Skip to main content
Top
Published in: International Journal of Pediatric Endocrinology 1/2012

Open Access 01-12-2012 | Research

Physical, social and societal functioning of children with congenital adrenal hyperplasia (CAH) and their parents, in a Dutch population

Authors: Sarita A Sanches, Therese A Wiegers, Barto J Otten, Hedi L Claahsen-van der Grinten

Published in: International Journal of Pediatric Endocrinology | Issue 1/2012

Login to get access

Abstract

Background

Most research concerning congenital adrenal hyperplasia (CAH) and related conditions caused by primary adrenal insufficiency, such as Addison's or Cushing's disease, has focused on medical aspects rather than on patients' quality of life. Therefore, our objective was to investigate the physical, social and societal functioning of children with CAH and their parents in a Dutch population.

Methods

The study is descriptive and cross-sectional. Self-designed questionnaires, based on questionnaires developed in the Netherlands for different patient groups, were sent to parents of children with CAH between 0 and 18 years old. Participants were recruited through the Dutch patient group for Adrenal Disease (NVACP) and six hospitals in the Netherlands. Three different questionnaires were designed for parents: for children aged 0 - 4, aged 4 - 12 and aged 12 - 18. Additionally, a fourth questionnaire was sent to adolescents with CAH aged 12 - 18. Main outcome measures were experienced burden of the condition, self-management and participation in several areas, such as school and leisure time.

Results

A total of 106 parents returned the questionnaire, 12 regarding pre-school children (0-4 years), 63 regarding primary school children (4-12 years), and 32 regarding secondary school children (12-18 years), combined response rate 69.7%. Also, 24 adolescents returned the questionnaire. Children and adolescents with CAH appear to be capable of self-management at a young age. Experienced burden of the condition is low, although children experience several health related problems on a daily basis. Children participate well in school and leisure time. Few children carry a crisis card or emergency injection with them.

