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Psychopathology, psychosocial, gender and cognitive outcomes in patients with cloacal exstrophy.

Mukherjee B, McCauley E, Hanford RB, Aalsma M, Anderson AM

University of Washington, Seattle Children's Hospital, Seattle, Washington, USA.

PURPOSE: Psychological functioning, as reflected in psychopathology, psychosocial functioning, gender identity, gender role and cognitive abilities, was examined in a sample of patients with cloacal exstrophy. MATERIALS AND METHODS: Nine participants 11 to 37 years old completed the evaluation. Standardized measures were used and participant responses were compared to the norms of the various instruments. Gender reassigned participants with cloacal exstrophy were compared with nonassigned participants with cloacal exstrophy. Mean differences between the 2 groups were calculated using the t test. RESULTS: Overall the participants with cloacal exstrophy reported good psychological functioning. Significant differences between reassigned and nonassigned participants were found in the area of depression. All participants had a stable gender identity. XY females showed more male-typical gender roles. There were no significant group differences on cognitive assessments. Reassigned and nonassigned participants did not differ in IQ. CONCLUSIONS: Although being born with cloacal exstrophy puts patients at risk for psychopathology and psychosocial problems, it does not necessarily mean that these problems will develop. With the appropriate support these patients can have remarkably well adjusted lives.

Published 13 July 2007 in J Urol, 178(2): 630-5; discussion 634-5.
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