title: Psychological assessment of mothers and their daughters at the time of diagnosis of precocious puberty.
abstract: BACKGROUND
  Concerns about psychological distress are often used to justify treatment of girls with precocious puberty, but there is little evidence to support these concerns. The extent to which psychological problems are associated with central precocious puberty (CPP) compared with other forms of early puberty in girls has likewise not been established.
  
  
  METHODS
  Girls presenting with untreated CPP, premature adrenarche (PA) or early normal puberty (ENP) were recruited from our pediatric endocrine clinic along with their mothers. Child psychological adjustment was assessed by child self-report and parent report. Parent self-reported personality, anxiety, and depression were also assessed. Differences between groups were explored using one-way ANOVA and Dunnett's T3 test.
  
  
  RESULTS
  Sixty-two subjects (aged 7.5 ± 1.4 years, range 4.8-10.5) were enrolled, of whom 19 had CPP, 22 had PA, and 21 had ENP. Girls with ENP were significantly older (8.9 ± .9 years) than girls with CPP (6.9 ± 1.1 years, p < .001) and PA (6.6 ± 1.0 years, p < .001). Girls with PA had significantly higher BMI z-scores (1.7 ± .8) than girls with CPP (1.1 ± .6, p = .01) and ENP (1.2 ± .6, p = .04). More girls with PA and ENP were from racial minorities (47% and 50% respectively) than girls with CPP (32%). No group differences were found for any child measure of psychological adjustment. However, mothers of girls with PA scored significantly higher than mothers of girls with ENP on one measure of depression (p = .04) and stress (p = .01).
  
  
  CONCLUSIONS
  While mothers of girls with PA report increased psychological distress on some measures, no differences in psychological adjustment were found at baseline amongst the girls themselves. Whether these results will change as puberty progresses in the PA and ENP groups or with treatment of CPP is unknown. Long-term prospective studies are needed in order to further investigate psychological correlates of early puberty in girls.
authors.affiliation: Pediatrics, Section of Pediatric Endocrinology, Riley Hospital for Children, 705 Riley Hospital Drive, Room 5960, Indianapolis, IN 46202 USA.
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Schoelwer
authors.affiliation: Pediatrics, Section of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN USA.
authors.forename: Kelly L
authors.initials: KL
authors.lastname: Donahue
authors.affiliation: Psychology and Pediatrics, The Pennsylvania State University, University Park, PA USA.
authors.forename: Kristina
authors.initials: K
authors.lastname: Bryk
authors.affiliation: Pediatrics, Section of Pediatric Endocrinology, Riley Hospital for Children, 705 Riley Hospital Drive, Room 5960, Indianapolis, IN 46202 USA.
authors.forename: Paula
authors.initials: P
authors.lastname: Didrick
authors.affiliation: Psychology, The Pennsylvania State University, University Park, PA USA.
authors.forename: Sheri A
authors.initials: SA
authors.lastname: Berenbaum
authors.affiliation: Pediatrics, Section of Pediatric Endocrinology, Riley Hospital for Children, 705 Riley Hospital Drive, Room 5960, Indianapolis, IN 46202 USA.
authors.forename: Erica A
authors.initials: EA
authors.lastname: Eugster
keywords: Central precocious puberty; Early normal puberty; Premature adrenarche; Psychopathology