The following information may help to address your question:
Do teenagers with Klinefelter syndrome experience psychosocial symptoms?
Boys with Klinefelter syndrome
(KS) are known to have an increased risk for psychosocial problems.
While large studies of boys with KS are uncommon (only 10% of affected males are diagnosed during childhood), the time around puberty (peripubertal time) is presumed to be a susceptible time for the emergence of physical and psychosocial health issues.
Poor outcomes have been reported on measures of well-being, body image, self-esteem, mental health, social support, and general health for males with KS compared with the general male population. Studies have suggested that the majority of youth with KS report poor quality of life, with a risk for depression and/or suicidality. One study found that 68.8% of the affected males studied had clinically significant levels of depressive symptoms.
Little is understood about the underlying cause, manifestations, and consequences of depression in affected males. However, depression is a leading cause of disability in adolescents and adults in the general population.
Research has also raised concerns that there is an increased risk for psychiatric disorders besides depression, including anxiety, schizophrenia, and other psychotic disorders.
For those who are diagnosed with KS, attention to self-esteem, self-concept, depression risk, and quality of life are important aspects of health care. Early neurocognitive and behavioral interventions for children who have psychosocial vulnerabilities are recommended.
Last updated: 10/26/2015
Where can a teenager with Klinefelter syndrome, or a parent, get support for psychosocial symptoms?
Mental health therapists or counselors, including psychologists and psychiatrists
, can help males with Klinefelter syndrome (KS) find ways to cope with feelings of sadness, depression, self-doubt, and low self-esteem. These professionals can also help families deal with the emotions of having a son with KS.
People who are concerned about their child's behaviors should seek appropriate care:
- Talk to the child's doctor, school nurse, or another health care provider and seek further information about the behaviors or symptoms that are causing worry
- Ask the child's primary care physician or other health care provider for a referral to a specialist with experience in child emotional and/or behavioral problems
Many professional associations have listings of mental health providers, including:
Seek immediate assistance if you think your child is in danger of harming themselves or others. You can call a crisis line or the National Suicide Prevention Lifeline at 1.800.273.TALK (8255). The National Suicide Prevention Lifeline provides free and confidential emotional support to people in suicidal crisis or emotional distress, and can help you to find a therapist or support group near you. They also provide services to friends and loved ones of people thinking about suicide, and connect them to local resources.
Last updated: 10/22/2015
What are the management recommendations for teenagers with Klinefelter syndrome?
Medical management of boys with Klinefelter syndrome (KS) is multidisciplinary and may involve several types of specialists. While there are age-specific recommendations for medical management, the specific signs and symptoms present in each affected person also play a role in treatment needs.
Management recommendations for boys during pubertal years include:
- Consideration of mild androgen supplementation in early or mid puberty if the affected male is lacking age-appropriate sexual characteristics, has tall stature, has hypogonadal appearance, or has gynecomastia (and when LH increases to supranormal levels)
- Semen collection and cryopreservation (sperm banking) if there are motile sperm in the ejaculate
- Exercise and lifestyle recommendations
- Bone density scan for bone mineralization and body composition every 2–3 years
- Supplementation with calcium/vitamin D if needed
for associated diseases such as metabolic syndrome
, autoimmune diseases
, thyroid dysfunction, and malignancies is warranted during this period of life.
Screening and/or intervention for psychosocial, behavioral, cognitive, or educational needs is also important.
People with questions about treatment for Klinefelter syndrome should speak with an endocrinologist
or other healthcare provider with knowledge of the condition.
Last updated: 10/22/2015
Is hormone replacement recommended for teenagers with Klinefelter syndrome?
Androgens (specifically testosterone) are known to have a broad influence on physical development, neurological development, cognitive functioning, and social behavior in males - beginning in utero and continuing through adulthood.
Most adolescents with KS have enough circulating levels of serum testosterone
to initiate puberty, but they often then fail to progress adequately. In these cases, testosterone supplementation can allow for normal pubertal development, increased muscle mass, and preservation of bone density.
It may also improve mood, self-image, and behavior.
To our knowledge, there are no official guidelines for the best duration of therapy, or the best route of administration (e.g., injections, pills, or topical gel).
It has been suggested that androgen therapy is the most important aspect of treatment and should begin at puberty (around age 12), with the dose increasing until it is enough to maintain age-appropriate serum concentrations of testosterone and other hormones
However, not all males with KS benefit from testosterone therapy.
There have also been concerns about potential negative effects, such as aggressive behavior, hypercoagulability (excessive blood clotting) and the suppression of native testicular function.
The results of a 2014 study on the safety and tolerability of testosterone replacement therapy in a large group of adolescents with KS showed that early hormonal therapy in adolescents with KS can restore and maintain serum testosterone within the normal range. With close, appropriate followup, testosterone replacement therapy was not associated with any adverse effects. Topical testosterone gel was an acceptable choice of administration among adolescents, avoiding the anxiety and needle phobia associated with intramuscular testosterone injections.
People with questions about hormone therapy
for themselves or family members should speak with their endocrinologist.
Last updated: 10/26/2015
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