Personality, manual preference and neuroendocrine reactivity in hirsute subjects J. Martin Martins a,b, * , S. do Vale a,b , A. Trinca c , C. Saldanha b , J. Martins e Silva b a Endocrine Unit, Curry Cabral Hospital, Lisbon, Portugal b Biochemistry Institute, Lisbon Medical School, Lisbon, Portugal c Youth Project Association, Lisbon, Portugal Received 25 August 2003; received in revised form 7 June 2004; accepted 17 June 2004 Abstract Behavioral and neuroendocrine differences may be postulated in hirsute subjects since central effects of gonadal steroids are well established. We conducted a controlled clinical study with 25 consecutive young hirsute participants compared with 20 consecutive controls. Neuropsychological evaluation included the Minnesota Multiphasic Personality Inventory (MMPI) and the Edinburgh Inventory of Manual Preference (EIMP). Neuroendocrine reactivity was assessed by the adrenocorticotropic hormone (ACTH) and cortisol responses to corticotropin releasing hormone (CRH). Hirsute participants presented a flattened personality profile with lower neurotic triad scores— 146F20 versus 166F28. Left-hand preference was more common in hirsute participants—4/21 versus 0/20. Decreased ACTH [area under the curve (AUC)—36F28 vs. 72F63 pg/ml h] and cortisol (AUC—18F4 vs. 25F10 Ag/dl h) responses to CRH were found in the hirsute group. In the hirsute group, higher manual preference scores were associated with lower ACTH responses to CRH, while the opposite association was found in the control group. In the hirsute group, the hyporeactive hypothalamic–pituitary–adrenal (HPA) axis was associated with lower behavior-deviant scores, while in the control group, the hyporeactive HPA axis was associated with more psychopathology. We conclude that personality and HPA axis reactivity are different in hirsute female participants when compared with controls, with a trend for differences regarding handedness. Personality and handedness are differently associated with HPA reactivity. Distinctive features in hirsute participants are probably established very early during ontogenic development. D 2004 Elsevier Inc. All rights reserved. Keywords: Hyperandrogenism; Personality profile; Manual preference; Pituitary–adrenal axis reactivity 1. Introduction Hirsutism with or without oligoamenorhea is a common condition during the reproductive years [1]. Transient or permanent hyperandrogenemia is generally present, and this, together with the related anovulation, impairs fertility [1,2]. Besides the reproductive effects, hyperandrogenemia and/or increased androgen sensitivity at target organs are associated with a more general systemic syndrome with defeminization and masculinization, involving several tis- sues and organs [1]. Metabolic abnormalities are also common, including abdominal body fat distribution, dysli- pidemia and insulin resistance, while cardiovascular disease may be more common [3,4]. The hyperandrogenic syndrome may also include beha- vioral and neuroendocrine characteristics because central effects of gonadal steroids are well established [5,6]. More dramatic organizational effects occur in conditions with sustained and long-lasting hyperandrogenism, e.g., congen- ital adrenal hyperplasia [7]. However, subtle activational effects also occur, as illustrated by extensive research on cognitive performance and mood fluctuation along the menstrual cycle and research on transsexual subjects [8,9]. Important activational effects are also suggested by the 0031-9384/$ - see front matter D 2004 Elsevier Inc. All rights reserved. doi:10.1016/j.physbeh.2004.06.015 * Corresponding author. Lisbon Medical School, Biochemistry Insti- tute, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal. Tel.: +351-21- 7985136; fax: +351-21-7939791. E-mail address: j.martin.martins@mail.telepac.pt (J. Martin Martins). Physiology & Behavior 82 (2004) 741 – 749