Park BY, Lee BK, Burstyn I, Tabb LP, Keelan JA, Whitehouse AJO, et al. Umbilical cord blood androgen levels and ASD-related phenotypes at 12 and 36 months in an enriched risk cohort study. Mol Autism 2017; 8(1):3.
  • 16. Whitehouse AJO, Mattes E, Maybery MT, Dissa-nayake C, Sawyer M, Jones RM, et al. Perinatal testosterone exposure and autistic-like traits in the general population: a longitudinal pregnancy-cohort study. J Neurodev Disord 2012; 4(1):25.
  • 17. Kosidou K, Dalman C, Widman L, Arver S, Lee BK, Magnusson C, et al. Maternal polycystic ovary syndrome and risk for attention-deficit/hyperac-tivity disorder in the offspring. Biol Psychiatry 2017; 82(9):651-659.
  • 18.De Bruin EI, Verheij F, Wiegman T, Ferdinand RF. Differences in finger length ratio between males with autism, pervasive developmental disorder-not otherwisespecified, ADHD, and anxiety disor-ders. Dev Med Child Neurol 2006; 48(12):962-965.
  • 19. Fink B, Manning JT, Williams JHG, Podmore-Nappin C. The 2nd to 4th digit ratio and devel-opmental psychopathology in school-aged chil-dren. Pers Individ Dif 2007; 42(2):369-379.
  • 20. McFadden D, Westhafer JG, Pasanen EG, Carl-son CL, Tucker DM. Physiological evidence of hypermasculinization in boys with the inattentive type of attention-deficit/hyperactivity disorder (ADHD). Clin Neurosci Res 2005; 5(5-6):233-245.
  • 21. Engberg H, Butwicka A, Nordenström A, Lindén A, Falhammar H, Lichtenstein P, et al. Congenital adrenal hyperplasia and risk for psychiatric disor-ders in girls and women born between 1915 and 2010: A total population study. Psychoneuro-endocrinology 2015;60:195-205.
  • 22. Hines M. Gender development and the human brain. Annu Rev Neurosci 2011; 34(1):69-88.
  • 23. Turcu AF, Auchus RJ. Adrenal steroidogenesis and congenital adrenal hyperplasia. Endocrinol Metab Clin NA 2015; 44(2):275-296.
  • 24. Pang S, Levine LS, Cederqvist LL, Fuentes M, Riccardi VM, Holcombe JH, et al. Amniotic fluid concentrations of ∆5 and ∆4 steroids in fetuses with congenital adrenal hyperplasia due to 21 hydroxylase deficiency and in anencephalic fe-tuses. J Clin Endocrinol Metab 1980; 51(2):223-229.
  • 25.Wudy SA, Dörr HG, Solleder C, Djalali M HJ. Profiling steroid hormones in amniotic fluid of midpregnancy by routine stable isotope dilution / gas hydroxylase deficiency. J Clin Endocrinol Metab 1999; 84(8):2724-2728.
  • 26. Knickmeyer R, Baron-cohen S, Fane BA, Wheel-wright S, Mathews GA, Conway GS, et al. Andro-gens and autistic traits: A study of individuals with congenital adrenal hyperplasia. Horm Behav 2006; 50(1):148-153.
  • 27. Mueller SC, Ng P, Sinaii N, Leschek EW, Green-Golan L,VanRyzin C, et al. Psychiatric charac-terization of children with genetic causes of hyper-androgenism. Eur J Endocrinol 2010; 163(5):801-810.
  • 28. Oner O, Aycan Z, Tiryaki T, Soy D, Cetinkaya E, Kibar E. Variables related to behavioral and emo-tional problems and gender typed behaviors in female patients with congenital adrenal hyperpla-sia. J Pediatr Endocrinol Metab 2009; 22(2):143-151.
  • 29. Rutter M, Bailey A, Lord C, CianchettiC, Fancello G. SCQ: Social Communication Questionnaire: Manuale, Giunti OS, 2007.
  • 30. Avcil S, Baykara B, Baydur H, Münir KM, Inal Emiroğlu N. The validity and reliability of the social communication questionnaire-Turkish form in autistics aged 4-18 years. Turk Psikiyatr Derg 2015; 26(1):56-64.
  • 31. Turgay A. Disruptive behavior disorders child and adolescent screening and rating scales for children, adolescents, parents and teachers. West Blomfield (Michigan): Integrative Therapy Institute Publication, 1994.
  • 32.Ercan, ES, Amado, S, Somer, O, Cikoglu S. Development of a test battery for attention deficit hyperactivity and disruptive behavior disorders. Turk J Child Adolesc Ment Heal 2001; 8:132-144. (In Turkish)
  • 33. Alexander GM. Postnatal testosterone concentra-tions and male social development. Front EndocrinolLausanne 2014; 5:15.
