Parental stress parameter difference after caring for congenital adrenal hyperplasia children with genital ambiguity

Abstract

Introduction: Congenital adrenal hyperplasia (CAH) disrupts cortisol biosynthesis, which may cause genital ambiguity in females. Caring for children with genital ambiguity creates parental distress. Common stress parameters include biological (e.g., serotonin cortisol) and psychological (e.g., Depression, Anxiety, and Stress Scale [DASS] scores). This study elaborated parental stress parameter differences among parents of CAH children with and without genital ambiguity. Methods: This cross-sectional study included 34 fathers and 44 mothers of children with CAH. All participants agreed to fill in the DASS-42 and socioeconomic questionnaire. Morning serum serotonin and cortisol samples were examined using the enzyme-linked immune-absorbent assay technique. Results: The median (minimum–maximum) value of serotonin concentration was lower in fathers compared to mothers (281.18 [78.44–122.91] ng/ml vs. 399.78 [122.91–1050.0] ng/ml, P = 0.11); in parents of children with genital ambiguity (292.22 [78.44–1050.00] ng/ml vs. 426.71 [150.78–1050.00] ng/ml, P = 0.01); and in parents of children with a diagnosis time <1 year (225.00 [93.41–570.33] ng/ml vs. 371.815 [78.44–1050.00] ng/ml, P = 0.046). Higher cortisol concentration was observed in parents of children with diagnosis time <1 year (78.65 [50.89–126.89] ng/ml vs. 63.33 [6.14–283.67] ng/ml, P = 0.046). The proportion of depression was 24.4%, anxiety 45.1%, and stress 21.8%. Conclusion: Fathers, parents of children with genital ambiguity, and being recently diagnosed had lower serum serotonin levels. Parents of recently diagnosed children had higher cortisol levels. Anxiety was more common than depression and stress.

Keywords

• anxiety
• congenital adrenal hyperplasia
• cortisol
• depression
• parents
• serotonin
• stress