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Cognitive, emotional,and psychosocial functioning of girls treated with pharmacological puberty blockage for idiopathic central precocious puberty

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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, gonadotropin releasing hormone analog, cognitive function, emotion regulation, psychosocial function, heart rate variability, puberty, GONADOTROPIN-RELEASING-HORMONE, HEART-RATE-VARIABILITY, ANDROGEN DEPRIVATION THERAPY, SPATIAL ORIENTATION, MENTAL ROTATION, GENE-EXPRESSION, PROSTATE-CANCER, WORKING-MEMORY, SHEEP, AGONIST

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Chicago
Wojniusz, Slawomir, Nina Callens, Stefan Sütterlin, Stein Andersson, Jean De Schepper, Inge Gies, Jesse Vanbesien, et al. 2016. “Cognitive, Emotional,and Psychosocial Functioning of Girls Treated with Pharmacological Puberty Blockage for Idiopathic Central Precocious Puberty.” Frontiers in Psychology 7.
APA
Wojniusz, S., Callens, N., Sütterlin, S., Andersson, S., De Schepper, J., Gies, I., Vanbesien, J., et al. (2016). Cognitive, emotional,and psychosocial functioning of girls treated with pharmacological puberty blockage for idiopathic central precocious puberty. FRONTIERS IN PSYCHOLOGY, 7.
Vancouver
1.
Wojniusz S, Callens N, Sütterlin S, Andersson S, De Schepper J, Gies I, et al. Cognitive, emotional,and psychosocial functioning of girls treated with pharmacological puberty blockage for idiopathic central precocious puberty. FRONTIERS IN PSYCHOLOGY. 2016;7.
MLA
Wojniusz, Slawomir, Nina Callens, Stefan Sütterlin, et al. “Cognitive, Emotional,and Psychosocial Functioning of Girls Treated with Pharmacological Puberty Blockage for Idiopathic Central Precocious Puberty.” FRONTIERS IN PSYCHOLOGY 7 (2016): n. pag. Print.
@article{8079837,
  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.},
  articleno    = {1053},
  author       = {Wojniusz, Slawomir and Callens, Nina and S{\"u}tterlin, Stefan and Andersson, Stein and De Schepper, Jean and Gies, Inge and Vanbesien, Jesse and De Waele, Kathleen and Van Aken, Sara and Craen, Margarita and V{\"o}gele, Claus and Cools, Martine and Haraldsen, Ira},
  issn         = {1664-1078},
  journal      = {FRONTIERS IN PSYCHOLOGY},
  keyword      = {central precocious puberty,gonadotropin releasing hormone analog,cognitive function,emotion regulation,psychosocial function,heart rate variability,puberty,GONADOTROPIN-RELEASING-HORMONE,HEART-RATE-VARIABILITY,ANDROGEN DEPRIVATION THERAPY,SPATIAL ORIENTATION,MENTAL ROTATION,GENE-EXPRESSION,PROSTATE-CANCER,WORKING-MEMORY,SHEEP,AGONIST},
  language     = {eng},
  pages        = {12},
  title        = {Cognitive, emotional,and psychosocial functioning of girls treated with pharmacological puberty blockage for idiopathic central precocious puberty},
  url          = {http://dx.doi.org/10.3389/fpsyg.2016.01053},
  volume       = {7},
  year         = {2016},
}

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