Conclusions

Overall, our research shows that, according to their parents, children with CAH experience few negative effects of the condition and that they participate well in several areas such as school and leisure time. However, improvements can be made concerning the measures parents and children must take to prevent an adrenal crisis.
Literature
1.
go back to reference Trakakis E, Loghis C, Kassanos D: Congenital Adrenal Hyperplasia Because of 21-Hydroxylase Deficiency. A Genetic Disorder of interest to Obstetrics and Gynecologists. Obstet Gynecol Surv. 2009, 64: 177-187. 10.1097/OGX.0b013e318193301b.CrossRefPubMed Trakakis E, Loghis C, Kassanos D: Congenital Adrenal Hyperplasia Because of 21-Hydroxylase Deficiency. A Genetic Disorder of interest to Obstetrics and Gynecologists. Obstet Gynecol Surv. 2009, 64: 177-187. 10.1097/OGX.0b013e318193301b.CrossRefPubMed
2.
go back to reference Claahsen- van der Grinten HL: Van gen naar ziekte; het adrenogenitaal syndroom en het CYP21A2-gen (From gene to disease: adrenogenital syndrome and the CYP21A2 gene). Nederlands tijdschrift voor geneeskunde. 2007, 151 (Suppl 21): 1174-1177.PubMed Claahsen- van der Grinten HL: Van gen naar ziekte; het adrenogenitaal syndroom en het CYP21A2-gen (From gene to disease: adrenogenital syndrome and the CYP21A2 gene). Nederlands tijdschrift voor geneeskunde. 2007, 151 (Suppl 21): 1174-1177.PubMed
3.
go back to reference Grosse SD, Van Vliet G: How many deaths can be prevented by newborn screening for Congenital Adrenal Hyperplasia?. Horm Res. 2007, 67: 284-291. 10.1159/000098400.CrossRefPubMed Grosse SD, Van Vliet G: How many deaths can be prevented by newborn screening for Congenital Adrenal Hyperplasia?. Horm Res. 2007, 67: 284-291. 10.1159/000098400.CrossRefPubMed
4.
go back to reference Bachelot A, Chakthoura Z, Rouxel A, Dulon J, Touraine P: Classical Forms of Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency in Adults. Horm Res. 2008, 69: 203-211. 10.1159/000113020.CrossRefPubMed Bachelot A, Chakthoura Z, Rouxel A, Dulon J, Touraine P: Classical Forms of Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency in Adults. Horm Res. 2008, 69: 203-211. 10.1159/000113020.CrossRefPubMed
5.
go back to reference Malouf MA, Inman AG, Carr AG, Franco J, Brooks LM: Health-related quality of life, mental health and psychotherapeutic considerations for women diagnosed with a disorder of sexual development: Congenital Adrenal Hyperplasia. Int J Ped Endcorinol. 2010, 2010: 253465-10.1186/1687-9856-2010-253465.CrossRef Malouf MA, Inman AG, Carr AG, Franco J, Brooks LM: Health-related quality of life, mental health and psychotherapeutic considerations for women diagnosed with a disorder of sexual development: Congenital Adrenal Hyperplasia. Int J Ped Endcorinol. 2010, 2010: 253465-10.1186/1687-9856-2010-253465.CrossRef
6.
go back to reference Speiser PW, Azziz R, Baskin LS, Ghizzoni L, Hensle TW, Merke DP, Meyer-Bahlburg HFL, Miller WL, Montori VM, Oberfield SE, Ritzen M, White PC: Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2010, 95 (Suppl 9): 4133-4160.PubMedCentralCrossRefPubMed Speiser PW, Azziz R, Baskin LS, Ghizzoni L, Hensle TW, Merke DP, Meyer-Bahlburg HFL, Miller WL, Montori VM, Oberfield SE, Ritzen M, White PC: Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2010, 95 (Suppl 9): 4133-4160.PubMedCentralCrossRefPubMed
7.
go back to reference RIVM: Informatieblad in het kader van het landelijke neonatale screeningsprogramma (Information leaflet of the national neonatal screening program). 2006, Bilthoven RIVM: Informatieblad in het kader van het landelijke neonatale screeningsprogramma (Information leaflet of the national neonatal screening program). 2006, Bilthoven
8.
go back to reference Arlt W, Willis DS, Wild SH, Krone N, Doherty EJ, Hahner S, Han TS, Carroll PV, Conway GS, Rees DA, Stimson RH, Walker BR, Connell JMC, Ross RJ, the United Kingdom Congenital Adrenal Hyperplasia Adult Study Executive (CaHASE): Health status of adults with congenital adrenal hyperplasia: A cohort study of 203 patients. J Clin Endocrinol Metab. 2010, 95 (Suppl 11): 5110-5121.PubMedCentralCrossRefPubMed Arlt W, Willis DS, Wild SH, Krone N, Doherty EJ, Hahner S, Han TS, Carroll PV, Conway GS, Rees DA, Stimson RH, Walker BR, Connell JMC, Ross RJ, the United Kingdom Congenital Adrenal Hyperplasia Adult Study Executive (CaHASE): Health status of adults with congenital adrenal hyperplasia: A cohort study of 203 patients. J Clin Endocrinol Metab. 2010, 95 (Suppl 11): 5110-5121.PubMedCentralCrossRefPubMed
9.
go back to reference Westert GP, Schellevis FG, de Bakker DH, Groenewegen PP, Bensing JM, van der Zee J: Monitoring health inequalities through general practice: the Second Dutch National Survey of General Practice. Eur J Public Health. 2005, 15 (Suppl 1): 59-65.CrossRefPubMed Westert GP, Schellevis FG, de Bakker DH, Groenewegen PP, Bensing JM, van der Zee J: Monitoring health inequalities through general practice: the Second Dutch National Survey of General Practice. Eur J Public Health. 2005, 15 (Suppl 1): 59-65.CrossRefPubMed
10.
