Girls and boys who enter puberty before 8 and 9 years of age, respectively (corresponding to about –3 SDS), are arbitrarily considered to need referral for endocrine investigation. A recent report from the Lawson Wilkins Pediatric Endocrine Society suggested that the limit for investigation of girls and boys should be lowered to 7 and 8 years, respectively. For African-American girls, 6 years is the suggested age. This recommendation has been criticized. Although short stature is a common end result of precocious puberty, short- and long-term psychological symptoms may be more important, since several studies have indicated psychopathology in this patient group. Whether this can be prevented by gonadotropin releasing hormone agonist treatment remains to be shown. This review will highlight the psychological aspects of early puberty. In short, aspects other than height should also be evaluated when considering treatment of the early maturing child.

Herman-Giddens ME, Slora EJ, Wasserman RC, Bourdony CJ, Bhapkar MV, Koch GG, Hasemeier CM: Secondary sexual characteristics and menses in young girls seen in office practice: A study from the Pediatric Research in Office Settings network. Pediatrics 1997;99:505–512.
Kaplowitz PB, Oberfield SE: Reexamination of the age limit for defining when puberty is precocious in girls in the United States: Implications for evaluation and treatment. Drug and Therapeutics and Executive Committees of the Lawson Wilkins Pediatric Endocrine Society. Pediatrics 1999;104:936–941.
Midyett LK, Moore WV, Jacobson JD: Are pubertal changes in girls before age 8 benign? Pediatrics 2003;111:47–51.
Rosenfield RL, Bachrach LK, Chernausek SD, Gertner JM, Gottschalk M, Hardin DS, Pescovitz OH, Saenger P: Current age of onset of puberty. Pediatrics 2000;106:622–623.
Heger S, Partsch CJ, Sippell WG: Long-term outcome after depot gonadotropin-releasing hormone agonist treatment of central precocious puberty: Final height, body proportions, body composition, bone mineral density, and reproductive function. J Clin Endocrinol Metab 1999;84:4583–4590.
Partsch CJ, Heger S, Sippell WG: Treatment of central precocious puberty: Lessons from a 15 years prospective trial. German Decapeptyl Study Group. J Pediatr Endocrinol Metab 2000;13(suppl 1):747–758.
Mul D, Oostdijk W, Otten BJ, Rouwe C, Jansen M, Delemarre-van de Waal HA, Waelkens JJ, Drop SL: Final height after gonadotrophin releasing hormone agonist treatment for central precocious puberty: The Dutch experience. J Pediatr Endocrinol Metab 2000;13(suppl 1):765–772.
Klein KO, Barnes KM, Jones JV, Feuillan PP, Cutler GB Jr: Increased final height in precocious puberty after long-term treatment with LHRH agonists: The National Institutes of Health experience. J Clin Endocrinol Metab 2001;86:4711–4716.
Mul D, Bertelloni S, Carel JC, Saggese G, Chaussain JL, Oostdijk W: Effect of gonadotropin-releasing hormone agonist treatment in boys with central precocious puberty: Final height results. Horm Res 2002;58:1–7.
Léger J, Reynaud R, Czernichow P: Do all girls with apparent idiopathic precocious puberty require gonadotropin-releasing hormone agonist treatment? J Pediatr 2000;137:819–825.
Tuvemo T, Gustafsson J, Proos LA: Growth hormone treatment during suppression of early puberty in adopted girls. Swedish Growth Hormone Advisory Group. Acta P√diatr 1999;88:928–932.
Mul D, Oostdijk W, Waelkens JJ, Schulpen TW, Drop SL: Gonadotrophin releasing hormone agonist treatment with or without recombinant human GH in adopted children with early puberty. Clin Endocrinol (Oxf) 2001;55:121–129.
O’Sullivan E, O’Sullivan M: Precocious puberty: A parent’s perspective. Arch Dis Child 2002;86:320–321.
Sonis WA, Comite F, Blue J, Pescovitz OH, Rahn CW, Hench KD, Cutler GB Jr, Loriaux DL, Klein RP: Behaviour problems and social competence in girls with true precocious puberty. J Pediatr 1985;106:156–160.
Hayward C, Killen JD, Wilson DM, Hammer LD, Litt IF, Kraemer HC, Haydel F, Varady A, Taylor CB: Psychiatric risk associated with early puberty in adolescent girls. J Am Acad Child Adolesc Psychiatry 1997;36:255–262.
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.
Baumann DA, Landolt MA, Wetterwald R, Dubuis JM, Sizonenko PC, Werder EA: Psychological evaluation of young women after medical treatment for central precocious puberty. Horm Res 2001;56:45–50.
Xhrouet-Heinrichs D, Lagrou K, Heinrichs C, Craen M, Dooms L, Malvaux P, Kanen F, Bourguignon JP: Longitudinal study of behavioral and affective patterns in girls with central precocious puberty during long-acting triptorelin therapy. Acta Paediatr 1997;86:808–815.
Mul D, Versluis-den Bieman HJ, Slijper FM, Oostdijk W, Waelkens JJ, Drop SL: Psychological assessments before and after treatment of early puberty in adopted children. Acta Paediatr 2001;90:965–971.
Stattin H, Kerr M, Magnusson D: Psychosocial outcomes of early puberty in females. Presented at the 6th Joint Meeting of LWPES and ESPE, Montreal 2001.
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