Ann Pediatr Endocrinol Metab.  2013 Sep;18(3):135-140. 10.6065/apem.2013.18.3.135.

Depression and self-concept in girls with perception of pubertal onset

• Yang JH
• Han SW
• Yeom CW
• Park YJ
• Choi WS
• Seo JY
• Koo YJ

• KMID: 2266365
• DOI: http://doi.org/10.6065/apem.2013.18.3.135

Abstract

PURPOSE
Early pubertal timing in girls is associated with psychological and behavioral problems. This study aimed to evaluate the psychological features of girls who perceived breast development beginning by analyzing their depression levels and self-concept.
METHODS
From March 2007 to December 2012, 93 girls were enrolled and assigned to a pre-8 (younger than 8 years, n=43) or post-8 (8 years and older, n=50) group according to the age at onset of perceived breast development, and their height, body weight, body mass index, bone age (BA), Tanner stage, and luteinizing hormone and follicle-stimulating hormone levels were examined. We investigated their psychological state with the Korean Children's Depression Inventory (CDI) and Piers-Harris Children's Self-Concept Scale (PHCSC) to evaluate depression levels and self-concept, respectively.
RESULTS
The pre-8 group had a significantly greater height standard deviation score, (0.5+/-1.01 vs. 0.11+/-0.86, P = 0.048) and more advanced BA (2.07+/-1.02 years vs. 1.40+/-0.98 years, P = 0.004) compared to the post-8 group. There were no statistically significant intergroup differences for the CDI and PHCSC scores; however, the pre-8 group scored higher than the post-8 group in the physical appearance and attributes domain of the PHCSC (9.93+/-2.57 vs. 8.52+/-3.03, P = 0.017).
CONCLUSION
The timing of perceived breast development among girls who thought puberty to begin did not affect depression levels and self-concept. There was no correlation between Tanner stage and depression levels and self-concept despite the perception of pubertal onset. The pre-8 group had a more positive view of their physical appearance than the post-8 group.

Keyword

Puberty; Sexual development; Depression; Self concept

MeSH Terms

Adolescent
Body Height
Body Weight
Breast
Depression*
Human
Female
Follicle Stimulating Hormone
Luteinizing Hormone
Puberty
Self Concept
Sexual Development
Follicle Stimulating Hormone
Luteinizing Hormone

Reference

1. Park MJ. Update in the etiology and treatment of sexual precocity. Korean J Pediatr. 2006; 49:718–725.

2. Park YJ, Moon CM, Yoo HJ. A study of factors influencing advanced puberty. Korean J Pediatr. 2010; 53:146–151.

3. Na JM, Lee YJ, Kim MS, Lee DY, Yeo CY, Kim CJ, et al. Causes of precocious puberty: Multicenter Study in Honam Area. J Korean Soc Pediatr Endocrinol. 2009; 14:30–37.

4. Kim JH, Shin CH, Lee SY. Observed trends for an earlier onset of puberty: when is the need for treatment indicated? J Korean Med Assoc. 2009; 52:1189–1200.

5. Copeland W, Shanahan L, Miller S, Costello EJ, Angold A, Maughan B. Outcomes of early pubertal timing in young women: a prospective population-based study. Am J Psychiatry. 2010; 167:1218–1225. PMID: 20478880.

6. Michaud PA, Suris JC, Deppen A. Gender-related psychological and behavioural correlates of pubertal timing in a national sample of Swiss adolescents. Mol Cell Endocrinol. 2006; 254-255:172–178. PMID: 16806671.

7. Kaltiala-Heino R, Marttunen M, Rantanen P, Rimpela M. Early puberty is associated with mental health problems in middle adolescence. Soc Sci Med. 2003; 57:1055–1064. PMID: 12878105.

8. Ehrhardt AA, Meyer-Bahlburg HF. Psychosocial aspects of precocious puberty. Horm Res. 1994; 41(Suppl 2):30–35. PMID: 8088701.

