Endocrine Abstracts

JOINT1397

Background: There is limited data regarding the perception and psychological effects of central precocious puberty and early normal puberty (CPP/EP) among girls and their caregivers, particularly given the differences in socio-cultural contexts among different ethnicities. This study aimed to evaluate the psychological effects of CPP/EP on Thai girls and their caregivers, and to explore their perceptions of CPP/EP and the treatment using gonadotropin-releasing hormone analog (GnRHa).

Methods: CPP/EP girls were enrolled. Questionnaires were administered to assess the perceptions and psychological effects of CPP/EP. Newly diagnosed patients were additionally evaluated for bullying, depression, anxiety and low self-esteem using standardized tools.

Results: Nine hundred and fifty-four participants (340 CPP, 140 EP, and 474 caregivers) were included. Thirty-eight out of 480 girls were newly diagnosed, and 442 girls had been followed, with 427 out of 442 patients having received GnRHa therapy. Their mean (SD) age was 9.9 (1.1) years at enrollment. The duration of GnRHa treatment was 1.8 (1.0) years. Regarding the perception of CPP/EP; breast buds, body odor and acne were perceived by the girls as the signs of puberty in 234 (49%), 174 (36%), and 162 (34%) girls, respectively. Two hundred and sixteen (45%) girls believed that some kinds of foods were the cause of CPP/EP. Furthermore, 379 (79%) girls and 374 (79%) caregivers appreciated that menarche contributed to a reduction in height gain, and 352 (73%) girls and 304 (64%) caregivers believed that height gain would continue increasing if menstruation stopped. On a 10-point anxiety scale for CPP/EP, caregivers reported a high score of 8.3 (1.7). The child’s short final height was the most concern by caregivers (n = 369, 78%), followed by early menarche and side effects of GnRHa therapy. Among the 38 newly diagnosed girls, 8 (21%) reported being bullied, with experiences of verbal harassment about their breasts, breast grabbing, and social exclusion. Additionally, 4 (11%) girls were tested positive for depression, 9 (24%) for anxiety, and 5 (13%) for low self-esteem. Comparing CPP and EP girls, depression and anxiety were more prevalent in the CPP group (20% vs. 10% and 38% vs. 30%, respectively). Being bullied was significantly correlated with higher levels of depression, anxiety, and low self-esteem.

Conclusions: This study demonstrated that girls and their caregivers had inadequate knowledge about CPP/EP, highlighting the importance of providing accurate information. Given the psychological stress associated with CPP/EP, appropriate counseling and psychological support should be incorporated into its standard care.