Mul D, Versluis-den Bieman H J, Slijper F M, Oostdijk W, Waelkens J J, Drop S L
Department of Endocrinology, University Hospital Rotterdam, The Netherlands.
Acta Paediatr. 2001 Sep;90(9):965-71. doi: 10.1080/080352501316978011.
Early puberty is frequently observed in adopted children. This randomized trial treated 30 adopted children with early puberty and short stature with either gonadotropin-releasing hormone agonist (GnRHa) alone or in combination with growth hormone (GH) for 3 y. Before the start of treatment (T1) in the trial and at discontinuation (T2) the children and their parents underwent a psychological evaluation. At the start of treatment the children did not have increased levels of behavioural or emotional problems as assessed by the Child Behaviour Checklist (CBCL). During treatment the CBCL scores did not increase. Self-perception of the children appeared to be normal, and after 3 y a significantly higher score for acceptance by peers was observed. At T1, an overestimation of future height was present in 80% of the children and 17% of the parents. Lower family stress was observed at T1 and T2 compared with reference values. Intelligence quotient levels decreased significantly during treatment. The findings are discussed with reference to the reported levels of behavioural and emotional problems in adopted children and the psychosocial effects of precocious puberty.
This psychological evaluation did not reveal any consistent abnormalities in adopted children with early puberty. Treatment with GnRHa with or without GH did not increase emotional and behavioural problems in adopted children, nor was their self-perception decreased.
性早熟在领养儿童中经常被观察到。这项随机试验对30名患有性早熟和身材矮小的领养儿童进行了为期3年的治疗,治疗方法为单独使用促性腺激素释放激素激动剂(GnRHa)或与生长激素(GH)联合使用。在试验治疗开始前(T1)和治疗结束时(T2),对儿童及其父母进行了心理评估。在治疗开始时,根据儿童行为检查表(CBCL)评估,儿童的行为或情绪问题水平并未增加。在治疗期间,CBCL评分没有增加。儿童的自我认知似乎正常,3年后观察到同伴接受度得分显著更高。在T1时,80%的儿童和17%的父母对未来身高存在高估。与参考值相比,在T1和T2时观察到家庭压力较低。治疗期间智商水平显著下降。结合领养儿童中报告的行为和情绪问题水平以及性早熟的心理社会影响对研究结果进行了讨论。
这项心理评估未发现性早熟领养儿童存在任何一致的异常情况。使用GnRHa单独或联合GH治疗并未增加领养儿童的情绪和行为问题,他们的自我认知也没有下降。