9. Cho SC, Lee YS. Development of the Korean form of the Kovacs' Childrenn's Depression Inventory. J Korean Neuropsychiatr Assoc. 1990; 29:943–956.

10. Charman T. The stability of depressed mood in young adolescents: a school-based survey. J Affect Disord. 1994; 30:109–116. PMID: 8201125.

11. Kim BR, Cho SC, Shin YO. Development of Korean form of Piers-Harris Children's Self-Concept Scale. J Korean Neuropsychiatr Assoc. 1994; 33:1351–1369.

12. Mazur T, Clopper RR. Pubertal disorders: psychology and clinical management. Endocrinol Metab Clin North Am. 1991; 20:211–230. PMID: 2029887.

13. Ehrhardt AA, Meyer-Bahlburg HF. Idiopathic precocious puberty in girls: long-term effects on adolescent behavior. Acta Endocrinol Suppl (Copenh). 1986; 279:247–253. PMID: 3465165.

14. Johansson T, Ritzen EM. Very long-term follow-up of girls with early and late menarche. Endocr Dev. 2005; 8:126–136. PMID: 15722621.

15. Kim EY, Lee MI. Psychosocial aspects in girls with idiopathic precocious puberty. Psychiatry Investig. 2012; 9:25–28.

16. Kaltiala-Heino R, Kosunen E, Rimpela M. Pubertal timing, sexual behaviour and self-reported depression in middle adolescence. J Adolesc. 2003; 26:531–545. PMID: 12972267.

17. Mull MS, Evans EM. Did she mean to do it? Acquiring a folk theory of intentionality. J Exp Child Psychol. 2010; 107:207–228. PMID: 20553689.

18. Koopman HM, Baars RM, Chaplin J, Zwinderman KH. Illness through the eyes of the child: the development of children's understanding of the causes of illness. Patient Educ Couns. 2004; 55:363–370. PMID: 15582342.

19. McCabe MP, Ricciardelli LA, Salmon J. Evaluation of a prevention program to address body focus and negative affect among children. J Health Psychol. 2006; 11:589–598. PMID: 16769738.

20. Chaplin JE, Kristrom B, Jonsson B, Halldin Stenlid M, Aronson AS, Dahlgren J, et al. When do short children realize they are short? Prepubertal short children's perception of height during 24 months of catch-up growth hormone treatment. Horm Res Paediatr. 2012; 77:241–249. PMID: 22516981.

21. Chaplin JE. Growth-related quality of life. Horm Res Paediatr. 2011; 76(Suppl 3):51–52. PMID: 21912168.

22. Finkelstein BS, Imperiale TF, Speroff T, Marrero U, Radcliffe DJ, Cuttler L. Effect of growth hormone therapy on height in children with idiopathic short stature: a meta-analysis. Arch Pediatr Adolesc Med. 2002; 156:230–240. PMID: 11876666.

23. van Gool SA, Kamp GA, Visser-van Balen H, Mul D, Waelkens JJ, Jansen M, et al. Final height outcome after three years of growth hormone and gonadotropin-releasing hormone agonist treatment in short adolescents with relatively early puberty. J Clin Endocrinol Metab. 2007; 92:1402–1408. PMID: 17284626.

24. Saggese G, Cesaretti G, Barsanti S, Rossi A. Combination treatment with growth hormone and gonadotropin-releasing hormone analogs in short normal girls. J Pediatr. 1995; 126:468–473. PMID: 7869212.

25. Cohen P, Rogol AD, Deal CL, Saenger P, Reiter EO, Ross JL, et al. Consensus statement on the diagnosis and treatment of children with idiopathic short stature: a summary of the Growth Hormone Research Society, the Lawson Wilkins Pediatric Endocrine Society, and the European Society for Paediatric Endocrinology Workshop. J Clin Endocrinol Metab. 2008; 93:4210–4217. PMID: 18782877.