The early diagnosis of 47XXY- Klinefelter syndrome (KS) associated with infertility confronts the parents with concerns about their child outcome on cognitive, social skills and sexual identity. Few studies relate the weakness of intelligence, mainly verbal, and relational inhibition. Androgen may be offered to adolescents to normalize anatomic and psychic puberty processes. This has never been evaluated in psychological terms.
Subjects and methods: Eight adolescents aged from 11 to 17 with 47XXY-KS were recruited. The protocol included a semi-directive interview, a Wechsler intelligence scale and projective tests (Rorschach and TAT) offered before (t1) and after 12 months of testosterone treatment (t2).
Results: Interviews underline four themes in the narratives: i) insufficient knowledge of the disorder and medical history ii) problems in socio-educational integration iii) inhibition of psychic conflicts and relational withdrawal iv) shame and secrecy regarding the diagnosis and infertility inside the family. The small cohort only allows for descriptive cognitive results. At t1, the global cognitive abilities are clearly below the standard (average IQ =75) with a significant dispersion between verbal and logical/practical skills. At t2, a slight improvement in the global level is observed (average IQ =79) with an important homogenization of the scores. Besides, projective tests revealed inhibition in affective life underlined in representations of human relationship (phobic avoidance) and expression of sexual identity. At t2 improvement of relational skills is observed.
Conclusion: Inhibition of cognitive, affective and relational skills is understood as a specific way of expression of the processes of adolescence. The benefits of this research-action are observed at the cognitive and relational levels. More than normalization, it offers to these adolescents the opportunity of a psychic work. This allows the appropriation of their medical history which supports the development of psychic processes of adolescence.
Supported by the Pfizer Foundation.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This work was supported, however funding details unavailable.
05 - 09 May 2012
European Society of Endocrinology