  • 34. Geier DA, Geier MR. A prospective assessment of androgen levels in patients with autistic spectrum disorders: Biochemical underpinnings and sug-gested therapies. Neuro Endocrinol Lett 2007; 28(5):565-573.
  • 35. Takagishi H, Takahashi T, Yamagishi T, Shinada M, Inukai K, Tanida S, et al. Salivary testosterone levels and autism-spectrum quotient in adults. Neuro Endocrinol Lett 2010; 31(6):837-841.
  • 36. Tordjman S, Ferrari P, Sulmont V, Duyme M, Roubertoux P. Androgenic activity in autism. Am J Psychiatry 1997; 154(11):1626-1627.
  • 37. Auyeung B, Ahluwalia J, Thomson L, Taylor K, Hackett G, O’Donnell KJ, et al. Prenatal versus postnatal sex steroid hormone effects on autistic traits in children at 18 to 24 months of age. Mol Autism 2012; 3(1):17.
  • 38. Kung KTF, Constantinescu M, Browne WV, Noor-derhaven RM, Hines M. No relationship between early postnatal testosterone concentrations and autistic traits in 18 to 30-month-old children. Mol Autism 2016; 7(1):15.
  • 39. Taylor JL, Corbett B. A review of rhythm and re-sponsiveness of cortisol in individuals with autism spectrum disorders. Psychoneuroendocrinology 2014; 49:207-228.
  • 40. Pasterski V, Hindmarsh P, Geffner M, Brook C, Brain C, Hines M. Increased aggression and acti-vity level in 3-to 11-year-old girls with congenital adrenal hyperplasia (CAH). Horm Behav 2007; 52(3):368-374.
  • 41. Bakker-Huvenaars MJ, Greven CU, Herpers P, Wiegers E, Jansen A, van der Steen R, etal. Saliva oxytocin, cortisol, and testosterone levels in adolescent boys with autism spectrum disorder, oppositional defiant disorder/conduct disorder and typically developing individuals. Eur Neuro-psychopharmacol. 2020; 30:87-101.
  • 42. Grotzinger O, Grotzinger AD, Mann FD, Patterson MW. Hair and salivary testosterone, hair cortisol, and externalizing behaviors in adolescents. Psychol Sci 2018; 29(5):688-689.
  • 43.Loney BR, Butler MA, Lima EN, Counts CA, Eckel LA. The relation between salivary cortisol, callous-unemotional traits, and conduct problems in an adolescent non-referred sample. J Child Psychol Psychiatry 2006; 47(1):30-36.
  • 44. Van Goozen SHM, Van Den Ban E, Matthys W, Cohen-Kettenis PT, Thijssen JHH, Van Engeland H. Increased adrenal androgen functioning in children with oppositional defiant disorder: A comparison with psychiatric and normal controls. J Am Acad Child Adolesc Psychiatry 2000; 39(11):1446-1451.
  • 45.Van Goozen SHM, Matthys W, Cohen-Kettenis PT, Thijssen JHH, Van Engeland H. Adrenal androgens and aggression in conduct disorder prepubertal boys and normal controls. Biol Psychi-atry 1998; 43(2):156-158.
  • 46. Wang LJ, Lee SY, Chou MC, Lee MJ, Chou WJ. Dehydroepiandrosterone sulfate, free testoster-one, and sex hormone-binding globulin on sus-ceptibility to attention-deficit/hyperactivity disor-der. Psychoneuroendocrinology 2019; 103:212-218.
  • 47.Schoorl J, Rijn SV, Wied M, van Goozen S, Swaab H.The role of anxiety in cortisol stress response and cortisol recovery in boys with oppositional defiant disorder/conduct disorder. Psychoneuro-endocrinology 2016; 73:217-223.
  • 48. Schoorl J, van Rijn S, de Wied M, van Goozen S, Swaab H. Neurobiological stress responses pre-dict aggression in boys with oppositional defiant disorder/conduct disorder: a 1-year follow-up intervention study. Eur Child Adolesc Psychiatry 2017; 26(7):805-813.
  • 49. Freitag CM, Hanig S, Palmason H, Meyer J, Wust S, Seitz C. Cortisol awakening response in healthy children and children with ADHD: Impact of comorbid disorders and psychosocial risk factors. Psychoneuroendocrinology 2009; 34(7):1019-1028.
