ESPE Abstracts

Key words: early puberty, mood change, GnRH analogue

Introduction-Aim: In cases with early puberty, neuroendocrine, physical, and psychological changes are considered to result in several mood disorders. The aim of this research was to assess the mental problems of pubertal girls with rapidly progressive puberty (RPP) with menarche before the 10 years of age. To the best of our knowledge, there is no similar prospective cross-sectional research in the medical literature.

Method: In this prospective study, females with RPP (breast developmental Tanner stage ≥ 3 and basal LH value >0.3 IU/L) who presented with menarche under the age of 10 years were included in Group I. The control group (Group II) consisted of prepubertal girls aged 9 to 10 years. All cases were evaluated concurrently at the Department of Child and Adolescent Mental Health and Diseases. Cases with a previous diagnosis of mood disorder or psychiatric treatment for any reason or chronic diseases were excluded. All subjects underwent relevant psychiatric tests: 1) Affective Disorders and Schizophrenia Form-Now And Lifelong Form DSM-5- Turkish version (CDSG-PL-DSM-5-T), 2) Screen for Child Anxiety Related Disorders (SCARED), 3) Child Behavior Checklist (CBCL/6-18), and 4) the revised form of a Depression Rating Scale for children (CDRS-R).

Results: A total of 49 girls (Group I, n=28; Group II, n=21) were included in the study. Height, weight, and BMI SDS values were significantly higher in Group I (P<0,01) while target height was similar among groups. Predicted adult height was higher than target height in Group I. Mood disorder was detected in four cases: Group I (n=2, 7%, social phobia-depression/adjustment disorder with depressive symptoms) and Group II (n=2, 9.0%, childhood depression). There was no significant difference between the two groups in terms of the total and sub-group scores obtained from anxiety, behavior, and depression assessment criteria.

Conclusion: There was no significant difference in the prevalence of mood disorders between the early menarche and control groups. GnRH analogue therapy should not be based on the assumption that premature pubertal development will cause psychosocial effects and should only be considered after a thorough psychiatric evaluation.