Perceptions and Psychological Adverse Effects of Central Precocious Puberty or Early Normal Puberty, and Its Treatment Among Affected Girls and Their Caregivers

Objective: To evaluate psychological adverse effects of idiopathic central precocious puberty and early normal puberty (iCPP/ENP) on Thai girls and their caregivers, and to explore their perceptions of iCPP/ENP and the treatment. Design, Patients and Measurements: Questionnaires were used to assess the perceptions and psychological adverse effects of iCPP/ENP. Newly diagnosed patients were additionally evaluated for bullying, depression, anxiety and low self-esteem. Results: Nine hundred and fifty-four participants (340 iCPP, 140 ENP, and 474 caregivers) were included. Mean (SD) age at enrolment was 9.9 (1.1) years. Breast buds, body odour and acne were perceived by the girls as their signs of puberty in 234 (49%), 174 (36%), and 162 (34%) girls, respectively. Two hundred and sixteen (45%) girls believed that certain types of food were the cause of iCPP/ENP. Additionally, the greatest concerns of caregivers were the child's short final adult height and early menarche. On a 10-point anxiety scale, caregivers reported a score of 8.3 (1.7). Among the 38 newly diagnosed girls, 8 (21%) reported being bullied, with experiences of verbal harassment about their breasts and breast grabbing. Additionally, 4 (11%) girls had depression, 9 (24%) had anxiety, and 5 (13%) had low self-esteem. Depression and anxiety were more prevalent in the iCPP group. Conclusions: This study demonstrated that girls and their caregivers lacked adequate knowledge of iCPP/ENP. Given that psychological stress was associated with iCPP/ENP, screening for psychological stress should be considered as part of caring for these patients.