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Front Psychol. 2016 Jul 12;7:1053. doi: 10.3389/fpsyg.2016.01053. eCollection 2016.

Cognitive, Emotional, and Psychosocial Functioning of Girls Treated with Pharmacological Puberty Blockage for Idiopathic Central Precocious Puberty.

Author information

1
Division of Surgery and Clinical Neuroscience, Department of Medical Neurobiology, Oslo University HospitalOslo, Norway; Department of Physiotherapy, Oslo and Akershus University College of Applied SciencesOslo, Norway.
2
Division of Pediatric Endocrinology, Department of Pediatrics, Ghent University Hospital and Ghent University Ghent, Belgium.
3
Division of Surgery and Clinical Neuroscience, Department of Medical Neurobiology, Oslo University HospitalOslo, Norway; Section for Psychology, Lillehammer University CollegeLillehammer, Norway.
4
Division of Surgery and Clinical Neuroscience, Department of Medical Neurobiology, Oslo University HospitalOslo, Norway; Department of Psychology, University of OsloOslo, Norway.
5
Division of Pediatric Endocrinology, Department of Pediatrics, Ghent University Hospital and Ghent UniversityGhent, Belgium; Division of Pediatric Endocrinology, Department of Pediatrics, Brussels University HospitalBrussels, Belgium.
6
Division of Pediatric Endocrinology, Department of Pediatrics, Brussels University Hospital Brussels, Belgium.
7
Research Unit INSIDE, Institute for Health and Behavior, University of Luxembourg Luxembourg, Luxembourg.
8
Division of Surgery and Clinical Neuroscience, Department of Medical Neurobiology, Oslo University Hospital Oslo, Norway.

Abstract

Central precocious puberty (CPP) develops due to premature activation of the hypothalamic-pituitary-gonadal (HPG) axis, resulting in early pubertal changes and rapid bone maturation. CPP is associated with lower adult height and increased risk for development of psychological problems. Standard treatment of CPP is based on postponement of pubertal development by blockade of the HPG axis with gonadotropin releasing hormone analogs (GnRHa) leading to abolition of gonadal sex hormones synthesis. Whereas the hormonal and auxological effects of GnRHa are well-researched, there is a lack of knowledge whether GnRHa treatment influences psychological functioning of treated children, despite the fact that prevention of psychological problems is used as one of the main reasons for treatment initiation. In the present study we seek to address this issue by exploring differences in cognitive function, behavior, emotional reactivity, and psychosocial problems between GnRHa treated CPP girls and age-matched controls. Fifteen girls with idiopathic CPP; median age 10.4 years, treated with slow-release GnRHa (triptorelin acetate-Decapeptyl SR® 11.25) and 15 age-matched controls, were assessed with a comprehensive test battery consisting of paper and pencil tests, computerized tasks, behavioral paradigms, heart rate variability, and questionnaires filled in by the children's parents. Both groups showed very similar scores with regard to cognitive performance, behavioral and psychosocial problems. Compared to controls, treated girls displayed significantly higher emotional reactivity (p = 0.016; Cohen's d = 1.04) on one of the two emotional reactivity task conditions. Unexpectedly, the CPP group showed significantly lower resting heart rates than the controls (p = 0.004; Cohen's d = 1.03); lower heart rate was associated with longer treatment duration (r = -0.582, p = 0.037). The results suggest that GnRHa treated CPP girls do not differ in their cognitive or psychosocial functioning from age matched controls. However, they might process emotional stimuli differently. The unexpected finding of lower heart rate that was associated with longer duration of the treatment should be further explored by methods appropriate for assessment of cardiac health.

KEYWORDS:

central precocious puberty; cognitive function; emotion regulation; gonadotropin releasing hormone analog; heart rate variability; psychosocial function; puberty

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