Choi Min-Seon, Kim Eun-Young
Department of Pediatrics, Chosun University School of Medicine, Gwangju, Korea.
Ann Pediatr Endocrinol Metab. 2016 Sep;21(3):155-160. doi: 10.6065/apem.2016.21.3.155. Epub 2016 Sep 30.
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.
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.
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 (<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) (<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(<0.05).
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.
性早熟(PP)与心理和行为问题相关。本研究旨在评估接受促性腺激素释放激素(GnRH)类似物治疗的性早熟女孩对身体形象的认知及抑郁情况。
2013年3月至8月,纳入82例接受GnRH类似物治疗的性早熟女孩。评估身高、体重、体重指数及青春期发育阶段。参与者完成一系列关于身体形象认知和青春期自我评估的问卷。使用韩国科瓦奇儿童抑郁量表计算抑郁得分。
患者认为自己比对照组更肥胖。患者与对照组的平均抑郁得分无差异。根据坦纳分期(1:青春期前,2:青春期早期,3 - 5:青春期中晚期)自我评估的平均抑郁得分分别为5.2±3.6、6.8±4.9和11.4±10.1(<0.05)。患者对整体身材和体型的认知(%)及平均抑郁得分情况为:不满意(25.6%,9.7±7.8)和满意(74.4%,5.5±3.4)(<0.05)。多元线性回归分析发现,自我T3期(自我认知为坦纳3 - 5期)及对整体身材和体型的不满意显著影响抑郁得分(<0.05)。
青春期状态认知及对身高或体重的满意度与客观身体检查结果无关。性早熟患者容易对自己的身体形象和乳房发育产生扭曲认知。这种不正确的身体形象似乎会影响抑郁得分。