Background: Concerns about psychological distress are often used to justify treatment of girls with precocious\npuberty, but there is little evidence to support these concerns. The extent to which psychological problems are\nassociated with central precocious puberty (CPP) compared with other forms of early puberty in girls has likewise\nnot been established.\nMethods: Girls presenting with untreated CPP, premature adrenarche (PA) or early normal puberty (ENP) were\nrecruited from our pediatric endocrine clinic along with their mothers. Child psychological adjustment was assessed\nby child self-report and parent report. Parent self-reported personality, anxiety, and depression were also assessed.\nDifferences between groups were explored using one-way ANOVA and Dunnettâ��s T3 test.\nResults: Sixty-two subjects (aged 7.5 �± 1.4 years, range 4.8-10.5) were enrolled, of whom 19 had CPP, 22 had PA,\nand 21 had ENP. Girls with ENP were significantly older (8.9 �± .9 years) than girls with CPP (6.9 �± 1.1 years, p < .001)\nand PA (6.6 �± 1.0 years, p < .001). Girls with PA had significantly higher BMI z-scores (1.7 �± .8) than girls with CPP\n(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%\nrespectively) than girls with CPP (32%). No group differences were found for any child measure of psychological\nadjustment. However, mothers of girls with PA scored significantly higher than mothers of girls with ENP on one\nmeasure of depression (p = .04) and stress (p = .01).\nConclusions: While mothers of girls with PA report increased psychological distress on some measures, no\ndifferences in psychological adjustment were found at baseline amongst the girls themselves. Whether these results\nwill change as puberty progresses in the PA and ENP groups or with treatment of CPP is unknown. Long-term\nprospective studies are needed in order to further investigate psychological correlates of early puberty in girls.
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