Psychiatric and psychosocial characteristics of children with premature adrenarche: a prospective study

Although psychiatric disorders such as depression and anxiety have been reported to be more common in children with precocious puberty, the psychosocial characteristics of puberty variants remain unclear. This study aimed to investigate the psychosocial characteristics of children with premature adrenarche (PA) and evaluate their relationships with clinical and laboratory findings.

This prospective case-control study included 34 patients aged 4-8 years diagnosed with PA who presented to our clinic between June and December 2023. Socio-demographic data were collected, and psychological assessments were performed using the Child Behaviour Checklist (CBCL) and the Revised Child Anxiety and Depression Scale-Child (RCADS-Child). A control group consisting of 35 age- and sex-matched healthy children was also included.

Pubic hair was present in most patients with PA, and the majority were at Tanner stage 2 for pubic hair. The median dehydroepiandrosterone sulfate (DHEAS) level was 82.5 μg/dL. Among the psychiatric scales, only the RCADS-Child panic disorder and obsessive-compulsive disorder scores were significantly higher in children with PA compared with controls (p = 0.019 and p = 0.020). Possible psychiatric conditions were also more frequent in the PA group than in the control group (33.3% vs. 8.6%, p = 0.007). No significant association was found between DHEAS levels and psychiatric scale scores.

Children with premature adrenarche showed higher psychiatric symptom scores compared with healthy controls, suggesting a possible association. Similar to precocious puberty, premature adrenarche may affect psychosocial adaptation to pubertal development, highlighting the importance of monitoring potential psychosocial problems in these patients.