Endocrine Abstracts

JOINT2733

Background: Early menarche within the general population has previously been linked to increased risk of mental health disorders. Therefore, extremely early puberty (precocious puberty (PP)) is likely to influence risk of long-term disease. However, little information about the risk of mental health disorders among individuals with PP exist.

Aim: To investigate the prospective association between PP and psychiatric disorders.

Methods: A register-based cohort study including all individuals with a diagnosis of PP in the National Patient Registry (NPR) from 1995 to 2020 (n = 9,315 (girls, n = 8,289, 89%)) using International Classification of Disease, tenth revision, including a diagnosis of central precocious puberty, premature puberty, premature thelarche, and premature adrenarche. We included boys and girls with a diagnosis of PP before 10 years of age and 9 years of age, respectively. All individuals with a diagnosis of PP were matched with 5 randomly selected references from the background population (n = 46,566) according to age, gender, and calendar time (at diagnosis). The study population was followed-up in NPR, the Psychiatric Central Research Registry, the National Prescription Registry, and the National Cause of Death Registry for incident psychiatric disorder (addiction, attention deficit hyperactive disorder (ADHD), anxiety, autism spectrum disorder, bipolar disorder, depression, eating disorder, schizophrenia, and suicide including attempt and completed). The minimum average follow-up time was 7.9 years. The association between PP and psychiatric disorders was analyzed using Cox Proportional Hazard models, with strata for matched PP cases and references.

Results: PP was associated with a statistically significant increased risk of ADHD (Hazard Ratio (HR): 1.55, 95% confidence interval (CI): 1.32-1.82), anxiety (HR: 1.60, 95% CI: 1.46-1.76), autism (HR: 1.85, 95% CI: 1.57-2.19), depression (HR: 1.46, 95% CI: 1.33-1.61), eating disorders (HR: 1.32, 95% CI: 1.08-1.61), and schizophrenia (HR: 1.66, 95% CI: 1.31-2.11) but not addiction, bipolar disorder, and suicide (attempt and completed) when compared to matched references. Similar results were observed when stratifying by sex but generally with a larger effect size for boys than girls. However, the association between PP and eating disorders and schizophrenia was only statistically significant for girls.

Conclusion: Our large register-based cohort study highlights a markedly increased risk of psychiatric disorders amongst individuals (boys and girls) with a diagnosis of PP compared to their matched references from the background population. This has important implications for prevention and early intervention.