Early Puberty Linked to Increased Risk of Mental Illness

Central precocious puberty (CPP), generally defined as pubertal onset in girls before they are 8 years old and boys before they are 9 years old, may increase the risk of mental illnesses such as depression, anxiety disorders, and attention deficit/hyperactivity disorder (ADHD), according to a study published yesterday in JAMA Network Open.

For some disorders, the risk associated with CPP remained elevated for many years.

Lars Dinkelbach, M.D., of the University of Duisburg-Essen in Germany, and colleagues compared mental health outcomes of 1,094 patients with idiopathic CPP (91.3% female) with those of 5,448 matched controls. They focused on six disorders that commonly emerge during childhood and adolescence: ADHD, anxiety disorders, depression, oppositional defiant disorder/conduct disorder (ODD/CD), self-harm, and substance use disorders. Patients were born between 2000 and 2023 and followed for just under 11 years.

Compared with controls, patients with CPP had a 48% increased risk of receiving a diagnosis of any of the selected mental disorders over follow-up. This included a 45% increased risk of anxiety disorders, a 53% increased risk of ADHD, a 73% increased risk of depression, and a 76% increased risk of ODD/CD. The incidence of depression and ADHD remained higher in youth with CPP for at least eight years after the initial diagnosis.

The researchers noted several possible explanations for the link between CPP and mental illness:

• Physical and social changes resulting from early puberty (e.g., bullying), combined with age-related limitations in coping capacities, may lead to psychological distress.
• Endocrine changes associated with early puberty may lead to disrupted brain maturation or pathologically altered brain activity patterns.
• Substantial preexisting psychological and social burdens may impair coping with early puberty and CPP, thereby exacerbating its negative effects on mental health.

“Early intervention for mental health disorders in children and adolescents can alleviate disease burden and long-term negative psychosocial consequences,” Dinkelbach and colleagues wrote. “Thus, caretakers of patients with CPP should actively explore psychological symptoms and facilitate early intervention to influence lifetime trajectories of this vulnerable patient population positively. Because our findings indicate long-term sequelae of CPP on mental health, caretakers should be vigilant even after normalization of pubertal development.”

For related information, see the Psychiatric News Alert “Childhood Trauma, Early Puberty Associated With Internalizing Symptoms in Girls.”

(Image: Getty Images/iStock/FangXiaNuo)

---

PN Alert Maintenance Psychiatric News will be pausing Alerts for the rest of the week as we finalize the move to our new platform. We apologize for the disruption but will soon resume our daily summaries of the latest clinical, research, and policy updates in psychiatry.

Follow Psychiatric News on X, LinkedIn and Instagram!

Childhood Trauma, Early Puberty Associated With Internalizing Symptoms in Girls

Girls who experience childhood trauma are at a higher risk of developing internalizing symptoms like depression and anxiety by ages 12 to 14, an association that is partially explained by starting puberty ahead of their peers, according to a study issued this week in The Journal of Child Psychology and Psychiatry.

Niamh MacSweeney, Ph.D., of the University of Oslo, Norway, and colleagues used data from 4,225 girls enrolled in the Adolescent Brain Cognitive Development Study. Each participant, who enrolled at age nine or 10, was assessed annually over four years, with their parents reporting their exposure to trauma at baseline and their pubertal development at each assessment. When participants were between the ages of 12 and 14, they self-reported their internalizing symptoms.

Participants followed three distinct patterns of pubertal development:

• Typical developers (76% of participants) were in the early stages of puberty when the study began and had the most rapid pace of development over time, such that they were in the later stages by ages 12 to 14.
• Slow developers (15%) were just entering the early stages of puberty by ages 12 to 14.
• Early starters (9%) were already midway through puberty by ages nine to 10 (these participants, however, showed a protracted pace of development and had about the same degree of pubertal maturation on average as typical developers by ages 12 to 14).

Early starters had significantly higher exposure to trauma at baseline compared with slow or typical developers, while slow developers had lower trauma exposure compared with typical developers. Slow developers also had significantly lower internalizing symptoms compared with early starters and typical developers. In examining the trajectories of the girls’ development, the researchers found that greater childhood trauma was linked with greater internalizing symptoms at ages 12 to 14, and this association was mediated by early puberty onset. Among early developers, having a slower pace of puberty development after age nine partially reduced this risk of internalizing symptoms.

“It has been proposed that the association between early pubertal timing and internalizing symptoms is underpinned by an asynchrony between a young person’s physical, cognitive and social development,” the authors wrote. “Additionally, the type of trauma experienced (e.g., threat vs. neglect) and the trajectory of internalizing difficulties across adolescence (e.g., limited to early adolescence, persistent across adolescence, or only emerging in later adolescence) will be crucial to consider in future longitudinal research to better characterize at-risk and resilient youth and inform prevention strategies.”

For related information, see the Psychiatric News article “Group School Intervention Helps Girls Cope With Internalized Trauma.”

(Image: Getty Images/iStock/Yobro10)

---

Don't miss out! To learn about newly posted articles in Psychiatric News, please sign up here.

Follow Psychiatric News on X!

Follow Psychiatric News on LinkedIn!