go back to reference Heijmans MJWM, Rijken M: De impact van de ziekte van Addison, AGS of het syndroom van Cushing op het dagelijks leven en de zorg: een onderzoek vanuit patiëntenperspectief (The impact of Addison's disease, CAH and Cushing's syndrome on daily life and healthcare: a study from the patient's perspective.). 2006, Utrecht: NIVEL Heijmans MJWM, Rijken M: De impact van de ziekte van Addison, AGS of het syndroom van Cushing op het dagelijks leven en de zorg: een onderzoek vanuit patiëntenperspectief (The impact of Addison's disease, CAH and Cushing's syndrome on daily life and healthcare: a study from the patient's perspective.). 2006, Utrecht: NIVEL
11.
go back to reference Calsbeek H: The social position of adolescents and young adults with chronic digestive disorders. 2003, Utrecht: NIVEL Calsbeek H: The social position of adolescents and young adults with chronic digestive disorders. 2003, Utrecht: NIVEL
12.
go back to reference Sanches S, Wiegers T: Het fysiek, sociaal en maatschappelijk functioneren van kinderen met AGS (en hun ouders) (The physical, social and societal functioning of children with CAH (and their parents). 2010, Utrecht: NIVEL Sanches S, Wiegers T: Het fysiek, sociaal en maatschappelijk functioneren van kinderen met AGS (en hun ouders) (The physical, social and societal functioning of children with CAH (and their parents). 2010, Utrecht: NIVEL
13.
go back to reference Erichsen MM, Løvås K, Skinningsrud B, Wolff AB, Undlien DE, Svartberg J, Fougner KJ, Berg TJ, Bollerslev J, Mella B, Carlson JA, Erlich H, Husebye ES: Clinical, immunological, and genetic features of autoimmune primary adrenal insufficiency: Observations from a Norwegian registry. J Clin Endocrinol Metab. 2009, 94: 4882-4890. 10.1210/jc.2009-1368.CrossRefPubMed Erichsen MM, Løvås K, Skinningsrud B, Wolff AB, Undlien DE, Svartberg J, Fougner KJ, Berg TJ, Bollerslev J, Mella B, Carlson JA, Erlich H, Husebye ES: Clinical, immunological, and genetic features of autoimmune primary adrenal insufficiency: Observations from a Norwegian registry. J Clin Endocrinol Metab. 2009, 94: 4882-4890. 10.1210/jc.2009-1368.CrossRefPubMed
14.
go back to reference Løvås K, Loge JH, Husebye ES: Subjective health status in Norwegian Patients with Addison's disease. Clin Endocrinol (Oxf). 2002, 56: 581-588. 10.1046/j.1365-2265.2002.01466.x.CrossRef Løvås K, Loge JH, Husebye ES: Subjective health status in Norwegian Patients with Addison's disease. Clin Endocrinol (Oxf). 2002, 56: 581-588. 10.1046/j.1365-2265.2002.01466.x.CrossRef
15.
go back to reference Bleicken B, Hahner S, Loeffler M, Ventz M, Allolio B, Quinkler M: Impaired subjective health status in chronic adrenal insufficiency: impact of different glucocorticoid replacement regimens. Eur J Endocrinol. 2008, 159: 811-817. 10.1530/EJE-08-0578.CrossRefPubMed Bleicken B, Hahner S, Loeffler M, Ventz M, Allolio B, Quinkler M: Impaired subjective health status in chronic adrenal insufficiency: impact of different glucocorticoid replacement regimens. Eur J Endocrinol. 2008, 159: 811-817. 10.1530/EJE-08-0578.CrossRefPubMed
16.
go back to reference Hahner S, Loeffler M, Fassnacht M, Weisman D, Koschker AC, Quinkler M, Decker O, Arlt W, Allolio B: Impaired subjective health status in 256 patients with adrenal insufficiency based on cross sectional analysis. J Clin Endocrinol Metab. 2007, 92: 3912-3922. 10.1210/jc.2007-0685.CrossRefPubMed Hahner S, Loeffler M, Fassnacht M, Weisman D, Koschker AC, Quinkler M, Decker O, Arlt W, Allolio B: Impaired subjective health status in 256 patients with adrenal insufficiency based on cross sectional analysis. J Clin Endocrinol Metab. 2007, 92: 3912-3922. 10.1210/jc.2007-0685.CrossRefPubMed
17.
go back to reference Gurnell EM, Hunt PJ, Curran SE, Conway CL, Pullenayegum EM, Huppert FA, Compston JE, Herbert J, Chatterjee VK: Longterm DHEA replacement in primary adrenal insufficiency: a randomized, controlled trial. J Clin Endocrinol Metab. 2008, 93: 400-409. 10.1210/jc.2007-1134.PubMedCentralCrossRefPubMed Gurnell EM, Hunt PJ, Curran SE, Conway CL, Pullenayegum EM, Huppert FA, Compston JE, Herbert J, Chatterjee VK: Longterm DHEA replacement in primary adrenal insufficiency: a randomized, controlled trial. J Clin Endocrinol Metab. 2008, 93: 400-409. 10.1210/jc.2007-1134.PubMedCentralCrossRefPubMed
18.
go back to reference Witchel SF: The medical home concept and Congenital Adrenal Hyperplasia: a comfortable habitat!. Int J Ped Endcorinol. 2010, 2010: 561526-10.1186/1687-9856-2010-561526.CrossRef Witchel SF: The medical home concept and Congenital Adrenal Hyperplasia: a comfortable habitat!. Int J Ped Endcorinol. 2010, 2010: 561526-10.1186/1687-9856-2010-561526.CrossRef
Metadata
Title
Physical, social and societal functioning of children with congenital adrenal hyperplasia (CAH) and their parents, in a Dutch population
Authors
Sarita A Sanches
Therese A Wiegers
Barto J Otten
Hedi L Claahsen-van der Grinten
Publication date
01-12-2012
Publisher
BioMed Central
Published in
International Journal of Pediatric Endocrinology / Issue 1/2012
Electronic ISSN: 1687-9856
DOI
https://doi.org/10.1186/1687-9856-2012-2

Other articles of this Issue 1/2012

International Journal of Pediatric Endocrinology 1/2012 Go to the issue