Individuals who were exposed in utero to the synthetic estrogen, Diethylstilbestrol (DES), are at increased risk of developing a variety of genito-urinary abnormalities and cancer. Therefore, psychosocial and emotional responses of varying severity and duration to being identified as a DES daughter or DES son have been reported. Moreover, animal research and human studies suggest lasting effects of prenatal sex hormones on the developing brain and psychosexual development. This study has three goals: (1) To assess the psychosexual development of females and males aged 18-36 years who have been exposed in utero to DES: (2) To assess the impact of being identified as a DES-exposed individual with its health implications on psychopathology and psychosocial functioning: (3) To construct a clinical manual for the health care of DES daughter and DES sons. In continuation of a psychiatric study of adult men and women with a history of prenatal DES-exposure, the following subjects will be examined: a group of high-dose DES daughters (N=30) and their unexposed controls (N=30); a group of DES-plus-progesterone daughters (N=30) and their unexposed controls (N=30); the unexposed sisters of both DES groups (approximately N=30); and the available mothers of all daughters (approximately N=100). We will also study 30 DES sons compared to 30 unexposed controls and another sample of 30 DES sons compared to 30 unexposed brothers, as well as their available mothers (approximately N=80). The assessment will consist of interviews and questionnaires and will be partly blind as to sample membership of the subjects. Male subjects will undergo a standard urological examination. Subjects' mothers will serve as informants on the study subjects and will also undergo a psychiatric evaluation. Data on prenatal hormone exposure and medical findings in adulthood will be excerpted from the subjects' medical charts. The data analysis will involve comparisons among the newly examined groups as well as comparisons of these groups with the ones currently under study (N=60 DES daughters vs. N=60 controls vs. approximately N=30 sisters, and approximately N=80-100 mothers; and N=45 documented or suspected DES-exposed males vs. N=30 controls and their respective mothers). Subsequently, data sets will be combined to permit detailed analysis of DES effects in behaviorally and medically defined subgroups. This is the first comprehensive controlled study of the psychiatric and psychosexual sequelae of prenatal DES exposure in females and males.
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