[Chronic suicidality in depression due to untreated adrenogenital syndrome]. / Chronische Suizidalität bei organisch bedingter Depression infolge eines adrenogenitalen Syndroms.

A 38-year-old female suffered from adrenogenital syndrome with 21-hydroxylase deficiency requiring a corticosteroid substitution. The virilized patient claims to have discontinued treatment with corticosteroids since the age of 15. In the 12 months prior to admission, the patient experienced addisonian crises and repeated decompensation with depressive-suicidal symptoms. Due to the second suicide attempt within a short period, the patient underwent psychiatric treatment presenting an organic depressive syndrome. Under sufficient medication including corticosteroids, antidepressants, and mood stabilizing therapy, the psychopathologic findings improved impressively. Noncompliance after discharge led to a relapse and another suicide attempt, which remitted promptly after adequate therapy.

[Treatment of male adrenogenital syndrome (report of 17 cases)].

OBJECTIVE: To discuss the treatment of male adrenogenital syndrome. METHODS: The clinical data of 17 patients with male adrenogenital syndrome, including 15 cases of congenital adrenal hyperplasia (CAH) and 2 cases of adrenocortical tumors, were analyzed retrospectively. The patients with 21-hydroxylase deficiency (21-OHD) and 11beta-hydroxylase deficiency (11beta-OHD) were treated with adrenocortical hormone, those with 17-hydroxylase deficiency (17-OHD) received sexual glands excision and estrogen besides adrenocortical hormone, and those with adrenocortical tumors underwent surgical removal. RESULTS: Sexual precocity symptoms disappeared and abnormal laboratory results returned to normal in 5 of the 21-OHD patients, who adhered to hormone treatment, and height growth was improved in the other 2, who received the medicine at an early age. The testicular adrenal rest (TAR) tumor was reduced dramatically in 1 case of 21-OHD after treatment. A left TAR found in another 21-OHD patient who discontinued the hormone therapy became softened after the resumption. Sperm could be seen in the semen of 3 21-OHD patients, but in small quantity and of poor quality. One 11beta-OHD patient with sexual precocity symptoms and hypertension became normal after the hormone treatment, and six 17-OHD patients maintained their female sexuality after the hormone treatment and operation. No relapse was found after resection of the adrenocortical tumors. CONCLUSION: Adrenocortical hormone therapy helps improve the height growth and testicular function of CAH patients, and surgical removal is necessary for adrenocortical tumors.