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管理性早熟:精神评估的必要性。

Managing precocious puberty: A necessity for psychiatric evaluation.

机构信息

Ankara Dr Sami Ulus Maternity Child Health and Diseases Training and Research Hospital, Department of Child and Adolescent Psychiatry, Ankara, Turkey.

Aksaray University Education and Research Hospital, Department of Child and Adolescent Psychiatry, Aksaray, Turkey.

出版信息

Asian J Psychiatr. 2021 Apr;58:102617. doi: 10.1016/j.ajp.2021.102617. Epub 2021 Feb 21.

Abstract

OBJECTIVE

Precocious puberty (PP) is one of the most common endocrine disorders in school-age girls. It has been reported that there is an increased tendency for psychiatric disorders for early maturing girls. The aim of this study was to determine the prevalence of psychiatric problems and to investigate depression and anxiety levels, and self-concept characteristics in girls with PP.

METHODS

Girls with PP (n = 41) and controls (n = 45) aged 7-11 years participated in this study. Psychiatric evaluations were conducted with semi-structured interviews. Behavioral and emotional problems were assessed using Child Behavior Check List and Teacher Report Form. Children's Depression Inventory, State-Trait Anxiety Inventory for Children and Piers-Harris Children's Self Concept Scale were administered, respectively.

RESULTS

Girls with PP had significantly more psychiatric diagnosis than controls (68.3 % vs 20 %, p < 0.001). PP group had significantly higher anxious-depressed, somatic complaints, social problems, aggresive behaviors and interestingly autistic traits. Increased symptom levels of depression and anxiety, and lower self-concept scores were also obtained from PP subjects.

CONCLUSIONS

PP is an independent predictor of psychiatric disorders. It is also associated with poorer psychiatric status, lower self esteem characteristics, and autistic traits. A multidisciplinary approach combining endocrinologic and psychiatric evaluations seem to be beneficial for the management of girls with PP.

摘要

目的

性早熟(PP)是学龄女童最常见的内分泌紊乱之一。据报道,早期成熟的女孩有更高的精神障碍倾向。本研究旨在确定精神问题的患病率,并调查性早熟女童的抑郁和焦虑水平以及自我概念特征。

方法

本研究纳入了 7-11 岁的性早熟女童(n=41)和对照组女童(n=45)。采用半结构式访谈进行精神评估。使用儿童行为检查表和教师报告表评估行为和情绪问题。分别使用儿童抑郁量表、儿童状态-特质焦虑量表和皮尔斯-哈里斯儿童自我概念量表进行评估。

结果

性早熟女童的精神障碍诊断明显多于对照组(68.3% vs 20%,p<0.001)。性早熟组在焦虑抑郁、躯体抱怨、社会问题、攻击行为方面得分更高,且具有显著的自闭症特征。性早熟组的抑郁和焦虑症状水平升高,自我概念评分降低。

结论

性早熟是精神障碍的独立预测因素。它还与较差的精神状态、自尊心较低和自闭症特征有关。内分泌和精神评估相结合的多学科方法似乎有益于性早熟女童的管理。

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