[Psychological behavior of girls with idiopathic central precocious puberty before and after treatment with gonadotropin-releasing hormone analogue]

Fei Zheng, Hong Zhu, You-Jun Jiang
Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences 2008, 37 (3): 289-94

OBJECTIVE: To observe the psychological behavior of girls with idiopathic central precocious puberty (ICPP) before and after treatment by gonadotropin-releasing hormone analogue (GnRHa).

METHODS: Raven's Standard Progressive Matrices(SPM), Achenbach's Child Behavior Checklist (CBCL), Self-Esteem Scale (SES), and Body-Esteem Scale (BES) were used to assess the psychological behavior in the ICPP girls before and after GnRHa treatment, as well as in control girls. The serum levels of dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) were measured by ELISA before and after GnRHa treatment.

RESULT: (1) The SES and BES scores in ICPP were significantly lower than those of controls(P <0.05). The CBCL scores in depressed, withdrawn,aggressive and somatic complaint assessment were significantly higher in ICPP group than those of control group. (2) The SES score, the body strength scores for BES 12 months after treatment were significantly higher than those pretreatment (P <0.05). Serum DHEA levels in ICPP group and control group were Log(0.77 +/-0.36)microg/L and Log (0.28 +/-0.22) microg/L respectively, with a significant difference (P <0.01). Serum DHEA and DHEAS of ICPP 3 months after treatment were decreased from Log(0.83 +/-0.35)microg/L and Log(2.27 +/-0.30)microg/L to Log(0.68 +/-0.44)microg/L and Log (2.11 +/-0.43)microg/L (both P <0.05). The serum DHEA and DHEAS levels 12 months after treatment were Log(0.78 +/-0.30)microg/L and Log(2.40 +/-0.34)microg/L, there was no significant difference before and after treatment (P >0.05). (3) The SES score,the weight concern and body strength scores for BES were negatively correlated with serum DHEA and DHEAS levels in precocious puberty girls (r=-0.492,-0.356,-0.202 and -0.216, all P <0.05). The nine CBCL factors were not correlated with serum DHEA levels.

CONCLUSION: Precocious puberty girls are prone to lower self-esteem and less confidence, which are correlated with the increase of serum DHEA levels. There is more frequency to be depressed, withdrawn, aggressive and complaining in these girls, however, which are not correlated with serum DHEA levels. GnRHa may reverse the problem of psychological behavior in ICPP girls.

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