Ann Pediatr Endocrinol Metab.  2016 Sep;21(3):155-160. 10.6065/apem.2016.21.3.155.

Body image and depression in girls with idiopathic precocious puberty treated with gonadotropin-releasing hormone analogue

• Choi MS
• Kim EY

• KMID: 2366791
• DOI: http://doi.org/10.6065/apem.2016.21.3.155

Abstract

PURPOSE
Precocious puberty (PP) is associated with psychological and behavioral problems. This study aimed to evaluate the perception of body image and depression in girls with PP receiving gonadotropin-releasing hormone (GnRH) analogue therapy.
METHODS
From March to August 2013, 82 girls with PP receiving GnRH analogue therapy were enrolled. Height, weight, body mass index, and stages of pubertal development were assessed. Participants completed a series of questionnaires on their body image perception and pubertal self-assessment. The depression score was calculated using the Korean Kovacs' Children's Depression Inventory.
RESULTS
The patients perceived their body to be more obese than the controls did. The mean depression score did not differ between the patients and controls. The mean depression scores according to Tanner stages (1: prepubertal, 2: early pubertal, and 3-5: mid to late pubertal stage) by self-assessment were 5.2±3.6, 6.8±4.9, and 11.4±10.1 (P<0.05), respectively. The perception of overall body build and figure (%) and the mean depression scores in patients were: dissatisfied (25.6%, 9.7±7.8) and satisfied (74.4%, 5.5±3.4) (P<0.05). In multiple linear regression analysis, self-T3 (Tanner stage 3-5 by self-awareness) and dissatisfaction about overall body build and figure were found to significantly affect the depression score(P<0.05).
CONCLUSION
The perception of pubertal status and satisfaction about height or weight are unrelated to objective physical findings. Patients with PP are prone to distorted perception about their body image and breast development. Such incorrect body image seems to contribute to depression score.

Keyword

Precocious puberty; Body image; Depression

MeSH Terms

Body Image*
Body Weight
Breast
Depression*
Female*
Gonadotropin-Releasing Hormone*
Humans
Linear Models
Problem Behavior
Puberty, Precocious*
Self-Assessment
Somatotypes
Gonadotropin-Releasing Hormone

Reference

1. Mendle J, Turkheimer E, Emery RE. Detrimental psychological outcomes associated with early pubertal timing in adolescent girls. Dev Rev. 2007; 27:151–171. PMID: 20740062.

2. Rierdan J, Koff E. Depressive symptomatology among very early maturing girls. J Youth Adolesc. 1991; 20:415–425. PMID: 24263398.

3. Graber JA, Lewinsohn PM, Seeley JR, Brooks-Gunn J. Is psychopathology associated with the timing of pubertal development? J Am Acad Child Adolesc Psychiatry. 1997; 36:1768–1776. PMID: 9401339.

4. Hayward C, Killen JD, Wilson DM, Hammer LD, Litt IF, Kraemer HC, et al. Psychiatric risk associated with early puberty in adolescent girls. J Am Acad Child Adolesc Psychiatry. 1997; 36:255–262. PMID: 9031579.

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

6. O'Dea JA, Abraham S. Improving the body image, eating attitudes, and behaviors of young male and female adolescents: a new educational approach that focuses on self-esteem. Int J Eat Disord. 2000; 28:43–57. PMID: 10800013.

7. Hall CH, Burstein GR. Adolescent development. In : Kliegman RM, Stanton BF, St. Geme JW, Schor NF, Behrman RE, editors. Nelson textbook of pediatrics. 20th ed. Philadelphia: Elsevier Saunders;2015. p. 928.

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

9. Abraham S, O'Dea JA. Body mass index, menarche, and perception of dieting among peripubertal adolescent females. Int J Eat Disord. 2001; 29:23–28. PMID: 11135329.

10. Duncan PD, Ritter PL, Dornbusch SM, Gross RT, Merrill Carlsmith J. The effects of pubertal timing on body image, school behavior, and deviance. J Youth Adolesc. 1985; 14:227–235. PMID: 24301178.

11. Carlson Jones D. Body image among adolescent girls and boys: a longitudinal study. Dev Psychol. 2004; 40:823–835. PMID: 15355169.

12. Bukowski WM, Sippola LK, Newcomb AF. Variations in patterns of attraction to same- and other-sex peers during early adolescence. Dev Psychol. 2000; 36:147–154. PMID: 10749072.

13. Wardle J, Cooke L. The impact of obesity on psychological well-being. Best Pract Res Clin Endocrinol Metab. 2005; 19:421–440. PMID: 16150384.

14. Stice E, Presnell K, Bearman SK. Relation of early menarche to depression, eating disorders, substance abuse, and comorbid psychopathology among adolescent girls. Dev Psychol. 2001; 37:608–619. PMID: 11552757.

15. Angold A, Costello EJ, Erkanli A, Worthman CM. Pubertal changes in hormone levels and depression in girls. Psychol Med. 1999; 29:1043–1053. PMID: 10576297.

16. Brooks-Gunn J, Warren MP. Biological and social contributions to negative affect in young adolescent girls. Child Dev. 1989; 60:40–55. PMID: 2702873.

17. Ge X, Conger RD, Elder GH Jr. Pubertal transition, stressful life events, and the emergence of gender differences in adolescent depressive symptoms. Dev Psychol. 2001; 37:404–417. PMID: 11370915.

18. Petersen AC, Sarigiani PA, Kennedy RE. Adolescent depression: Why more girls? J Youth Adolesc. 1991; 20:247–271. PMID: 24265009.