ESPE Abstracts

Background: Emotional and behavioural problems are often used in support of GnRH agonists therapy in girls with early pubertal timing. However, there is little evidence to show that CPP leads to psychological distress and whether treatment is associated with improved psychological outcome.

Objective and hypotheses: The objective of this qualitative study was to explore the psychosocial impact of ICPP in recently diagnosed girls.

Method: 27 girls and their parents were included until data saturation was reached. Data were collected from individual interviews and thematically analysed by an anthropologist, a psychologist and an endocrinologist. Three main themes emerged from the analysis, describing body changes, relationship with family members and peers, understanding of the condition and its treatment.

Results: Girls’ interviewees described the emotions they felt (pride or embarrassment due to breast development), the emotional situations they faced (rare bullying, embarrassment due to pubic or axillary hair, “social” benefit from pubertal changes and tall stature). They perceived CPP either as a normal condition but coming too early or as a disease requiring medical care and worried about painful injections. Mothers’ interviewees revealed anxiety and fear of body changes and early menses. Mothers felt disturbed by the femininity of their daughters’ body, raising the issue of early sexual behaviour and even pregnancy. They reported emotional instability and sometimes conflicting relationship with their daughters. Both parents worried about the perception of pubertal signs in the social environment of their daughters. Mothers were more prone to ask for therapy to stop pubertal progression than fathers.

Conclusion: Emotions varied widely among CPP girls and their parents. Thus, considering emotions to justify treatment is hazardous. These data will allow the creation of a tool to assess the psychosocial functioning of patients and families. Such an instrument is needed to improve decision making on treatment in this context.