APA ÖZHAN BAYKAN H, TANIDIR C, DOKTUR H, ÖNAL Z, KUTLU E, ÖNAL H, KARAKAYA M (2020). Prenatal androgens and autistic, attention deficit hyperactivity disorder, and disruptive behavior disorders traits. , 435 - 442. 10.5455/apd.72180
Chicago ÖZHAN BAYKAN Hatice Güneş,TANIDIR Canan,DOKTUR Hilal,ÖNAL Zerrin,KUTLU Esra,ÖNAL Hasan,KARAKAYA Münir Kerim Prenatal androgens and autistic, attention deficit hyperactivity disorder, and disruptive behavior disorders traits. (2020): 435 - 442. 10.5455/apd.72180
MLA ÖZHAN BAYKAN Hatice Güneş,TANIDIR Canan,DOKTUR Hilal,ÖNAL Zerrin,KUTLU Esra,ÖNAL Hasan,KARAKAYA Münir Kerim Prenatal androgens and autistic, attention deficit hyperactivity disorder, and disruptive behavior disorders traits. , 2020, ss.435 - 442. 10.5455/apd.72180
AMA ÖZHAN BAYKAN H,TANIDIR C,DOKTUR H,ÖNAL Z,KUTLU E,ÖNAL H,KARAKAYA M Prenatal androgens and autistic, attention deficit hyperactivity disorder, and disruptive behavior disorders traits. . 2020; 435 - 442. 10.5455/apd.72180
Vancouver ÖZHAN BAYKAN H,TANIDIR C,DOKTUR H,ÖNAL Z,KUTLU E,ÖNAL H,KARAKAYA M Prenatal androgens and autistic, attention deficit hyperactivity disorder, and disruptive behavior disorders traits. . 2020; 435 - 442. 10.5455/apd.72180
IEEE ÖZHAN BAYKAN H,TANIDIR C,DOKTUR H,ÖNAL Z,KUTLU E,ÖNAL H,KARAKAYA M "Prenatal androgens and autistic, attention deficit hyperactivity disorder, and disruptive behavior disorders traits." , ss.435 - 442, 2020. 10.5455/apd.72180
ISNAD ÖZHAN BAYKAN, Hatice Güneş vd. "Prenatal androgens and autistic, attention deficit hyperactivity disorder, and disruptive behavior disorders traits". (2020), 435-442. https://doi.org/10.5455/apd.72180
APA ÖZHAN BAYKAN H, TANIDIR C, DOKTUR H, ÖNAL Z, KUTLU E, ÖNAL H, KARAKAYA M (2020). Prenatal androgens and autistic, attention deficit hyperactivity disorder, and disruptive behavior disorders traits. Anadolu Psikiyatri Dergisi, 21(4), 435 - 442. 10.5455/apd.72180
Chicago ÖZHAN BAYKAN Hatice Güneş,TANIDIR Canan,DOKTUR Hilal,ÖNAL Zerrin,KUTLU Esra,ÖNAL Hasan,KARAKAYA Münir Kerim Prenatal androgens and autistic, attention deficit hyperactivity disorder, and disruptive behavior disorders traits. Anadolu Psikiyatri Dergisi 21, no.4 (2020): 435 - 442. 10.5455/apd.72180
MLA ÖZHAN BAYKAN Hatice Güneş,TANIDIR Canan,DOKTUR Hilal,ÖNAL Zerrin,KUTLU Esra,ÖNAL Hasan,KARAKAYA Münir Kerim Prenatal androgens and autistic, attention deficit hyperactivity disorder, and disruptive behavior disorders traits. Anadolu Psikiyatri Dergisi, vol.21, no.4, 2020, ss.435 - 442. 10.5455/apd.72180
AMA ÖZHAN BAYKAN H,TANIDIR C,DOKTUR H,ÖNAL Z,KUTLU E,ÖNAL H,KARAKAYA M Prenatal androgens and autistic, attention deficit hyperactivity disorder, and disruptive behavior disorders traits. Anadolu Psikiyatri Dergisi. 2020; 21(4): 435 - 442. 10.5455/apd.72180
Vancouver ÖZHAN BAYKAN H,TANIDIR C,DOKTUR H,ÖNAL Z,KUTLU E,ÖNAL H,KARAKAYA M Prenatal androgens and autistic, attention deficit hyperactivity disorder, and disruptive behavior disorders traits. Anadolu Psikiyatri Dergisi. 2020; 21(4): 435 - 442. 10.5455/apd.72180
IEEE ÖZHAN BAYKAN H,TANIDIR C,DOKTUR H,ÖNAL Z,KUTLU E,ÖNAL H,KARAKAYA M "Prenatal androgens and autistic, attention deficit hyperactivity disorder, and disruptive behavior disorders traits." Anadolu Psikiyatri Dergisi, 21, ss.435 - 442, 2020. 10.5455/apd.72180
ISNAD ÖZHAN BAYKAN, Hatice Güneş vd. "Prenatal androgens and autistic, attention deficit hyperactivity disorder, and disruptive behavior disorders traits". Anadolu Psikiyatri Dergisi 21/4 (2020), 435-442. https://doi.org/10.5455/apd.72180